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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": "The most impoant mechanism by which gram negative bacilli acquire chloramphenicol resistance is:" }, { "role": "assistant", "content": "The correct answer is Resistance to chloramphenicol is usually by a plasmid encoded enzyme acetyltransferase which inactivates the drug. it can also be due to decreased permeability of the drug into the cell and also due to ribosomal mutation. Antimicrobial resistance through inactivating enzymes develops against: A: Aminoglycosides B: Beta lactams C: Chloramphenicol" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Alzheimer Disease, Apolipoprotein E4, Apolipoproteins E, Cerebral Amyloid Angiopathy, Cerebrovascular Disorders, Female, Genotype, Humans, Male, Neurofibrillary Tangles, Plaque, Amyloid, Reverse Transcriptase Polymerase Chain Reaction, Risk Factors, Stroke." }, { "role": "user", "content": "Is association between severe cerebral amyloid angiopathy and cerebrovascular lesions in Alzheimer disease a spurious one attributable to apolipoprotein E4? Context: We have previously reported an association between severe cerebral amyloid angiopathy (CAA) and cerebrovascular lesions in Alzheimer disease (AD), which is particularly strong for microinfarcts, hemorrhages, and multiple lesion types. Cerebral amyloid angiopathy has also been associated with the apolipoprotein E4 (APOE4) genotype, which is in turn associated with premature coronary artery disease and atherosclerosis. To test whether severe CAA would be more strongly associated with cerebrovascular lesions than would APOE4 genotype. We reviewed 306 cases of autopsy-confirmed AD (from the University of California, San Diego, brain autopsy series) to assess whether APOE genotype and other clinical risk factors were predictive of vascular lesions (VLs) in AD. Cerebral amyloid angiopathy severity was assessed using a semiquantitative scale in 4 brain regions (ie, hippocampus, midfrontal cortex, inferior parietal cortex, and superior temporal cortex) and an average score was computed for each case. We found that severe CAA was associated with an increased frequency of VLs (33% of the cases of severe CAA had VLs vs 19% of the cases of mild or absent CAA; P=.02). While the APOE4/4 genotype was associated with an increased severity of CAA, there was no significant relationship between APOE genotype and frequency of VLs. Logistic regression models showed that severe CAA, advanced age, atherosclerosis, and Hachinski Ischemia Scale score of 7 or more were all significantly associated with VLs, but the number of APOE4 alleles, history of hypertension, coronary artery disease, sex, and serum cholesterol levels had nonsignificant effects. Within strata of APOE genotype, the presence of severe CAA was associated with increased frequency of VLs (eg, within APOE4/4 homozygotes, VLs were present within 47% of the cases of severe CAA vs 9.5% of the cases of mild or absent CAA; P=.01)." }, { "role": "assistant", "content": "Severe CAA confers a greater risk of VLs in AD, even within strata of APOE genotype. Therefore, the association between severe CAA and VLs in AD is not a spurious one owing to APOE4. Overall, our cases of AD with APOE4 do not seem to be a more \"vasculopathic\" subtype of AD. The mechanisms by which CAA produces VLs of various types need to be further elucidated, as these are probably important in producing the common entity of \"mixed\" AD/vascular dementia. Arch Neurol. 2000. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A pregnant lady presented with painless bleeding in the 3rd trimester. Most common cause will be" }, { "role": "assistant", "content": "The correct answer is Ans a Ref: Sheila balakrishna obs, page 157Clinical features of placenta previaSymptomsClassical presentation of painless antepartum haemorrhage. Recurrent initial bleeding is unusually not severeSignsPallor proportionate to amount of bleedingSize of the uterus correspond to period of amenorrhoeaUterus soft, non tenderMalpresentations and floating headFHS heard." } ]

[ { "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": "Polio virus is shed in stool up to -" }, { "role": "assistant", "content": "The correct answer is - the polio is transmitted by faecal oral route by contaminmates food , water or hands. - in faeces, the virus is excreted as long as 3-4 months. Reference : Park's textbook of preventive and social medicine, 23rd edition, pg no:205 <\\p>" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, RESULTS. Meshes: HIV-2, Humans, Molecular Chaperones, Osmolar Concentration, RNA, Transfer, Lys, RNA, Viral, RNA-Binding Proteins, Sodium Chloride, gag Gene Products, Human Immunodeficiency Virus." }, { "role": "user", "content": "Does the matrix domain contribute to the nucleic acid chaperone activity of HIV-2 Gag? Context: The Gag polyprotein is a multifunctional regulator of retroviral replication and major structural component of immature virions. The nucleic acid chaperone (NAC) activity is considered necessary to retroviral Gag functions, but so far, NAC activity has only been confirmed for HIV-1 and RSV Gag polyproteins. The nucleocapsid (NC) domain of Gag is proposed to be crucial for interactions with nucleic acids and NAC activity. The major function of matrix (MA) domain is targeting and binding of Gag to the plasma membrane but MA can also interact with RNA and influence NAC activity of Gag. Here, we characterize RNA binding properties and NAC activity of HIV-2 MA and Gag, lacking p6 domain (GagΔp6) and discuss potential contribution of NC and MA domains to HIV-2 GagΔp6 functions and interactions with RNA. We found that HIV-2 GagΔp6 is a robust nucleic acid chaperone. HIV-2 MA protein promotes nucleic acids aggregation and tRNA(Lys3) annealing in vitro. The NAC activity of HIV-2 NC is affected by salt which is in contrast to HIV-2 GagΔp6 and MA. At a physiological NaCl concentration the tRNA(Lys3) annealing activity of HIV-2 GagΔp6 or MA is higher than HIV-2 NC. The HIV-2 NC and GagΔp6 show strong binding to the packaging signal (Ψ) of HIV-2 RNA and preference for the purine-rich sequences, while MA protein binds mainly to G residues without favouring Ψ RNA. Moreover, HIV-2 GagΔp6 and NC promote HIV-2 RNA dimerization while our data do not support MA domain participation in this process in vitro." }, { "role": "assistant", "content": "We present that contrary to HIV-1 MA, HIV-2 MA displays NAC activity and we propose that MA domain may enhance the activity of HIV-2 GagΔp6. The role of the MA domain in the NAC activity of Gag may differ significantly between HIV-1 and HIV-2. The HIV-2 NC and MA interactions with RNA are not equivalent. Even though both NC and MA can facilitate tRNA(Lys3) annealing, MA does not participate in RNA dimerization in vitro. Our data on HIV-2 indicate that the role of the MA domain in the NAC activity of Gag differs not only between, but also within, retroviral genera. 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 rise in the incidence of ectopic pregnancy is related to all, except:" }, { "role": "assistant", "content": "The correct answer is Today rate of ectopic pregnancies has increased dramatically partly due to a rise in pelvic inflammatory disease (PID), and partly due to a number of other issues. Previous pelvic surgery, congenital or acquired abnormalities of the uterine cavity and fallopian tubes may contribute to the condition, as does tubal\nmicrosurgery, drug ovulation stimulation, and ART." } ]

[ { "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 34-year-old man presents with dysphagia. The patient says that he has pain on swallowing which gradually onset 2 weeks ago and has not improved. He denies any change in diet but does say that he recently returned from a prolonged work trip to the Caribbean. No significant past medical history or current medications. On physical examination, the patient looks pale. His tongue is swollen and has a beefy, red appearance. Angular stomatitis is present. Laboratory findings are significant for macrocytic, megaloblastic anemia, decreased serum folate, increased serum homocysteine, and normal methylmalonic acid levels. Which of the following conditions most likely caused this patient’s symptoms?" }, { "role": "assistant", "content": "Tropical sprue" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Humans, Immunization Schedule, Mandatory Reporting, Netherlands, Pertussis Vaccine, Retrospective Studies, Risk Factors, Time Factors, Whooping Cough." }, { "role": "user", "content": "Is [ The obligatory notification of pertussis effective for the protection of unvaccinated children ]? Context: To determine the effectiveness of the obligatory notification of pertussis in the Netherlands and the measures based on this notification in the prevention of infection in unvaccinated or insufficiently vaccinated children. Descriptive, retrospective. The period between the first day of the illness and the date of notification was calculated for all 9310 cases of pertussis that were notified in the Netherlands in 2004. A period of 21 days is the maximum during which appropriate measures can be taken in the family of the index patient to protect unprotected siblings at risk from infection. For the province of Groningen (n = 411 notified cases), it was also determined whether there were actually children that were not or insufficiently vaccinated in the immediate environment and whether preventive measures were necessary. In the Netherlands in 2004, 890 (10.7%) of all notified pertussis cases were notified within a three-week period after the first day of illness. In Groningen, this number was 30 (9.1%) and in none of these cases was there an insufficiently vaccinated child in the family." }, { "role": "assistant", "content": "In an endemic situation with severe under-reporting, the obligatory notification of pertussis is not effective to prevent infection of insufficiently vaccinated children. Alternative vaccination strategies directed at the prevention of the spread of pertussis among insufficiently vaccinated children would probably be more effective and merit further investigation. 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": "Basic emergency obstetric services includes all, except:" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A young asymptomatic female is observed to have a Midsystolic Click on routine examination. Valves are likely to show" }, { "role": "assistant", "content": "The correct answer is Answer is A (Myxomatous degeneration) Presence of midsystolic click in an asymptomatic female suggests a diagnosis of Mitral Valve Prolapse (MVP). MVP is associated with myxomatous degeneration of the mitral valves. Ruptured chordae tendinae may be seen in MVP but these patients are usually symptomatic with significant Regurgitation (MR)." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Disease Models, Animal, Endotoxins, Enzyme-Linked Immunosorbent Assay, Injections, Intraperitoneal, Interferon-gamma, Interleukin-6, Mice, Mice, Inbred C57BL, Mice, Knockout, Recombinant Proteins, Salmonella typhimurium, Tumor Necrosis Factor-alpha, Uveitis." }, { "role": "user", "content": "Does systemic interferon-gamma suppress the development of endotoxin-induced uveitis in mice? Context: It has been shown that interferon (IFN)-gamma is involved in the development of endotoxin-induced uveitis (EIU), but its exact role is unclear. We aimed to elucidate the role that endogenous systemic IFN-gamma plays in EIU pathogenesis. EIU was induced in wild-type (WT) or IFN-gamma knockout (GKO) mice on the C57BL/6 background by injecting Salmonella typhimurium endotoxin into a hind footpad. Twenty-four hours later, the eyes were harvested for histological analysis, and the serum was collected for cytokine ELISAs. WT and GKO mice were also intraperitoneally injected with 1 microg of recombinant murine IFN-gamma (rmIFN-gamma) just after and 6 h after EIU induction, and their eyes and sera were evaluated 24 h after EIU induction, as above. The GKO mice had significantly more severe EIU as determined by the number of ocular infiltrating cells and lower serum IL-6 levels after EIU induction compared to WT mice. The injection of rmIFN-gamma suppressed the severity of EIU and increased the serum IL-6 levels in both the WT and GKO mice." }, { "role": "assistant", "content": "Endogenous IFN-gamma suppresses EIU pathogenesis. In addition, the systemic administration of IFN-gamma suppresses EIU. The suppressive mechanism involved is unclear but may relate to the production of IL-6. 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: Acute Disease, Animals, Anti-Bacterial Agents, Anti-Inflammatory Agents, Non-Steroidal, Azithromycin, Conjunctivitis, Cyclooxygenase 2, Disease Models, Animal, Gene Expression, Interleukin-6, Matrix Metalloproteinase 2, Matrix Metalloproteinase 9, NF-kappa B, Rats, Rats, Wistar, Tumor Necrosis Factor-alpha." }, { "role": "user", "content": "Does azithromycin reduce inflammation in a rat model of acute conjunctivitis? Context: Macrolide antibiotics are known to have various anti-inflammatory effects in addition to their antimicrobial activity, but the mechanisms are still unclear. The effect of azithromycin on inflammatory molecules in the lipopolysaccharide-induced rat conjunctivitis model was investigated. Twenty-four Wistar rats were divided into two groups receiving topical ocular azithromycin (15 mg/g) or vehicle. In total, six doses (25 µl) were administered as one dose twice a day for three days before subconjunctival lipopolysaccharide injection (3 mg/ml). Before the rats were euthanized, mucus secretion, conjunctival and palpebral edema and redness were evaluated. Real-time polymerase chain reaction was used to determine gene expression for interleukin-6, cyclooxygenase-2, tumor necrosis factor-α, matrix metalloproteinase (MMP)-2, and MMP-9. Interleukin-6 was determined with enzyme-linked immunosorbent assay, nuclear factor-kappa B with western blot, and MMP-2 activity with gelatin zymogram. Four eyes per group were processed for histology and subsequent periodic acid-Schiff staining and CD68 for immunofluorescence. The Student t test or the Wilcoxon test for independent samples was applied (SPSS v.15.0). Azithromycin-treated animals showed a significant reduction in all clinical signs (p<0.05) compared to controls. Interleukin-6 (p<0.05), nuclear factor-kappa B protein expression (p<0.01), and MMP-2 activity (p<0.05) in conjunctival homogenates were significantly reduced compared with the control animals. MMP-2 gene expression showed a tendency to decrease in the azithromycin group (p=0.063). Mucus secretion by goblet cells and the macrophage count in conjunctival tissue were also decreased in the azithromycin group (p<0.05)." }, { "role": "assistant", "content": "These results suggest that azithromycin administration ameliorates induced inflammation effects in a rat model of acute conjunctivitis. 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": "Anopheles species for the transmission of malaria in urban areas is" }, { "role": "assistant", "content": "The correct answer is Vector of rural malaria is Anopheles culicifacies.\nVector of urban malaria is Anopheles stephensi." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, STUDY DESIGN, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Cohort Studies, Decision Making, Female, Humans, Hyperparathyroidism, Male, Middle Aged, Minimally Invasive Surgical Procedures, Monitoring, Intraoperative, Parathyroid Hormone, Parathyroidectomy, Reproducibility of Results, Retrospective Studies, Treatment Outcome." }, { "role": "user", "content": "Intraoperative parathyroid hormone measurement during minimally invasive parathyroidectomy: does it \"value-add\" to decision-making? Context: Routine use of intraoperative parathyroid hormone levels (IOPTH) during minimally invasive parathyroidectomy (MIP) has been challenged simply because the test works best when needed least, ie, once a solitary adenoma has been resected, and is less accurate with multiple gland disease. It has also been shown not to be cost-effective. The aim of this study was to determine if IOPTH \"value-added\" to decision-making during MIP. The study group comprised 100 consecutive patients with sporadic hyperparathyroidism and an unequivocally positive sestamibi scan who were undergoing MIP in our unit from June 2004 until October 2005, from whom blood was collected for parathyroid hormone measurement preoperatively, preexcision, and at 10 and 30 minutes postremoval. No action was taken on the results of the test. Ninety-eight patients were cured by MIP alone. Two patients had persistent hyperparathyroidism, one of whom was cured with subsequent open reexploration and removal of a second adenoma, and the other remains hypercalcemic despite additional open neck exploration. IOPTH in both patients failed to fall in retrospect, only the first would have been cured by conversion at the time of operation. The value-added accuracy of IOPTH was really only 1%. In an additional nine patients, IOPTH at 10 minutes had failed to fall by>50% from the highest level, those patients (9%) would have been subjected to an unnecessary conversion on the basis of a false-negative result." }, { "role": "assistant", "content": "IOPTH does not substantially value-add to decision-making during MIP. Most patients will be cured with appropriate selection for MIP based on preoperative localization studies." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Aged, Cardiac Pacing, Artificial, Coronary Disease, Death, Sudden, Cardiac, Electrocardiography, Female, Germany, Humans, Male, Myocardial Infarction, Pacemaker, Artificial, Risk Factors, Stroke Volume, Tachycardia, Ventricular, Ventricular Dysfunction, Left." }, { "role": "user", "content": "Does incidence of ventricular tachyarrhythmias during permanent pacemaker therapy in low-risk patients result from the German multicentre EVENTS study? Context: Current studies found an incidence of 12-31% ventricular tachyarrhythmias and sudden cardiac death during cardiac pacing months or even years after pacemaker insertion. MADIT(12) and MUSTT(13) demonstrated that patients with poor LV function after Myocardial infarction (MI) showing non-sustained ventricular tachycardia (nsVT) and inducibility during electrophysiologic testing benefit from an ICD. The present study was dedicated to assess the global incidence of non-sustained ventricular arrhythmias in a general population of pacemaker patients. Special regard was on patients with a potential ICD indication, e.g. those matching the MADIT/MUSTT criteria. Two hundred and thirty-one patients (72 +/- 11 years; 134 men) with an indication for dual chamber pacing entered the study. In all patients pacemaker systems capable of automatic storing of intracardiac electrocardiograms were implanted (Pulsar, Discovery, Guidant). Follow-up time was 15 months after inclusion. In 54 (25.7%) of 210 patients with at least one follow-up, episodes of nsVT were documented by stored electrocardiograms (up to >30 beats, >200 b.p.m.). Multiple-up to nine-episodes of ventricular tachycardia were retrieved in 31 of these patients. Three out of 14 patients with an LVEF <40% after MI presented nsVT during the follow-up. One of these patients received an ICD." }, { "role": "assistant", "content": "A significant number of pacemaker patients present with ventricular tachycardia. Intracardiac electrocardiograms and alert functions from pacemakers may enhance physicians' awareness of the patient's intrinsic arrhythmic profile and help uncover underlying mechanisms of arrhythmias by storing the initiation of the arrhythmia. 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: Adaptor Proteins, Signal Transducing, Animals, Blotting, Western, Collagen Type IV, Cytoskeletal Proteins, Glomerular Basement Membrane, Glomerulonephritis, Integrin alpha3beta1, Kidney Glomerulus, Laminin, Membrane Proteins, Mice, Mice, Inbred C57BL, Mice, Inbred DBA, Mice, Inbred ICR, Mice, Knockout, Microscopy, Electron, Transmission, Microscopy, Fluorescence, Nephrotic Syndrome, Phosphoprotein Phosphatases, Podocytes, Proteinuria, Species Specificity, Tensins." }, { "role": "user", "content": "Do tenc1-deficient mice develop glomerular disease in a strain-specific manner? Context: Tenc1 (also known as tensin2) is an integrin-associated focal adhesion molecule that is broadly expressed in mouse tissues including the liver, muscle, heart and kidney. A mouse strain carrying mutated Tenc1, the ICR-derived glomerulonephritis (ICGN) strain, develops severe nephrotic syndrome. To elucidate the function of Tenc1 in the kidney, Tenc1(ICGN) was introduced into 2 genetic backgrounds, i.e. DBA/2J (D2) and C57BL/6J (B6), strains that are respectively susceptible and resistant to chronic kidney disease. Biochemical and histological analysis revealed that homozygous Tenc1(ICGN) mice develop nephrotic syndrome on the D2 background (D2GN) but not on the B6 background (B6GN). Initially, abnormal assembly and maturation of glomerular basement membrane (GBM) were observed, and subsequently effacement of podocyte foot processes was noted in the kidneys of D2GN but not B6GN mice. These defects are likely to be involved in the integrin signaling pathway." }, { "role": "assistant", "content": "This study suggests that Tenc1 contributes to the maintenance of GBM structures and that the genetic background influences the severity of nephrotic syndrome. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Biomarkers, Tumor, Carcinoma, Hepatocellular, Catheter Ablation, Female, Hepatitis B, Hepatitis B virus, Humans, Liver Neoplasms, Male, MicroRNAs, Middle Aged, Prognosis, Risk Factors." }, { "role": "user", "content": "Is high circulating microRNA-122 expression a poor prognostic marker in patients with hepatitis B virus-related hepatocellular carcinoma who undergo radiofrequency ablation? Context: Aim of this study was to investigate the prognostic potential of plasma microRNA-122 levels in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma after hepatic resection or radiofrequency ablation (RFA). A total of 120 patients with HBV-related hepatocellular carcinoma who underwent hepatic resection (n=63) or RFA (n=57) were included. The pretreatment plasma microRNA-122 level was assessed using quantitative real time polymerase chain reaction, and the correlation between microRNA-122 expression and various clinical parameters was investigated. Multivariate Cox regression analysis demonstrated that, in all patients, a low platelet count (<100×10(9)/L), low albumin level (≤3.5g/dL.), and advanced tumor stage (modified Union for International Cancer Control stage III/IV) were independent prognostic factors for disease-free survival, while a low albumin level and advanced tumor stage were independent prognostic factors for overall survival (OS). In a subgroup analysis of patients who underwent RFA, the patients with high miR-122 expression (>100) had significantly lower OS on Kaplan-Meier analysis (P=0.042). Furthermore, high microRNA-122 expression (hazard ratio [HR]=2.67; 95% confidence interval [CI]=1.12-6.35; P=0.026) and advanced tumor stage (HR=2.27; 95% CI=1.23-4.18; P=0.009) were independent risk factors for poor OS in patients treated with RFA. The combination of microRNA-122 and tumor stage resulted in an area under the curve of 0.818 for predicting 1-year OS in patients who underwent RFA." }, { "role": "assistant", "content": "High plasma microRNA-122 expression was associated with poor OS in patients with HBV-related hepatocellular carcinoma who underwent RFA. 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": "After thyroidectomy, on 2nd post operative day, an elderly lady developed dyspnoea with swelling of the neck. What is the next best step of management" }, { "role": "assistant", "content": "The correct answer is Patient is having dyspnoea and swelling it can be due to respiratory obstruction or postop complications. Shift to OT immediately and investigate to find out the underlying cause Complications of Thyroidectomy Hemorrhage Due to slipping of ligature on the superior thyroid aery, bleeding from muscular aery Hematoma may cause airway compromise and must be evacuated immediately Hematoma may occur immediately or later on An immediate bleed occurs after or sholy before extubatiin when the patient lightens from anaesthesia and may begin to cough, causing a vessel to open Respiratory obstruction : Causes includes Tension hematoma Laryngeal edema (by anaesthetic intubation) : MC cause of respiratory obstruction Bilateral recurrent laryngeal nerve paralysis Recurrent laryngeal nerve paralysis May be unilateral or bilateral, transient or permanent Bilateral paralysis causes respiratory obstruction - Dyspnea, stridor Injury to other nerves External branches of superior laryngeal nerve Cervical sympathetic trunk - May cause Horner's syndrome Parathyroid insufficiency Due to removal of the parathyroid glands or infarction due to vascular injury Vascular injury is more impoant Cases usually present 2-5 days after operation with symptoms of Hypocalcemia (circumoral and fingeip numbness and tingling tetany, carpopedal spasm and laryngeal stridor) Treatment with oral calcium & vitamin D supplements. IV calcium gluconatr may be required in severe cases Thyroid insufficiency Thyrotoxicosis crisis. Occurs in the thyrotoxic patients has been inadequately prepared for thyroidectomy Ref: schwaz's principle of surgery 10th edition Pgno : 1373" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Arteries, Binding Sites, Endothelial Cells, Enhancer Elements, Genetic, GATA Transcription Factors, Gene Expression Regulation, Developmental, Gene Silencing, Genes, Reporter, Immunoglobulin J Recombination Signal Sequence-Binding Protein, Introns, Mice, Transgenic, Mutagenesis, Site-Directed, Mutation, Neovascularization, Physiologic, Proto-Oncogene Proteins c-ets, Receptors, Notch, SOX Transcription Factors, Signal Transduction, Vascular Endothelial Growth Factor A, Vascular Endothelial Growth Factor Receptor-2, Veins, Zebrafish, Zebrafish Proteins." }, { "role": "user", "content": "Does an Intronic Flk1 Enhancer direct Arterial-Specific Expression via RBPJ-Mediated Venous Repression? Context: The vascular endothelial growth factor (VEGF) receptor Flk1 is essential for vascular development, but the signaling and transcriptional pathways by which its expression is regulated in endothelial cells remain unclear. Although previous studies have identified 2 Flk1 regulatory enhancers, these are dispensable for Flk1 expression, indicating that additional enhancers contribute to Flk1 regulation in endothelial cells. In the present study, we sought to identify Flk1 enhancers contributing to expression in endothelial cells. A region of the 10th intron of the Flk1 gene (Flk1in10) was identified as a putative enhancer and tested in mouse and zebrafish transgenic models. This region robustly directed reporter gene expression in arterial endothelial cells. Using a combination of targeted mutagenesis of transcription factor-binding sites and gene silencing of transcription factors, we found that Gata and Ets factors are required for Flk1in10 enhancer activity in all endothelial cells. Furthermore, we showed that activity of the Flk1in10 enhancer is restricted to arteries through repression of gene expression in venous endothelial cells by the Notch pathway transcriptional regulator Rbpj." }, { "role": "assistant", "content": "This study demonstrates a novel mechanism of arterial-venous identity acquisition, indicates a direct link between the Notch and VEGF signaling pathways, and illustrates how cis-regulatory diversity permits differential expression outcomes from a limited repertoire of transcriptional regulators. 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: Analysis of Variance, Animals, Blotting, Western, Brain, Chi-Square Distribution, Drug Therapy, Combination, Erythropoietin, Immunohistochemistry, Interleukin-1 Receptor-Associated Kinases, Intracranial Hemorrhages, Male, Matrix Metalloproteinase 9, NF-kappa B, Rats, Rats, Wistar, Stroke, Time Factors, Tissue Plasminogen Activator, Treatment Outcome." }, { "role": "user", "content": "Does erythropoietin in combination of tissue plasminogen activator exacerbate brain hemorrhage when treatment is initiated 6 hours after stroke? Context: Erythropoietin (EPO), a hematopoietic cytokine, exerts neuroprotective effects in experimental stroke. In the present study, we investigated the effect of recombinant human EPO (rhEPO) in combination with tissue plasminogen activator (tPA) on embolic stroke. Rats subjected to embolic middle cerebral artery occlusion (MCAO) were treated with rhEPO (5000 U/kg) in combination with tPA (10 mg/kg) at 2 or 6 hours after MCAO. Control groups consisted of ischemic rats treated with rhEPO (5000 U/kg) alone, tPA (10 mg/kg) alone, or saline at 2 or 6 hours after MCAO. The combination therapy of rhEPO and tPA initiated 6 hours after MCAO did not reduce the ischemic lesion volume and significantly (P<0.05) increased the incidence of brain hemorrhage measured by frequency of gross hemorrhage and a quantitative spectrophotometric hemoglobin assay compared with rats treated with rhEPO alone and tPA alone. However, when the combination therapy was initiated 2 hours after MCAO, the treatment significantly (P<0.05) reduced the lesion volume and did not substantially increase the incidence of hemorrhagic transformation compared with saline-treated rats. Immunostaining analysis revealed that the combination therapy of rhEPO and tPA at 6 hours significantly (P<0.05) increased matrix metalloproteinase-9, NF-kappaB, and interleukin-1 receptor-associated kinase-1 immunoreactive cerebral vessels compared with rats treated with rhEPO alone and saline." }, { "role": "assistant", "content": "EPO exacerbates tPA-induced brain hemorrhage without reduction of ischemic brain damage when administered 6 hours after stroke in a rat model of embolic MCAO and that matrix metalloproteinase-9, NF-kappaB, and interleukin-1 receptor-associated kinase-1 upregulated by the delayed combination therapy may contribute to augmentation of brain hemorrhage. 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 factor is mainly respon-sible for virulence in Streptococcus :" }, { "role": "assistant", "content": "The correct answer is M Protein\n\nIt is major virulence factor of group A Strep. pyogenes.\nIt is hair like projection of cell wall.\nIt is of 80 types (basis of Griffith classification) so immunity is type specific.\nM protein is also found in Group G streptococci.\n\nRemember :\n\nCarbohydrate is used as the basis of Lancefields classification.\nStreptokinase or fibrolysin and streptodornase or DNAse liquefy pus so used in enzymatic debridement" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Poison having garlic smell:" }, { "role": "assistant", "content": "The correct answer is Ans. (A). Arsenic(Ref: Review of Forensic Medicine and toxicology; Gautum Biswas; 2nd edition; Pg- 490)Garlic odour: Arsenic and aluminium phosphide.Poisons and SmellOrganophosphorus compoundsKeroseneQ (due to the addition of AROMAX)Arsenic, Aluminium phosphide/seleniumGarlicQCannabisBurnt ropeQSmell of carrotHemlock (conium maculatum)AlcoholFruity (due to congeners)CyanideBitter almondQHydrogen sulphide/ Mercaptans/ disulfiram/ N-acetyl cysteineRotten eggQChloral hydrate/ParaldehydeAcrid pearQ/AromaticNaphthaleneMoth ballSalicylateMentholZinc phosphideFishyShoe PolishNitrobenzene" } ]

[ { "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": "Quarantine period" }, { "role": "assistant", "content": "The correct answer is QUARANTINE Quarantine has been defined as \"the limitation of freedom of movement of such well persons or domestic animals exposed to communicable disease for a period of time not longer than the longest usual incubation period of the disease, in such manner as to prevent effective contact with those not so exposed\". Quarantine measures are also \"applied by a health authority to a ship, an aircraft, a train, road vehicle, other means of transpo or container, to prevent the spread of disease, reservoirs of disease or vectors of disease\" . Quarantine may comprise (a) absolute quarantine, as defined above; (b) modified quarantine, e.g., a selective paial limitation of freedom of movement, such as exclusionof children from school; (c) segregation which has been defined as \"the separation for special consideration, control of observation of some pa of a group of persons (or domestic animals) from the others to facilitate control 'of a communicable disease, e.g., removal of susceptible children to homes of immune persons\". In contrast to isolation, quarantine applies to restrictions on the healthy contacts of an infectious disease. Quarantine which was once a popular method of disease control has now declined in popularity. With better techniques of early diagnosis and treatment, quarantine, as a method of disease control, has become outdated. It has been replaced by active surveillance. Ref : Park 23rd edition Pgno : 120" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Anthracosis, Biomarkers, Calcium Carbonate, Cell Line, Coal, Dust, Epithelial-Mesenchymal Transition, Ferritins, Fluorescent Antibody Technique, Humans, Iron, Lung, Male, Mice, Microscopy, Confocal, Pennsylvania, Polymerase Chain Reaction, Protective Agents, Random Allocation, Receptors, Transferrin, Spectrometry, X-Ray Emission." }, { "role": "user", "content": "Laboratory studies of the impact of calcite on in vitro and in vivo effects of coal dust: a potential preventive agent for coal workers' pneumoconiosis? Context: Bioavailable iron (BAI) in coal, which may play a key role in causing coal workers' pneumoconiosis (CWP), is present at relatively high levels in Appalachian coals. Calcite decreases BAI and is more plentiful in Western coals than in Appalachian coals, possibly explaining the lower CWP prevalence among Western miners. We measured effects of calcite on BAI in non-cellular and cellular systems involving Pennsylvania (PA) coal dust. We also tested in vivo effects of calcite on transferrin receptor and markers of epithelial mesenchymal transition (EMT) and inflammation in mice exposed to PA coal. Calcite rapidly eliminated BAI in an aqueous suspension of PA coal. Ferritin induction in human lung epithelial cells exposed to PA coal was effectively eliminated by calcite. Mouse lung tissue markers indicated increased EMT after exposure to PA coal dust, but not after exposure to PA coal plus calcite. Markers of inflammation increased following exposure to PA coal alone, but not following exposure to PA coal plus calcite." }, { "role": "assistant", "content": "Additional research may lead to the use of supplemental calcite in coal mining as a safe and effective way to prevent CWP among Appalachian coal miners." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "In a population of 5000, on 1st January, total cases of myopia were 500. Till 31st December, 90 new cases were found. Calculate the incidence of myopia PER 100." }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A community survey shows crude birth rate 23, and crude death rate 6. The demographic stage of population is -" }, { "role": "assistant", "content": "The correct answer is Growth rate = Crude birth rate - Crude death rate\n Relationship between growth rate and population" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Appendectomy, Cholecystectomy, Laparoscopic, Feasibility Studies, Female, Gastrectomy, Herniorrhaphy, Humans, Length of Stay, Male, Middle Aged, Natural Orifice Endoscopic Surgery, Operative Time, Patient Safety, Prospective Studies, Treatment Outcome, Young Adult." }, { "role": "user", "content": "Broad clinical utilization of NOTES: is it safe? Context: Natural orifice transluminal endoscopic surgery (NOTES) has been the focus of several studies as a less invasive alternative to conventional laparoscopy to access and treat intracavitary organs. For the last 5 years, much has been accomplished with animal studies, yet the clinical utilization of this novel technique is still modest. After 2 years of experience in the laboratory, we started our clinical experience. We report our experience with clinical utilization of NOTES procedures from 2007 to 2010. Under UCSD institutional review board-approved trials, 104 patients were enrolled under seven different NOTES protocols from 2007 to 2010, where a NOTES procedure was offered as an alternative to conventional treatments. The treated pathologies were cholelithiasis, biliary dyskinesia, acute and chronic appendicitis, ventral hernias, morbid obesity, and achalasia. The access routes included transgastric (TG), transvaginal (TV), transesophageal (TE), and perirectal (PR). Among the 104 patients enrolled, 103 underwent a surgical procedure starting with diagnostic laparoscopy, and 94 cases were deemed appropriate to proceed via a NOTES approach. There were 9 aborted NOTES procedures at the time of the initial peritoneoscopy before creating a NOTES access route. The reasons to not proceed with a NOTES procedure in the TV cholecystectomy group (n = 5) were a large amount of pelvic adhesions in 4 patients and a severe inflammation of the gallbladder in 1 patient. In the TG cholecystectomy group (n = 1), it was severe inflammation of the gallbladder. In the TG appendectomy group (n = 1), it was the presence of localized peritonitis. In the TE endoscopic myotomy group (n = 2), it was the presence of megaesophagus with an inability to clean the esophagus of food debris. The NOTES procedures performed were 48 TV cholecystectomies, 4 TV appendectomies, 8 TG cholecystectomies, 2 PR peritoneoscopies, 3 TG appendectomies, 3 TV ventral hernia repairs, 5 TE endoscopic myotomies, 3 TV sleeve gastrectomies, and 18 TG sleeve gastrectomies. The average body mass indexes for those in the sleeve gastrectomy group was 42.1 kg/m(2) (TG route) and 40.6 kg/m(2) (TV route). There were no intraoperative complication and no conversions to standard laparoscopy during these procedures. The average hospital stay was 1-2 days. One patient who underwent TV cholecystectomy required an emergency department visit for nausea and vomiting. To date, 3 patients who underwent TV cholecystectomy have become pregnant and delivered normally." }, { "role": "assistant", "content": "NOTES is safe, feasible, and reproducible with previous training in the laboratory and a consistent team at a high-volume center. Prospective randomized studies of a large patient population are necessary to assess long-term results." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Chi-Square Distribution, Colorectal Surgery, Dogs, Enteral Nutrition, Gastrointestinal Motility, Models, Animal, Nutritional Status, Parenteral Nutrition, Total, Postoperative Period, Statistics, Nonparametric, Treatment Outcome." }, { "role": "user", "content": "Is early postoperative enteral nutrition useful for recovering gastrointestinal motility and maintaining the nutritional status? Context: The efficacy of enteral nutrition in postoperative nutritional management is known, but the effects on gastrointestinal motility and nutrition have not yet been elucidated. The purpose of this study was to compare the effects of enteral and parenteral nutrition soon after open abdominal surgery on gastrointestinal motility and nutritional status. A partial resection of rectum models was prepared to compare two types of nutrient administration: enteral nutrition and total parenteral nutrition. The differences between the effects of nutrition types in terms of gastrointestinal motility and nutritional status were investigated. Enteral nutrition contributed to recovery of gastrointestinal motility and maintenance of nutritional status." }, { "role": "assistant", "content": "Enteral nutrition should therefore be initiated soon after surgery if the gastrointestinal tract is available. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND AND PURPOSE, METHODS, RESULTS. Meshes: African Americans, Aged, Antihypertensive Agents, Blood Pressure, European Continental Ancestry Group, Female, Follow-Up Studies, Humans, Hypertension, Longitudinal Studies, Male, Middle Aged, Risk Factors, Stroke." }, { "role": "user", "content": "Is blood pressure control for stroke prevention the correct goal? Context: Although pharmacological treatment of hypertension has important health benefits, it does not capture the benefit of maintenance of ideal health through the prevention or delay of hypertension. A total of 26 875 black and white participants aged 45+ years were assessed and followed for incident stroke events. The association was assessed between incident stroke and: (1) systolic blood pressure (SBP)categorized as normal (<120 mm Hg), prehypertension (120-139 mm Hg), stage 1 hypertension (140-159 mm Hg), and stage 2 hypertension (160 mm Hg+), and (2) number of classes of antihypertensive medications, classified as none, 1, 2, or 3 or more. During 6.3 years of follow-up, 823 stroke events occurred. Nearly half (46%) of the population were successfully treated (SBP<140 mm Hg) hypertensives. Within blood pressure strata, the risk of stroke increased with each additional class of required antihypertensive medication, with hazard ratio [HR], 1.33; 95% confidence interval, 1.16 to 1.52 for normotensive, HR, 1.15; 95% confidence interval, 1.05 to 1.26 for prehypertension, and HR, 1.22; 95% confidence interval, 1.06 to 1.39 for stage 1 hypertension. A successfully treated (SBP<120 mm Hg) hypertensive person on 3+ antihypertensive medication classes was at marginally higher stroke risk than a person with untreated stage 1 hypertension (HR, 2.48 versus HR=2.19; relative to those with SBP<120 on no antihypertensive medications)." }, { "role": "assistant", "content": "Maintaining the normotensive status solely through pharmacological treatment has a profound impact, as nearly half of this general population cohort were treated to guideline (SBP<140 mm Hg) but failed to return to risk levels similar to normotensive individuals. Even with successful treatment, there is a substantial potential gain by prevention or delay of hypertension." } ]

[ { "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": "Umbilical aery is a branch of" }, { "role": "assistant", "content": "The correct answer is Anterior division of internal iliac aeryA pa of Umbilical aery persists as superior vesical aery and remaining aery becomes obliterated forming medial umbilical ligament." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "What is the structure seen in the given X-ray below?" }, { "role": "assistant", "content": "The correct answer is Plain abdominal X ray showing a stent in the right and left ureter. Ureteric stents,also known as double J stents or retrograde ureteric stents, is a urological catheter that has two \"J-shaped\" (curled) ends, where one is anchored in the renal pelvis and the other inside the bladder. Stents are used for the free passage of urine from the kidney to the bladder, in adverse conditions such as postoperative urologic procedures, and previously to lithotripsy and ureteral obstructions. Indications Stents may be uses for a sho of long term period depending on the indication: * obstruction from urolithiasis * malignant obstruction (typically pelvic malignancies) * benign strictures * retroperitoneal fibrosis REF : DAVID SUTTON 9TH ED:" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Adaptation, Psychological, Aged, Aged, 80 and over, Automobile Driving, Female, Humans, Life Style, Male, Middle Aged, Psychological Tests, Self Efficacy, Surveys and Questionnaires, Transportation." }, { "role": "user", "content": "Is planning for driving cessation critical for the well-being and lifestyle of older drivers? Context: Driving cessation has demonstrated impacts on well-being and lifestyle. Despite the recognized reluctance of older people to plan for driving cessation, this study has identified a new group who has a stated plan to stop driving within 12 months. Although gradual reduction of driving has been documented as part of the usual driving cessation, this study explored the differences between retired drivers and those with a stated plan to retire within 12 months in sociodemographic, well-being and lifestyle outcomes. This study extracted all baseline data from a clinical trial exploring the effectiveness of a group program for older retiring and retired drivers. Sociodemographic data included age, gender, health status, educational level, and living situation. All participants completed measures related to episodes away from home, well-being, and lifestyle. These were compared using parametric and nonparametric statistical analysis. Participants (n = 131) included 68 retired drivers (mean age 79.8 years) and 63 retiring drivers (mean age 77.8 years). Retiring drivers engaged in more episodes away from home (p = 0.03), and more social activities (p = 0.02), used less alternative transport (p<0.001), displayed fewer anxiety (p = 0.05), and depressive (p = 0.01) symptoms, but demonstrated lower transport and lifestyle self-efficacy (p = 0.04)." }, { "role": "assistant", "content": "Both retired and retiring drivers require support for driving cessation and community engagement. Retiring drivers may be in a critical position to engage in driving cessation interventions to improve self-efficacy and begin adapting community mobility." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Carcinoma, Female, Gene Expression Regulation, Neoplastic, Humans, Immunohistochemistry, Nuclear Proteins, Ovarian Neoplasms, RNA, Messenger, Reverse Transcriptase Polymerase Chain Reaction, Transcription Factors, Transcription, Genetic, Tumor Cells, Cultured." }, { "role": "user", "content": "Are iMUP-1 and IMUP-2 genes up-regulated in human ovarian epithelial tumors? Context: Normal cells lose their ability to divide after a finite number of cell divisions. Under the influence of Simian virus 40 (SV 40) large T-antigen, which interacts with the cell cycle regulators p53 and pRb, cells enter a phase of an extended pre-immortalized cells. Immortalization-up-regulated protein 1 (IMUP-1) and immortalization-up-regulated protein 2 (IMUP-2) genes have been recently cloned and are known to be involved in SV40-mediated immortalization. However, the roles of IMUP-1 and IMUP-2 are not known in human ovarian epithelial tumors. This study was performed to determine mRNA expression and intracellular localization of the IMUP-1 and IMUP-2 in ovarian epithelial tumors by RT-PCR and immunohistochemical staining using human IMUP-1 and IMUP-2 monoclonal antibodies. IMUP-1 (4.0-fold) and IMUP-2 (2.4-fold) mRNA expression in ovarian epithelial tumors were significantly higher than in normal ovarian tissues (p < 0.05). The mRNAs of IMUP-1 and IMUP-2 in the ovarian cancer cell lines were about 4.9- and 2.9-fold compared to the normal ovarian cell line, respectively. The subcellular expression of these two proteins in immunohistochemical stains was detected mainly in the nucleus of tumor cells, whereas adjacent normal ovarian stromal cells were faintly or negatively stained with these proteins. However, the staining intensity of IMUP-1 and IMUP-2 in ovarian epithelial tumors were not different between histological types or grades." }, { "role": "assistant", "content": "These results showed the up-regulation of IMUP-1 and IMUP-2 in human ovarian epithelial tumors and suggested that the altered mRNA level of these molecules is possibly associated with ovarian tumorigenesis. 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: Amino Acid Substitution, Aspartic Acid, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Neuropathies, European Continental Ancestry Group, Genotype, Glycine, Humans, Isoleucine, Membrane Glycoproteins, Mutation, Missense, Odds Ratio, Polymorphism, Single Nucleotide, Prevalence, Receptors, Cell Surface, Threonine, Toll-Like Receptor 4, Toll-Like Receptors." }, { "role": "user", "content": "Are asp299Gly and Thr399Ile genotypes of the TLR4 gene associated with a reduced prevalence of diabetic neuropathy in patients with type 2 diabetes? Context: To establish whether single nucleotide polymorphisms (Asp299Gly and Thr399Ile) of the toll-like receptor 4 have an association with late diabetic complications. The study was conducted in 246 type 1 and 530 type 2 diabetic patients. The alleles of both polymorphisms were detected using PCR and subsequent cleavage by NcoI and HinfI restriction endonucleases. No difference was found between type 1 and type 2 diabetic patients in the prevalence of alleles of the Asp299Gly and Thr399Ile polymorphisms. In most cases, the alleles Gly299 and Ile399 occurred in a co-segregatory manner. The prevalence of the Gly299/Ile399 haplotype was 10.6 and 12.1% in type 1 and type 2 diabetic patients, respectively (P = 0.63). No association with diabetic nephropathy or diabetic neuropathy was found in type 1 diabetic patients. In type 2 diabetic patients, however, heterozygote carriers of the Asp299Gly and Thr399Ile genotypes had a significantly reduced prevalence of diabetic neuropathy (odds ratio 0.35 [95% CI 0.19-0.61]; P = 0.0002); no association with diabetic nephropathy was found." }, { "role": "assistant", "content": "Our data indicate that Asp299Gly and Thr399Ile genotypes of the TLR4 gene are associated with reduced prevalence of diabetic neuropathy in type 2, but not in type 1, diabetes. Thus different mechanisms may be involved in the pathophysiology of diabetic neuropathy in type 1 and type 2 diabetes. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adiponectin, Albuminuria, Animals, Blood Platelets, Deoxyguanosine, Diabetes Mellitus, Experimental, Diabetic Nephropathies, Endothelium, Vascular, Immunohistochemistry, Kidney Glomerulus, Male, Nitric Oxide, Nitric Oxide Synthase, Platelet Aggregation, Rats, Rats, Wistar, Reactive Oxygen Species, Receptor, Serotonin, 5-HT2A, Serotonin 5-HT2 Receptor Antagonists, Serotonin Antagonists, Succinates, Time Factors." }, { "role": "user", "content": "Does blockade of serotonin 2A receptor improve glomerular endothelial function in rats with streptozotocin-induced diabetic nephropathy? Context: Serotonin (5-HT) is involved in vascular inflammation and atherosclerogenesis. Serum 5-HT concentrations are elevated in diabetes, and 5-HT is involved in diabetic vasculopathies. Sarpogrelate hydrochloride, a 5-HT2A receptor antagonist, has renoprotective effects, but its effect in diabetic nephropathy is not elucidated. The aim of this study was to examine the effects of sarpogrelate on endothelial dysfunction in rats with streptozotocin (STZ)-induced diabetes. Rats with STZ-induced diabetes were either untreated or treated with sarpogrelate (30 mg/kg P.O.) for 8 weeks. At the end of the experiment, we measured urinary albumin excretion, serum adiponectin concentration and platelet-derived microparticles. Intraglomerular coagulation was detected by immunostaining for platelets. Production of renal reactive oxygen species (ROS) and nitric oxide (NO) was investigated by confocal laser microscopy and used as an index of glomerular endothelial dysfunction. Diabetic nephropathy was associated with enhanced production of ROS and diminished bioavailable NO in the glomeruli. Treatment with sarpogrelate improved ROS/NO imbalance in glomeruli, suppressed platelet aggregation in glomeruli, reduced platelet-derived microparticles, increased serum adiponectin level and reduced the level of albuminuria, compared with non-treated diabetic rats." }, { "role": "assistant", "content": "Our results indicate that sarpogrelate improves endothelial function in rats with STZ-induced diabetes through a reduction of glomerular platelet activation and an increase in serum adiponectin concentrations and suggest that sarpogrelate is potentially useful for the treatment of diabetic nephropathy. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which is NOT a third generation Cephalosporin" }, { "role": "assistant", "content": "The correct answer is Ans. is 'd' i.e., Cefuroxime Third generation cephalosporins include Parenteral OralCefotaxime - CefiximeCeftizoxime - Cefpodoxime proxetilCeftriaxone - CefdinirCeftazidime - Ceftibuten Cefoperazone Also knowFourth generation cephalosporinsCefepimeCefaparole" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which is the true statement regarding post-dural anesthetic headache:" }, { "role": "assistant", "content": "The correct answer is B i.e. Occurs due to low CSF pressure Post Dural Puncture Headache (PDPH) Any breach of dura may result in PDPH. This may follow a lumber puncture, myelogram, spinal anesthesiaQ, wet epidural tapQ (in which epidural needle pierced dura) or uncomplicated epidural (dlt scratching of dura). It result from decreased intracranial pressure as CSF leaks from dural defect at a greater rate than it is being produced.Q The headache is BIL, frontal Or retro-orbital, occipital & extending into neck. It may be throbbing & associated with photophobia & nausea. The onset is usually 12-72 hoursQ following procedure (in first 3 days) may last for 1-2 weeksQ. The hallmark is its association with body positionQ (i.e. aggravated by sitting or standing & relieved by lying down)0 The incidence increases with ? 1. Larger needleQ 2. Cutting point (in comparision to pencil point) needle. 3. Young age, Female sex, PregnancyQ So, max incidence is expected in a wet epidural tap with a large epidural needle in an obstetric patient. Lowest incidence would be expected with an elderly male using 27 gauge pencil point needle. Management of PDPH Prevention by thinner needleQ (whitacre needle) Supine position, intravenous fluids & caffeine and analgesia. Epidural blood Patch is most effective treatment." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 55-year-old man comes to the physician because of worsening fatigue and recurrent bleeding from his gums for 2 weeks. Physical examination shows marked pallor. There are scattered red, nonblanching pinpoints spots on his trunk and extremities. Laboratory studies show a hemoglobin of 8.0 g/dL, a leukocyte count of 80,000/mm3, and a platelet count of 104,000/mm3. Genetic analysis of a bone marrow aspirate shows leukemic cells with a balanced translocation between the long arms of chromosome 15 and 17. These cells are most likely to stain positive for which of the following?" }, { "role": "assistant", "content": "Myeloperoxidase" } ]

[ { "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": "Tc labelled RBC's are used for" }, { "role": "assistant", "content": "The correct answer is D i.e. Splenic disease Tc99 - labelled RBCs provides information about red cell pooling, so it is used in : Haerningioma detection Gastrointestinal bleedingQ Spleenic diseaseQ Cardiac ventriculography" } ]

[ { "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": "Jarisch–Herxheimer reaction is seen in syphilis with :" }, { "role": "assistant", "content": "The correct answer is None" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A male patient presents with patchy loss of hair on scalp, eyebrows and beard. He also gives istory of rapid graying of hair in a few areas. The likely diagnosis is-" }, { "role": "assistant", "content": "The correct answer is History of patchy hair loss with retaining of grey hairs is alopecia areata. other options anagaen effluvium, telogen effluvium are diffuse hair loss. androgenetic alopecia is paterened hair loss or male pattern baldness which involve fronto temporal receding. Ref Harrison20th edition pg 1230" } ]

[ { "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 first line of treatment of infeility in PCOD is" }, { "role": "assistant", "content": "The correct answer is In pcos , ovulation is usually induced with combination of clomiphene citrate and hMG.The patient is advised to take CC 50-100mg/dl from day 2-6 of cycle for 5 days. Injecting hMG 75units IM is added on day 3,5 and 7 and more if required. Shaws Textbook of Gynaecology 16th edition page no 254." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Amides, Anesthetics, Intravenous, Anesthetics, Local, Anti-Bacterial Agents, Bupivacaine, Drug Antagonism, Drug Synergism, Enterococcus faecalis, Escherichia coli, Humans, Ropivacaine, Staphylococcus aureus, Sufentanil." }, { "role": "user", "content": "Does sufentanil modify the antibacterial activity of bupivacaine and ropivacaine? Context: The purpose of our study was to investigate the effect on the growth of Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), and Enterococcus faecalis (E. faecalis) of bupivacaine at a final concentration of 0.77 mg.mL(-1), ropivacaine at 1.2 mg.mL(-1), and sufentanil at 0.38 and 0.5 microg.mL(-1) (alone or in combination with bupivacaine and ropivacaine). The strains were diluted to approximately 3 x 10(4) cfu.mL(-1) in Mueller-Hinton broth. The anesthetics (0.5 mL) were incubated with the bacterial suspensions (0.5 mL) for 24 hr at 37 degrees C. Bupivacaine inhibited the growth of E. coli (59 +/- 0.8%; P < 0.05) and S. aureus (22 +/- 3.6%; P < 0.05). Ropivacaine also inhibited the growth of E. coli (41 +/- 1.2%; P < 0.05) and S. aureus (25.5 +/- 4.1%; P < 0.05). Both anesthetics were ineffective against E. faecalis. Sufentanil only inhibited S. aureus (13.8 +/- 3.1%; P < 0.05) at a concentration of 0.5 microg.mL(-1). Sufentanil modified the antibacterial activity of bupivacaine and ropivacaine. It increased the inhibitory effect of bupivacaine on E. faecalis and S. aureus by 10 +/- 2.1% (P < 0.05) and on E. coli by 7% (P < 0.05). Sufentanil did not increase the inhibitory effect of ropivacaine on the growth of S. aureus. On the other hand, sufentanil reduced the inhibitory effect of ropivacaine on E. coli by 11% (P < 0.05)." }, { "role": "assistant", "content": "Both bupivacaine and ropivacaine alone or combined with sufentanil inhibited the growth of E. coli and S. aureus. E. faecalis was partially sensitive to a bupivacaine + sufentanil mixture. Sufentanil had a partial synergistic effect on bupivacaine and a partial antagonistic effect on ropivacaine's antibacterial activity. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: AMP-Activated Protein Kinases, Adenoviridae, Animals, Blotting, Western, Enzyme Inhibitors, Genetic Vectors, Hypoglycemia, Hypoglycemic Agents, Hypothalamus, Injections, Intraventricular, Insulin, Male, Multienzyme Complexes, Neurosecretory Systems, Protein-Serine-Threonine Kinases, Rats, Rats, Sprague-Dawley." }, { "role": "user", "content": "Does hypothalamic AMP-activated protein kinase mediate counter-regulatory responses to hypoglycaemia in rats? Context: Appropriate counter-regulatory hormonal responses are essential for recovery from hypoglycaemia. Although the hypothalamus is known to be involved in these responses, the molecular mechanisms have not been fully elucidated. AMP-activated protein kinase (AMPK) functions as a cellular energy sensor, being activated during energy depletion. As AMPK is expressed in the hypothalamus, an important site of neuroendocrine regulation, the present study was undertaken to determine whether hypothalamic AMPK mediates counter-regulatory responses to hypoglycaemia. Hypoglycaemia was induced by i.p. injection of regular insulin (6 U/kg) in Sprague-Dawley rats. Hypothalamic AMPK phosphorylation and activities were determined 1 h after i.p. insulin injection. To investigate the role of hypothalamic AMPK activation in mediating counter-regulatory responses, an AMPK inhibitor, compound C, was pre-administered intracerebroventricularly (i.c.v.) or dominant-negative (DN)-AMPK was overexpressed in the hypothalamus before induction of hypoglycaemia. Insulin-induced hypoglycaemia increased hypothalamic AMPK phosphorylation and alpha2-AMPK activities in rats. The change was significant in the arcuate nucleus/ventromedial hypothalamus (ARC/VMH) and paraventricular nuclei (PVN). Prior i.c.v. administration of compound C attenuated hypoglycaemia-induced increases in plasma concentrations of corticosterone, glucagon and catecholamines, resulting in severe and prolonged hypoglycaemia. ARC/VMH DN-AMPK overexpression impaired early counter-regulation, as evidenced by reduced glucagon and catecholamine responses. In contrast, PVN DN-AMPK overexpression attenuated late counter-regulation and corticosterone responses." }, { "role": "assistant", "content": "Systemic hypoglycaemia causes hypothalamic AMPK activation, which is important for counter-regulatory hormonal responses. Our data indicate that hypothalamic AMPK acts as a fuel gauge, sensing the whole-body energy state and regulating not only energy homeostasis but also neuroendocrine functions. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVES, METHODS, RESULTS. Meshes: Antigens, CD34, Biomarkers, Tumor, Dermatofibrosarcoma, Down-Regulation, Factor XIIIa, Humans, Immunohistochemistry, Intermediate Filament Proteins, Mesenchymal Stromal Cells, Nerve Tissue Proteins, Nestin, Skin, Skin Neoplasms." }, { "role": "user", "content": "Dermatofibrosarcoma protuberans: a tumour of nestin-positive cutaneous mesenchymal stem cells? Context: There is an increasing body of evidence suggesting that malignancies arise from mutated stem cells, which has led to the formulation of the cancer stem cell hypothesis. It has also been suggested that cutaneous malignancies originate from a mutated stem cell. To date, mesenchymal tumours of the skin have not been the focus of the cancer stem cell hypothesis. A population of mesenchymal stem cells has recently been identified in the dermal compartment of the skin. These proposed stem cells are positive for the neuroepithelial stem cell marker nestin. To describe the expression pattern of nestin, a neuroepithelial stem cell protein, in dermatofibrosarcoma protuberans (DFSP). Immunohistochemical evaluation of DFSP with a monoclonal antibody against nestin was performed using standard techniques. For comparison we also analysed dermatofibromas (DF). In addition, we used antibodies against CD34 and Factor XIIIa; the proliferation marker Ki67 was also used. Strong immunoreactivity for nestin was found in DFSP whereas all DF cases were nestin-negative." }, { "role": "assistant", "content": "We propose that DFSP may represent a clonal expansion of a nestin-positive mesenchymal stem cell which would put this tumour in line with other neoplasms for which the cancer stem cell hypothesis was formulated. We suggest the use of nestin as an additional marker for DFSP, especially in cases of negative immunoreactivity for CD34. Nestin may also be employed for margin evaluation of DFSP in micrographic (Mohs) surgery." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, DESIGN, SETTING, PARTICIPANTS, FINDINGS. Meshes: Adult, Anecdotes as Topic, Down Syndrome, Female, Greece, Health Knowledge, Attitudes, Practice, Humans, Midwifery, Mothers, Nurse-Patient Relations, Nursing Methodology Research, Patient Education as Topic, Pregnancy, Prenatal Care, Prenatal Diagnosis, Surveys and Questionnaires." }, { "role": "user", "content": "Do pregnant women in Greece make informed choices about antenatal screening for Down's syndrome? Context: to investigate the knowledge and attitudes towards Down's syndrome screening among pregnant women presenting for prenatal screening in Greece, in order to explore whether Greek women are able to make informed choices. survey using self-administered questionnaires. public hospital in Athens, Greece. 135 pregnant women with a gestational age of between 11 and 20 weeks, just before antenatal screening for Down's syndrome. a total of 96% of women had a positive attitude towards screening and 45% had a good level of knowledge concerning the screening process for Down's syndrome. A standard measure of informed choice was used, which was validated for use in Greek. We found that 44% of women made an informed choice and 56% of women made an uninformed choice. This was because of the low percentage of women with a good level of knowledge. It was also found that knowledge and attitudes were not associated and seemed to be independent of each other. A higher level of informed choice was associated with a higher level of educational achievement and income, time of decision-making and the satisfaction with the decision." }, { "role": "assistant", "content": "health professionals should ensure that all women receive appropriate and intelligible information about antenatal screening for Down's syndrome. This information should be suited to women's learning ability in order to increase their knowledge before undergoing screening. Health professionals should educate and increase women's knowledge, and also give women a chance to explore their attitudes and discuss the issues involved." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: PURPOSE, MATERIALS AND METHODS, RESULTS. Meshes: Adult, Aged, Cubital Tunnel Syndrome, Diagnosis, Differential, Fascia, Fasciotomy, Female, Humans, Male, Middle Aged, Postoperative Complications, Reoperation, Sensitivity and Specificity, Ulnar Nerve, Ulnar Neuropathies, Ultrasonography." }, { "role": "user", "content": "The Ulnar Nerve After Surgical Transposition: Can Sonography Define the Reason of Persisting Neuropathy? Context: Ulnar nerve neuropathy is mainly caused by compression at the level of the cubital tunnel. Two main approaches are currently known for the surgical treatment of this condition: decompression of the nerve in its usual position or transposition to the ulnar flexor side. This study was performed to define the usefulness of ultrasound in patients with persisting symptoms after ulnar nerve transposition. We present the data of 8 subjects with persisting symptoms after nerve transposition due to compressive neuropathy. The cross-section areas (CSA) and texture changes were recorded. Each ulnar nerve was divided into 6 segments - 3 segments at the proximal pass and 3 segments at the distal pass through the subcutaneous fascia. Texture changes were recorded in 4.6 (76.7 %)  ± 1.2 and outer nerve sheath blurring in mean 4.1 (68.3 %)  ± 1.1 of the segments. Caliber changes were found in the course of the nerve based on the 6 segments: A mean CSA of 7.45  mm²  ±  2.24 was found proximal to the upper fascial passage (PUF), a mean CSA of 11.96  mm²  ±  3.61  at the upper fascial passage (UF), a mean CSA of 11.49  mm²  ±  8.16 distal to the upper fascial passage (DUF), a mean CSA of 10.84  mm²  ±  4.73 proximal to the lower fascial passage (PLF), a mean CSA of 12.12  mm²  ±  5  at the lower fascial passage (LF), and a mean CSA of 7.89  mm²  ±  3.42 distal to the lower fascial passage (DLF). All transposed nerves presented relevant kinks at the UF, 6 nerves presented relevant kinks at the LF." }, { "role": "assistant", "content": "In cases of secondary ulnar neuropathy after nerve transposition, ultrasound can reliably assess the actual \"situation\" of the nerve and thus at least ease the decision for secondary surgery." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Bile Ducts, Biopsy, Body Mass Index, Disease Progression, Fatty Liver, Female, Humans, Liver Cirrhosis, Liver Cirrhosis, Biliary, Male, Metabolic Syndrome, Middle Aged, Non-alcoholic Fatty Liver Disease, Overweight, Retrospective Studies, Severity of Illness Index, Single-Blind Method." }, { "role": "user", "content": "Is primary biliary cirrhosis more severe in overweight patients? Context: We sought to determine whether features of metabolic syndrome (MS) and histologic features of nonalcoholic steatohepatitis (NASH) are associated with increased fibrosis in patients with primary biliary cirrhosis (PBC). PBC is a chronic, progressive cholestatic disease. MS is strongly associated with NASH and fibrosis progression in some liver diseases. Patients with PBC seen consecutively at the University of Miami between 1985 and 2008 who had antimitochondrial antibody positivity and a liver biopsy performed at this center at the time of diagnosis were identified. Demographics, clinical features, and biochemical parameters were collected. All liver biopsies were reviewed by a single blinded pathologist for features of NASH, PBC, and fibrosis. The impact of NASH and features of MS on liver biopsy findings were analyzed. Forty-nine patients [median age 51 (34 to 78) years, 98% females] were enrolled. Higher degree of steatosis, severe inflammatory grade, and severe biliary duct damage were each associated with advanced fibrosis (P<0.0001). Regarding MS, only overweight status [body mass index (BMI) ≥ 25] was associated with nonalcoholic fatty liver activity score (NAS) ≥ 5 (P<0.0001), biliary duct damage (P<0.0001), and advanced fibrosis (71% vs. 32%, P=0.007). Patients with NAS ≥ 5 had more severe fibrosis (14/15, 96% vs. 11/34, 44%; P=0.0001) and more severe biliary duct damage (13/15, 87% vs. 3/34, 9%; P=<0.0001)." }, { "role": "assistant", "content": "NASH and BMI ≥ 25 are associated with severe biliary duct damage and fibrosis in patients with PBC. BMI could become a useful noninvasive tool to predict advanced fibrosis in PBC. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Which of the following is not a dimorphic fungus?" }, { "role": "assistant", "content": "The correct answer is Ans. d (Cryptococcus neoformans). (Textbook of Microbiology by Anantanarayan, 6th/576)HIGH YIELD FACTS IN FUNGOLOGYYeastC. Neoformans (only pathogenic yeast)Yeast likeCandida albicans (pseudomycelium present)Moulds/filamentous fungiDermatophytesDimorphic (filamentous as well as yeasts)Most fungi causing systemic infection *(not cryptococcus though).Commonest culture mediumSabourauds medium, czapek - dox and cormeal agar are other culture media for fungi.Reynolds-Braude phenomenonRapid method of identifying Candida albicans based on its ability to form germ tube when incubated in human serum at 37 degree for 42 hr.Sclerotic bodyChromoblastomycosisAsteroid bodiesSporotrichosisIndia ink preparationCryptococcus (other stains for it's capsule are alcian blue & mucicarmine)Desert rheumatism/ Valley feverCoccidioidomycosisAspergillusSeptate hypaeNot a dimorphic fungusCryptococcusTuberculate sporesHistoplasma capsulatum" } ]

[ { "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": "Number of Bones in adult skull are:" }, { "role": "assistant", "content": "The correct answer is The skull at birth contains 45 bones.\nThe adult skull consists of 22 bones (OR 28 bones including 3 paired ear ossicles).\n\nCalvaria/brain box - 8 bones (OR 14 bones, including 6 ear ossicles).\nFacial skeleton - 14 bones." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Aminoquinolines, Animals, Apoptosis, Biliary Atresia, Biliary Tract, Chemical and Drug Induced Liver Injury, Cholestasis, DNA Nucleotidylexotransferase, Disease Models, Animal, Gallbladder, Imiquimod, Interferon Regulatory Factor-7, Interferon-alpha, Membrane Glycoproteins, Mice, Mice, Inbred BALB C, RNA, Messenger, Rotavirus, Rotavirus Infections, Toll-Like Receptor 7, Tumor Necrosis Factor-alpha." }, { "role": "user", "content": "Does toll-like receptor 7 agonist induce hypoplasia of the biliary system in a neonatal mouse model? Context: Viral infections and innate immunity signaling, especially Toll-like receptor 7 (TLR7) have been implicated in the pathogenesis of biliary atresia (BA). Administration of rhesus rotavirus-type A to newborn Balb/c mice produces inflammatory obstruction of bile ducts, which resembles human BA. However, whether activation of TLR7 signaling plays a role in neonatal hepatobiliary injury remains to be investigated. TLR7 agonist, imiquimod (R837), was intraperitoneally administered to Balb/c mice within 24 hours of birth and then every other day. Morphological and histological injuries of liver and gallbladder were examined at 2 weeks. Hepatic messenger RNA expression of TLR7 signaling was studied. Terminal deoxynucleotidyl transferase 2'-deoxyuridine 5'-triphosphate nick end labeling staining was used to delineate hepatobiliary apoptosis upon TLR7 stimulation. TLR7 agonist, imiquimod, induced hypoplasia of the biliary system of neonatal Balb/c mice both in atrophic gallbladder and in paucity of intrahepatic bile ducts. There was significantly higher hepatic expression of TLR7 and downstream innate immunity-mediated interferon regulatory factor 7, interferon-α, and tumor necrosis factor-α. In addition, terminal deoxynucleotidyl transferase 2'-deoxyuridine 5'-triphosphate nick end labeling-positive cells in the liver were increased after injections of TLR7 agonist." }, { "role": "assistant", "content": "The results demonstrate that TLR7 activation may trigger innate immunity pathways and induce apoptosis and hypoplasia of neonatal biliary trees in Balb/c mice. The novel findings give an implication of pathogenesis of infantile cholestasis, such as BA. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Aged, Biomarkers, Cohort Studies, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Glucose Intolerance, Humans, Hyperinsulinism, Insulin Resistance, Male, Medical Records, Middle Aged, Mortality, Neoplasms, Netherlands, Proinsulin, Registries, Risk Factors, Survival Analysis." }, { "role": "user", "content": "Are fasting proinsulin levels significantly associated with 20 year cancer mortality rates . The Hoorn Study? Context: Proinsulin is possibly associated with cancer through activation of insulin receptor isoform A. We sought to investigate the associations between proinsulin and 20 year cancer mortality rates. The study was performed within the Hoorn Study, a population-based study of glucose metabolism in individuals aged 50-75 years in the Dutch population. Fasting proinsulin levels were measured twice by a double-antibody radioimmunoassay. Participants were continuously followed to register mortality; causes of death were derived from medical records. Cox survival analyses were performed to assess the 20 year risk of death from cancer in relation to proinsulin. All analyses were adjusted for age and sex, with additional adjustments for traditional risk factors. The effect modification of glucose metabolism and sex was tested. Proinsulin levels were measured in 438 individuals (41% normal glucose tolerance, 35.7% impaired glucose metabolism, 23.3% type 2 diabetes). Of these participants, 53 died from cancer. After adjustment for age and sex, proinsulin >16.5 pmol/l (the upper tertile) was significantly associated with a twofold risk of cancer mortality (HR 2.01, 95% CI 1.16, 3.46) compared with individuals with lower proinsulin levels. Additional adjustment for glucose metabolism, BMI and smoking did not substantially change the results (HR 1.91, 95% CI 1.04, 3.52). No interaction with glucose metabolism or sex was observed." }, { "role": "assistant", "content": "Individuals with fasting proinsulin levels >16.5 pmol/l have a twofold risk of cancer mortality over a 20 year time span. These findings provide population-based evidence for the independent association between high proinsulin levels and cancer mortality rates. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, OBJECTIVES, MATERIALS AND METHODS, RESULTS. Meshes: Belgium, Cosmetics, Dermatitis, Allergic Contact, Detergents, Humans, Paint, Preservatives, Pharmaceutical, Product Labeling, Thiazoles." }, { "role": "user", "content": "Methylisothiazolinone in selected consumer products in Belgium: Adding fuel to the fire? Context: Methylisothiazolinone (MI) contact allergy is severely affecting consumers with allergic contact dermatitis, owing to its presence in cosmetics, household detergents, and water-based paints, in particular. Data on the true isothiazolinone concentrations in these products are scarce, and labelling may be incorrect. To report on the MI concentrations in such products marketed in Belgium, in order to verify the accuracy of labelling (when applicable) and compliance with EU regulations. Thirty cosmetics (18 leave-on and 12 rinse-off), eight detergents and four paints were analysed for MI by the use of high-performance liquid chromatography with ultraviolet detection. The analysed leave-on, and to a lesser extent the rinse-off, cosmetics, contained MI at concentrations far exceeding the permitted 100 ppm use concentration. Household detergents contained high concentrations of MI, and mislabelling occurred for both cosmetics and detergents. The (limited) data on paints are in line with the existing literature." }, { "role": "assistant", "content": "Cosmetics and detergents may facilitate contact sensitization because of a (too) high MI concentration, and mislabelling may make its avoidance extremely difficult. Safer use concentrations and correct labelling should be ensured by adequate quality control." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Presence of it indicates remote contamination of water" }, { "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: Child, Preschool, Conscious Sedation, Drug Monitoring, Evoked Potentials, Auditory, Brain Stem, Female, Fluid Therapy, Humans, Hypotension, Infant, Isotonic Solutions, Magnetic Resonance Imaging, Male, Propofol, Sodium Chloride, Treatment Outcome." }, { "role": "user", "content": "Does a presedation fluid bolus decrease the incidence of propofol-induced hypotension in pediatric patients? Context: Propofol is commonly used in pediatric sedation, which may cause hypotension during induction. Our goal was to determine the effect of a preinduction 20-mL/kg isotonic fluid bolus on propofol-induced hypotension, assess clinical signs of hypoperfusion during hypotension, and evaluate for age-related propofol dosing differences. This prospective, randomized, controlled, nonblinded study was conducted at Children's Hospital of Illinois. Patients were children 6 to 60 months of age who needed sedation for MRI or auditory brainstem-evoked response testing. The treatment group received a preinduction 20-mL/kg isotonic saline bolus before procedure initiation. Patients were continuously monitored via cardiorespiratory monitor with pulse oximetry and end-tidal carbon dioxide measurements. Cardiovascular indices and clinical signs of hypoperfusion were compared between groups, and propofol dosing differences were compared between age groups. One hundred twenty-six patients were randomly assigned to treatment (n=52) or control (n=74) conditions. Twelve patients in the treatment group and 14 patients in the control group experienced postinduction hypotension, as defined by the Pediatric Advanced Life Support guidelines. One patient in each group was given volume resuscitation when blood pressure did not improve after a reduction in the propofol infusion rate. No hypotensive patients had physical signs of hypoperfusion, and patients≤1 year of age needed significantly more propofol." }, { "role": "assistant", "content": "A 20-mL/kg preinduction isotonic saline bolus does not prevent propofol-induced hypotension. No clinical signs of hypoperfusion were noted with induced hypotension, and infants≤12 months old need significantly more propofol per kilogram for procedures. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A female undergoing treatment for infeility with IVF was given Inj. HCG, present with history of vomiting, nausea, and headache. The USG is shown as below, what is the diagnosis?" }, { "role": "assistant", "content": "The correct answer is USG image showing multiple cysts along with h/o undergoing IVF treatment is suggestive of Ovarian Hyperstimulation syndrome Ovarian hyperstimulation syndrome (OHSS) It is a complication of ovarian stimulation treatment (ovarian induction therapy) orin-vitrofeilisation (IVF). Rarely, it may occur in pegnancy as a spontaneous event. Ascites and pleural effusion may also be present USG findings : Bilateral symmetric enlargement of ovaries. Multiple cysts of varying sizes, giving it \"spoke-wheel appearance\"" } ]

[ { "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": "Regarding CEA-false is -" }, { "role": "assistant", "content": "The correct answer is Ans. is 'd' i.e., Elevated only when there is hepatic metastasis" } ]

[ { "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 largest trematode infecting masn is -" }, { "role": "assistant", "content": "The correct answer is large or giant intestinal fluke Largest trematode infecting humans Pig serves as reservoir of infection (refer pgno:127 baveja 3 rd edition)" } ]

[ { "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 young couple expecting their first child present to the obstetrician for routine follow up at 16 weeks gestation. The father suffers from Leber hereditary optic neuropathy and wants to know if is possible that he has passed down the disease to his unborn daughter. The correct response is:" }, { "role": "assistant", "content": "No, the father cannot pass the disease to any offpring." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adolescent, Adult, Aged, Analysis of Variance, Animals, Female, Fibroblast Growth Factor 10, Forced Expiratory Volume, Genetic Predisposition to Disease, Haploinsufficiency, Humans, Male, Mice, Mice, Transgenic, Middle Aged, Pulmonary Disease, Chronic Obstructive, Terbutaline." }, { "role": "user", "content": "Does fibroblast growth factor 10 haploinsufficiency cause chronic obstructive pulmonary disease? Context: Genetic factors influencing lung function may predispose to chronic obstructive pulmonary disease (COPD). The fibroblast growth factor 10 (FGF10) signalling pathway is critical for lung development and lung epithelial renewal. The hypothesis behind this study was that constitutive FGF10 insufficiency may lead to pulmonary disorder. Therefore investigation of the pulmonary functions of patients heterozygous for loss of function mutations in the FGF10 gene was performed. The spirometric measures of lung function from patients and non-carrier siblings were compared and both groups were related to matched reference data for normal human lung function. The patients show a significant decrease in lung function parameters when compared to control values. The average FEV1/IVC quota (FEV1%) for the patients is 0.65 (80% of predicted) and reversibility test using Terbutalin resulted in a 3.7% increase in FEV1. Patients with FGF10 haploinsufficiency have lung function parameters indicating COPD. A modest response to Terbutalin confirms an irreversible obstructive lung disease." }, { "role": "assistant", "content": "These findings support the idea that genetic variants affecting the FGF10 signalling pathway are important determinants of lung function that may ultimately contribute to COPD. Specifically, the results show that FGF10 haploinsufficiency affects lung function measures providing a model for a dosage sensitive effect of FGF10 in the development of COPD. 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 inhalational anesthetic should be avoided in middle ear surgery?" }, { "role": "assistant", "content": "The correct answer is Nitrous oxide is more soluble than nitrogen in blood and diffuses into air-filled cavities quicker than nitrogen diffuses out. The ensuing increased middle ear pressure may be problematic, including potential dislodgement of tympanoplasty grafts. Fuhermore, acute discontinuation of high concentrations of nitrous oxide markedly decreases cavity pressure and may cause serous otitis. Basics of anesthesia 7e pg: 536" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Bronchiolitis Obliterans, Death, Female, Forced Expiratory Volume, Graft Rejection, Heart-Lung Transplantation, Humans, Incidence, Lung Diseases, Lung Transplantation, Male, Middle Aged, Retrospective Studies, Risk Factors, Survival Analysis, Survivors, Time Factors." }, { "role": "user", "content": "Is acute cellular rejection a risk factor for bronchiolitis obliterans syndrome independent of post-transplant baseline FEV1? Context: Post-transplant baseline forced expiratory volume in 1 second (FEV(1)) constitutes a systematic bias in analyses of bronchiolitis obliterans syndrome (BOS). This retrospective study evaluates risk factors for BOS adjusting for the confounding of post-transplant baseline FEV(1). A multivariate survival and competing risk analysis of a large consecutive series of patients (n = 389) from a national center 1992 to 2004. Exclusion criteria were patients not surviving at least 3 months after transplantation (n = 39) and no available lung function measurements (n = 4). The first maximum FEV(1) occurred at a median 183 days post-transplant. Freedom from BOS was 81%, 53%, 38% and 15%, and cumulative incidence of BOS was 18%, 43%, 57% and 77% at 1, 3, 5 and 10 years post-transplantation, respectively. Acute cellular rejection was independently associated with an increased cause-specific hazard of BOS (hazard ratio 1.4, confidence interval 1.1 to 1.8, p = 0.009). The absolute value of baseline FEV(1) was a significant confounder in all survival and competing risk analyses of BOS (p < 0.05)." }, { "role": "assistant", "content": "Despite early diagnosis and prompt treatment, acute cellular rejection remains an independent risk factor for the development of BOS after adjusting for the confounding of post-transplant baseline FEV(1). Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: ." }, { "role": "user", "content": "Does tRAP-seq define markers for novel populations of hypothalamic and brainstem LepRb neurons? Context: Leptin acts via its receptor (LepRb) on multiple subpopulations of LepRb neurons in the brain, each of which controls specific aspects of energy balance. Despite the importance of LepRb-containing neurons, the transcriptome and molecular identity of many LepRb subpopulations remain undefined due to the difficulty of studying the small fraction of total cells represented by LepRb neurons in heterogeneous brain regions. Here we sought to examine the transcriptome of LepRb neurons directly and identify markers for functionally relevant LepRb subsets. We isolated mRNA from mouse hypothalamic and brainstem LepRb cells by Translating Ribosome Affinity Purification (TRAP) and analyzed it by RNA-seq (TRAP-seq). TRAP mRNA from LepRb cells was enriched for markers of peptidergic neurons, while TRAP-depleted mRNA from non-LepRb cells was enriched for markers of glial and immune cells. Genes encoding secreted proteins that were enriched in hypothalamic and brainstem TRAP mRNA revealed subpopulations of LepRb neurons that contained neuropeptide-encoding genes (including prodynorphin, Pdyn) not previously used as functional markers for LepRb neurons. Furthermore, Pdyn (cre) -mediated ablation of Lepr (flox) in Pdyn-expressing neurons (LepRb (Pdyn) KO mice) blunted energy expenditure to promote obesity during high-fat feeding." }, { "role": "assistant", "content": "TRAP-seq of CNS LepRb neurons defines the LepRb neuron transcriptome and reveals novel markers for previously unrecognized subpopulations of LepRb neurons. 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": "Van den Berg test for" }, { "role": "assistant", "content": "The correct answer is ref : harissons 21st ed" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Acetylation, Adenylate Kinase, Animals, Apoptosis, Blotting, Western, Capillaries, Cellular Senescence, Diabetes Mellitus, Type 2, Endothelium, Vascular, Fluorescent Antibody Technique, Forkhead Box Protein O1, Forkhead Transcription Factors, Gene Silencing, Hyperglycemia, Hypoglycemic Agents, Metformin, Mice, Mice, Inbred C57BL, Reactive Oxygen Species, Signal Transduction, Sirtuin 1, beta-Galactosidase." }, { "role": "user", "content": "Does metformin modulate hyperglycaemia-induced endothelial senescence and apoptosis through SIRT1? Context: Endothelial dysfunction can be detected at an early stage in the development of diabetes-related microvascular disease and is associated with accelerated endothelial senescence and ageing. Hyperglycaemia-induced oxidative stress is a major contributing factor to the development of endothelial dysfunction. Clinical data indicate that the hypoglycaemic agent, metformin, has an endothelial protective action; however, its molecular and cellular mechanisms remain elusive. In the present study, we have investigated the protective effect of metformin during hyperglycaemia-induced senescence in mouse microvascular endothelial cells (MMECs). MMECs were cultured in normal glucose (11 mM) and high glucose (HG; 40 mM) in the presence and absence of metformin (50 μM) for 72 h. The expression of sirtuin-1 (SIRT1) and senescence/apoptosis-associated markers was determined by immunoblotting and immunocyto techniques. SIRT1 expression was inhibited with appropriate siRNA. Exposure of MMECs to HG significantly reduced SIRT1 protein expression, increased forkhead box O1 (FoxO-1) and p53 acetylation, increased p21 and decreased Bcl2 expression. In addition, senescence-associated β-galactosidase activity in MMECs was increased in HG. Treatment with metformin attenuated the HG-induced reduction of SIRT1 expression, modulated the SIRT1 downstream targets FoxO-1 and p53/p21, and protected endothelial cells from HG-induced premature senescence. However, following gene knockdown of SIRT1 the effects of metformin were lost." }, { "role": "assistant", "content": "HG-induced down-regulation of SIRT1 played a crucial role in diabetes-induced endothelial senescence. Furthermore, the protective effect of metformin against HG-induced endothelial dysfunction was partly due to its effects on SIRT1 expression and/or activity. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A most common complication of scaphoid fracture" }, { "role": "assistant", "content": "The correct answer is Avascular necrosis is associated with long-term steroid use and drinking too much alcohol. It's most common in people between the ages of 30 and 60 and often affects the hip.\nEarly stages may be symptom-free. Eventually, the affected joint may hurt when weight is put on it or when lying down.\nTreatment includes physiotherapy, surgery and medication." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Aged, Alleles, Carcinoma, Non-Small-Cell Lung, Case-Control Studies, China, Chromosomes, Human, Pair 5, Female, Gene Frequency, Genetic Loci, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Lung Neoplasms, Male, Membrane Proteins, Middle Aged, Models, Genetic, Neoplasm Proteins, Polymorphism, Single Nucleotide, Risk Factors." }, { "role": "user", "content": "Does replication study in Chinese population and meta-analysis support association of the 5p15.33 locus with lung cancer? Context: Common genetic polymorphisms on chromosome 5p15.33, including rs401681 in cleft lip and palate transmembrane 1-like gene (CLPTM1L), have been implicated in susceptibility to lung cancer through genome-wide association studies (GWAS); however, subsequent replication studies yielded controversial results. A hospital-based case-control study in a Chinese population was conducted to replicate the association, and then a meta-analysis combining our non-overlapping new data and previously published data was performed to clearly discern the real effect of lung cancer susceptibility. In our study with 611 cases and 1062 controls, the minor allele T carrier (TT plus CT) group conferred an OR of 0.801 (95% CI = 0.654-0.981) under the dominant model. The meta-analysis comprising 9111 cases and 11424 controls further confirmed the significant association in the dominant model (OR = 0.842, 95% CI = 0.795-0.891). By stratified analysis, we revealed that ethnicity and study design might constitute the source of between-study heterogeneity. Besides, the sensitivity and cumulative analyses indicated the high stability of the results." }, { "role": "assistant", "content": "The results from our case-control study and meta-analysis provide convincing evidence that rs401681 is significantly associated with lung cancer risk. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, MATERIALS AND METHODS, RESULTS. Meshes: Brain Neoplasms, Female, Humans, Lung Neoplasms, Male, Middle Aged, Neoplasms, Unknown Primary, Prevalence, Retrospective Studies, Tomography, X-Ray Computed." }, { "role": "user", "content": "Search for a primary lung neoplasm in patients with brain metastasis: is the chest radiograph sufficient? Context: We assessed whether chest CT provided an advantage over chest radiography when diagnosing a primary lung neoplasm in a selected group of patients. From a retrospective evaluation of 925 patients who had a discharge diagnosis of brain metastasis, we identified 32 patients who presented without a known primary tumor site and who were investigated subsequently with both chest radiography and CT. Reports of chest radiographs were classified as showing a primary lung neoplasm (positive), as abnormal but nonspecific, or as negative. Patients were categorized as having negative chest radiograph, negative CT; positive chest radiograph, positive CT; nonspecific chest radiograph, positive CT; or negative chest radiograph, positive CT. Radiographic technique and clinical and lesion characteristics were compared among these categories. We found negative chest radiograph and negative CT in one patient who ultimately proved to have breast cancer. The remaining 31 patients (97%) had primary lung carcinoma. In 19 (59%) of the 32 patients, chest radiographs and CT were positive. Twelve patients (38%) had a nonspecific or negative chest radiograph and positive CT. In the 31 patients with lung carcinoma, the mean diameter of lesions in patients with positive chest radiographs was 4.2 cm, compared with 2.5 cm in patients with normal or nonspecific radiographs (p<.01)." }, { "role": "assistant", "content": "Lung cancer is by far the most common cause of a de novo presentation with brain metastasis. Chest CT is valuable to supplement chest radiography in patients with metastatic brain disease in whom a primary lesion is sought. Lesion size appears to be the most important determinant of detectability of a primary tumor on chest radiographs." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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-Inflammatory Agents, Non-Steroidal, Azoles, Biomimetic Materials, Endoplasmic Reticulum Stress, Glutathione, Glutathione Peroxidase, Human Umbilical Vein Endothelial Cells, Humans, Organoselenium Compounds, Oxidative Stress, Sodium Selenite, Trace Elements." }, { "role": "user", "content": "Do the glutathione mimic ebselen inhibits oxidative stress but not endoplasmic reticulum stress in endothelial cells? Context: Reactive oxygen species are associated with cardiovascular disease, diabetes, and atherosclerosis, yet the use of antioxidants in clinical trials has been ineffective at improving outcomes. In endothelial cells, high-dextrose-induced oxidative stress and endoplasmic reticulum stress promote endothelial dysfunction leading to the recruitment and activation of peripheral blood lymphocytes and the breakdown of barrier function. Ebselen, a glutathione peroxidase 1 (GPX1) mimic, has been shown to improve β-cell function in diabetes and prevent atherosclerosis. To determine if ebselen inhibits both oxidative stress and endoplasmic reticulum (ER) stress in endothelial cells, we examined its effects in human umbilical vein endothelial cells (HUVEC) and human coronary artery endothelial cells (HCAEC) with and without high-dextrose. Oxidative stress and ER stress were measured by 2-methyl-6-(4-methoxyphenyl)-3,7-dihydroimidazo[1,2-A]pyrazin-3-one hydrochloride chemiluminescence and ER stress alkaline phosphatase assays, respectively. GPX1 over-expression and knockdown were performed by transfecting cells with a GPX1 expression construct or a GPX1-specific siRNA, respectively. Ebselen inhibited dextrose-induced oxidative stress but not ER stress in both HUVEC and HCAEC. Ebselen also had no effect on tunicamycin-induced ER stress in HCAEC. Furthermore, augmentation of GPX1 activity directly by sodium selenite supplementation or transfection of a GPX1 expression plasmid decreased dextrose-induced oxidative stress but not ER stress, while GPX1 knockout enhanced oxidative stress but had no effect on ER stress." }, { "role": "assistant", "content": "These results suggest that ebselen targets only oxidative stress but not ER stress. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 17-year-old male comes to the physician because of painful genital sores, malaise, and fever for 3 days. He is sexually active with 3 female partners and does not use condoms consistently. His temperature is 38.3°C (101°F). Physical examination shows tender lymphadenopathy in the left inguinal region and multiple, punched-out ulcers over the penile shaft and glans. Microscopic examination of a smear from the ulcer is most likely to show which of the following?" }, { "role": "assistant", "content": "Eosinophilic intranuclear inclusions" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Breast Neoplasms, Female, Humans, Lymphatic Metastasis, Middle Aged, Neoplasm Recurrence, Local, Phosphorylation, Prognosis, STAT3 Transcription Factor, Suppressor of Cytokine Signaling 3 Protein, Suppressor of Cytokine Signaling Proteins." }, { "role": "user", "content": "Is loss of SOCS3 expression associated with an increased risk of recurrent disease in breast carcinoma? Context: Constitutive activation of JAK/STAT pathway is observed in various solid tumors and hematological malignancies. SOCS3 acts as a key negative regulator of JAK/STAT pathway and represents one of the candidate tumor suppressor genes. In the current study, we aimed to evaluate SOCS3 expression in breast carcinoma and to explore the prognostic significance of SOCS3. The expression of SOCS3 was measured by Western blot and immunohistochemistry in breast carcinoma cells and a large cohort of tissue microarray, respectively. Among 367 human primary breast tumors, SOCS3 protein was detected in 103 patients. Deficient SOCS3 expression correlated significantly with lymph node metastasis (P = 0.003), blood vessel invasion (P = 0.029), VEGF (P = 0.001) and Ki-67 (P = 0.027). Univariate and multivariate analyses revealed that SOCS3 expression was an independent prognostic factor for disease-free survival (P < 0.0001). A positive SOCS3 protein expression correlated significantly with a low pSTAT3 protein expression in breast carcinoma (P = 0.015). The patients with a SOCS3 (+)/pSTAT3 (-) phenotype had a better prognosis than any other combination (DFI: P < 0.0001, BCSS: P = 0.013)." }, { "role": "assistant", "content": "Deficient expression of SOCS3 is associated with an aggressive phenotype and portends a poor clinical outcome in breast carcinoma. 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": "Sclerosing cholangitis Is most likely seen in?" }, { "role": "assistant", "content": "The correct answer is Ans. A. Ulcerative colitisExtra colonic manifestations of UC:-a. Constitutional symptoms- fever, weight loss.b. Arthritis (Sacroiliitis)c. Anterior uveitisd. Ankylosing spondylitis.e. Erythema nodosumf. Sclerosing cholangitis.g. Thromboembolic events.h. Cholestasisi. Pyoderma ganginosum" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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: Cadherins, Child, Child, Preschool, Cohort Studies, Gene Deletion, Gene Rearrangement, Genome, Human, Haplotypes, Heterozygote, Humans, Polymerase Chain Reaction, Usher Syndromes." }, { "role": "user", "content": "Are large genomic rearrangements within the PCDH15 gene a significant cause of USH1F syndrome? Context: Protocadherin-15 (PCDH15) is one of the five genes currently identified as being mutated in Usher 1 syndrome and defines Usher syndrome type 1F (USH1F). When PCDH15 was systematically analyzed for mutations in a cohort of USH1 patients, a number of deletions were found. Here we characterize these deletions as to extent, position, and breakpoints. Microsatellite and single nucleotide polymorphism (SNP) analyses, used in a preliminary survey of an Usher cohort of 31 patients, revealed large deletions in three patients. These deletions were further characterized by semiquantitative PCR assays to narrow down the breakpoints. The analysis of the three large deletions revealed that all six breakpoints are different. The breakpoint junction was identified in one patient and the four other breakpoints were mapped to 4 kb. There were no specific distinguishing features of the isolated breakpoints." }, { "role": "assistant", "content": "A complete screen of PCDH15 should include a search for large deletions. Failure to screen for gross genomic rearrangements is likely to significantly lower the mutation detection rate. A likely explanation for the high rate of such deletions is the unusual gene structure. PCDH15 gene spans nearly 1 Mb for a corresponding open reading frame (ORF) of 7,021 bp. The intron sizes of PCDH15 are up to 150 kb, and the first three exons of the gene cover 0.42 Mb. The genomic structure of any gene should be taken into consideration when designing a mutation screening strategy. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "Primary hyperaldosteronism presents with all of the following except-" }, { "role": "assistant", "content": "The correct answer is there is potassium depletion causing hypokalemia ( Harrison 17 pg2260)" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "A 60-year-old man comes to the physician because of persistent fatigue over the past ten months. His previous annual health maintenance examination showed no abnormalities. He appears pale. Physical examination shows numerous petechial lesions over the abdomen and marked splenomegaly. His serum hemoglobin concentration is 9.4 g/dL, leukocyte count is 4,100/mm3, and thrombocyte count is 110,000/mm3. A peripheral blood smear shows large white blood cells with centrally placed nuclei and multiple fine, radial cytoplasmic projections that stain positively for tartrate-resistant acid phosphatase (TRAP). Which of the following is the most likely characteristic of the medication used as first-line treatment for this patient's condition?" }, { "role": "assistant", "content": "Resistant to breakdown by adenosine deaminase" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Phytogenic, Apoptosis, Artemisinins, Artesunate, Cell Line, Tumor, Cell Proliferation, Endometrial Neoplasms, Female, Humans." }, { "role": "user", "content": "Does [ Artesunate suppress human endometrial carcinoma RL95-2 cell proliferation by inducing cell apoptosis ]? Context: To investigate the inhibitory effect of artesunate on human endometrial carcinoma RL95-2 cell line proliferation in vitro and the possible mechanisms. The inhibitory effect of artesunate on the cell proliferation was assessed with MTT assay. Transmission electron miscrosopy was used to observe the morphological change of the cells after the treatment. Flow cytometry was performed to examine the changes in the cell cycle, reactive oxygen species (ROS) levels (with DCFH-DA labeling) and mitochondrial membrane potential (rhodamine123 staining), and caspase-3 activity was detected by immunohistochemistry. Artesunate inhibited the proliferation of RL95-2 cells with an IC(50) of 26.29 microg/ml. Transmission electron microscopy revealed early apoptotic changes of the cells with obvious chromatin fragmentation. The cell cycle arrest at G(0)/G(1) phase was observed by flow cytometry, and immunohistochemistry demonstrated caspase-3 positivity in cytoplasm. ROS generation in the cells increased obviously after treatment with artesunate for 72 h, which also resulted in lowered mitochondrial membrane potential." }, { "role": "assistant", "content": "Artesunate suppressed the proliferation of RL95-2 cells in vitro possibly by inducing cell apoptosis. 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, METHODS, RESULTS. Meshes: Adult, Age of Onset, Alzheimer Disease, Atrophy, Brain, Case-Control Studies, Disease Progression, Disease Susceptibility, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Positron-Emission Tomography, Presenilin-1." }, { "role": "user", "content": "Does hypometabolism exceed atrophy in presymptomatic early-onset familial Alzheimer 's disease? Context: The aim of the present study is to compare brain atrophy with hypometabolism as preclinical markers of Alzheimer's disease (AD) by studying presymptomatic individuals from families with known early-onset autosomal dominant AD (FAD) carrying mutations in the Presenilin 1 gene. Seven asymptomatic at-risk FAD individuals (age, 35-49 y; 4 women; education >/= 12 y) and 7 matched healthy control subjects received complete clinical, neuropsychologic, MRI, and (18)F-FDG PET examinations. Regions of interest (ROIs: whole brain [WB], hippocampus [Hip], entorhinal cortex [EC], posterior cingulate cortex [PCC], inferior parietal lobule [IPL], and superior temporal gyrus (STG]) were drawn on the MRI scans of all subjects and used to measure volumes on MRI and glucose metabolism (MRglc) from the MRI-coregistered, atrophy-corrected PET scans. Compared with controls and after correcting for head size, MRI volume reductions in FAD subjects were restricted to the IPL (18%, P < 0.02). After atrophy correction and adjusting for pons MRglc, PET MRglc reductions were found in all FAD subjects compared with controls in the WB (13%), bilaterally in the IPL (17%) and in the STG (12%), and in the left EC (21%), PCC (20%), and Hip (12%) (P values < 0.05). PET MRglc measurements were consistently less variable than MRI measures, yielding significantly larger effect sizes in separating FAD from controls." }, { "role": "assistant", "content": "Presymptomatic FAD individuals show widespread MRglc reductions consistent with the typical AD PET pattern in the relative absence of structural brain atrophy. These data further suggest that PET MRglc measures may serve as biomarkers for the preclinical diagnosis of AD. 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": "Dissection of which aery is seen in pregnancy -" }, { "role": "assistant", "content": "The correct answer is Answer is 'b' i.e. Aoa" } ]

[ { "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 an etiological factor in Mirizzi's syndrome?" }, { "role": "assistant", "content": "The correct answer is Mirizzi's syndrome refers to obstruction of common hepatic duct resulting from compression by a gallstone impacted in the cystic duct. Two types of Mirizzi's syndrome are: Type I : Hepatic duct is compressed by a large stone impacted in the cystic duct or Haman's pouch. Type II: Calculus has eroded into the hepatic duct to produce a cholecystocholedochal fistula. Investigations: Ultrasonography reveals gallstones with a contracted gallbladder and moderate intrahepatic ductal dilatation with normal extrahepatic biliary anatomy." } ]

[ { "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 true regarding lung volumes during pregnancy" }, { "role": "assistant", "content": "The correct answer is FRC decreases by 30 % during pregnancy. Residual volume decreases. Lung compliance is unchanged during pregnancy." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Aneurysm, C-Reactive Protein, Female, Follow-Up Studies, Humans, Logistic Models, Male, Middle Aged, Neurologic Examination, Subarachnoid Hemorrhage, Thrombospondin 1, Time Factors, Tomography Scanners, X-Ray Computed, Ultrasonography, Doppler, Transcranial, Vasospasm, Intracranial." }, { "role": "user", "content": "Do elevated cerebrospinal fluid levels of thrombospondin-1 correlate with adverse clinical outcome in patients with aneurysmal subarachnoid hemorrhage? Context: Thrombospondin-1 (TSP-1) is a homotrimeric glycoprotein which modulates a wide range of biological functions. Elevated level of TSP-1 in plasma was reported to be correlated with intracerebral hemorrhage. Our study was designed to investigate the relationship between cerebrospinal fluid (CSF) TSP-1 levels and clinical outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH). CSF TSP-1 levels were measured in 31 aSAH patients on days 1-3, days 5-7 and days 8-10 after aSAH onset using enzyme-linked immunosorbent assay. Patients were under a close follow-up until death or completion of three months after aSAH. Binary logistic regression analyses were performed to determine independent risk factors for the clinical outcomes. TSP-1 levels peaked on days 1-3 after aSAH, kept up high on days 5-7 and remained elevated until days 8-10 (p<0.05). Significant elevation of CSF TSP-1 levels were found in patients both with and without vasospasm. Modified Rankin Scale at 3months after aSAH showed a significant correlation with CSF TSP-1 levels on days 1-3 and days 5-7 (both p<0.01). Binary logistic regression analysis showed that higher TSP-1 level on days 1-3 (p<0.05) and on days 5-7 (p<0.05) was a predictive marker of cerebrovasospasm and poor outcome of patient with aSAH." }, { "role": "assistant", "content": "Upregulation of TSP-1 may involve in the pathological process of aSAH and might be a risk factor of future adverse prognosis of aSAH. 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, Antimetabolites, Cell Differentiation, Cells, Cultured, Deoxyglucose, Glucose, Hypoglycemic Agents, Insulin, Muscle Fibers, Skeletal, Muscle, Skeletal, Myoblasts, Plasmids, Rats, Resistin, Transfection." }, { "role": "user", "content": "Does prolonged exposure to resistin inhibit glucose uptake in rat skeletal muscles? Context: To assess the effects and mechanisms of the action of resistin on basal and insulin-stimulated glucose uptake in rat skeletal muscle cells. Rat myoblasts (L6) were cultured and differentiated into myotubes followed by stimulation with single commercial resistin (130 ng/mL, 0-24 h) or cultured supernatant from 293-T cells transfected with resistin-expressing vectors (130 ng/mL, 0-24 h). Liquid scintillation counting was used to quantitate [3H] 2-deoxyglucose uptake. The translocation of insulin-sensitive glucose transporters GLUT4 and GLUT1, synaptosomal-associated protein 23 (SNAP23) and GLUT protein content, as well as the tyrosine phosphorylation status and protein content of insulin receptor substrate (IRS)-1, were assessed by Western blotting. Treatment of L6 myotubes with single resistin or cultured supernatant containing recombinant resistin reduced basal and insulin-stimulated 2-deoxyglucose uptake and impaired insulin-stimulated GLUT4 translocation. While SNAP23 protein content was decreased, no effects were noted in GLUT4 or GLUT1 protein content. Resistin also diminished insulin-stimulated IRS-1 tyrosine phosphorylation levels without affecting its protein content. The effects of recombinant resistin from 293-T cells transfected with resistin-expressing vectors were greater than that of single resistin treatment." }, { "role": "assistant", "content": "Resistin regulated IRS-1 function and decreased GLUT4 translocation and glucose uptake in response to insulin. The downregulated expression of SNAP23 may have been partly attributed to the decrease of glucose uptake by resistin treatment. These observations highlight the potential role of resistin in the pathophysiology of type 2 diabetes related to obesity. 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, Aorta, Connective Tissue, Endothelium, Vascular, Gene Expression, Hyperplasia, Immunohistochemistry, Inflammation, Lymphangiogenesis, Macrophages, Male, Neovascularization, Pathologic, RNA, Messenger, Rats, Rats, Wistar, Reverse Transcriptase Polymerase Chain Reaction, Tunica Intima." }, { "role": "user", "content": "Do aortic adventitial angiogenesis and lymphangiogenesis promote intimal inflammation and hyperplasia? Context: Adventitial inflammation is known to influence neointimal formation and vascular remodeling. The present study was aimed to clarify the relationship between neointima hyperplasia and adventitial angiogenesis and lymphangiogenesis after balloon-induced aortic endothelial injury. Seventy male Wistar rats were randomly divided into six interventional groups and one control group. The intimal area/medial area ratio (I/M ratio), the adventitial macrophage index, and the number of adventitial microvessels (Ad-MV) and lymphatic vessels (Ad-LV) in the aorta were measured, and the mRNA expressions of VEGF-A, VEGFR-1, VEGF-C, VEGFR-3, PDGF-B, and PDGFR-beta in the aortic wall were quantified by real-time RT-PCR. Compared with the control group, the I/M ratio, macrophage index, Ad-MV, Ad-LV, and the mRNA expressions of VEGF-A, VEGFR-1, VEGF-C, VEGFR-3, PDGF-B, and PDGFR-beta in interventional groups increased significantly after balloon-induced injury. I/M ratio showed significant correlations with Ad-MV and Ad-LV after balloon intervention. Multiple linear regression analysis indicated that Ad-MV and Ad-LV were independent factors of intimal hyperplasia." }, { "role": "assistant", "content": "Adventitial angiogenesis and lymphangiogenesis are induced by intimal inflammation after balloon injury, and these neogenetic vessels in turn promote intimal inflammation and hyperplasia probably via delivery and activation of inflammatory cells. Final Decision: yes" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response." }, { "role": "user", "content": "All are false statements regarding atherosclerotic plaque formation except ?" }, { "role": "assistant", "content": "The correct answer is Atherosclerotic plaque Subintimal collections of fat, smooth muscle cells, fibroblasts. Tends to develop at branching sites due to turbulence flow in epicardial vessels Characteristic -Grow into intima and media of epicardial coronary vessels and don't encroach lumen initially Mycotic aneurysm usually develops at site of an atherosclerotic plaque." } ]

[ { "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 SLE except?" }, { "role": "assistant", "content": "The correct answer is Shrinking lung syndrome is a feature of SLE but it is characterized by diaphragmatic myopathy leading to appearance of small lungs radiologically. Pulmonary fibrosis due to interstitial inflammation is seen in SLE. Premature atherosclerosis is a recognized feature of secondary anti-phospholipid syndrome. The vegetations in Libman sacks endocarditis are sterile and seen on inferior surface of valve cups N.S.I.P is common in connective tissue disorders . But remember that U.I.P is more commonly seen in Rheumatoid ahritis than N.S.I.P Clinical manifestations of SLE at onset and during disease. Signs and Symptoms Prevalence at Onset Prevalence at any Time Ahralgia 77% 85% Rashes 53% 78% Constitutional 53% 77% Kidney involvement 38% 74% Ahritis 44% 63% Raynaud phenomenon 33% 60% CNS involvement (most commonly headache) 24% 54% GI (most commonly abdominal pain) 18% 45% Lymphadenopathy 16% 32% Pleurisy 16% 30% Pericarditis 13%" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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, Aged, Bone Density, Femur Neck, Hip Fractures, Humans, Male, Predictive Value of Tests, Retrospective Studies, Risk Assessment, Sensitivity and Specificity, Spinal Fractures." }, { "role": "user", "content": "Is femoral neck shaft angle width associated with hip-fracture risk in males but not independently of femoral neck bone density? Context: To investigate the specificity of the neck shaft angle (NSA) to predict hip fracture in males. We consecutively studied 228 males without fracture and 38 with hip fracture. A further 49 males with spine fracture were studied to evaluate the specificity of NSA for hip-fracture prediction. Femoral neck (FN) bone mineral density (FN-BMD), NSA, hip axis length and FN diameter (FND) were measured in each subject by dual X-ray absorptiometry. Between-mean differences in the studied variables were tested by the unpaired t-test. The ability of NSA to predict hip fracture was tested by logistic regression. Compared with controls, FN-BMD (p < 0.01) was significantly lower in both groups of males with fractures, whereas FND (p < 0.01) and NSA (p = 0.05) were higher only in the hip-fracture group. A significant inverse correlation (p < 0.01) was found between NSA and FN-BMD. By age-, height- and weight-corrected logistic regression, none of the tested geometric parameters, separately considered from FN-BMD, entered the best model to predict spine fracture, whereas NSA (p < 0.03) predicted hip fracture together with age (p < 0.001). When forced into the regression, FN-BMD (p < 0.001) became the only fracture predictor to enter the best model to predict both fracture types." }, { "role": "assistant", "content": "NSA is associated with hip-fracture risk in males but is not independent of FN-BMD. 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": "Filgrastim is used for the treatment of" }, { "role": "assistant", "content": "The correct answer is Refer Katzung 11/e p 580-581 Filgrstim (G-CSF) and sargramostim(GM-CSF) are used to prevent or treat chemotherapy induced neutropenia Erythropoietin is used to treat anemia assosciated with chronic renal failure and cancer chemotherapy" } ]

[ { "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 malignant tumor of parotid gland is?" }, { "role": "assistant", "content": "The correct answer is ANSWER: (A) Mucoepidermoid carcinomaREF: Sabiston Textbook of Surgery, 18th ed. Chapter 33\"Mucoepidermoid carcinoma is the most common malignant tumor of the parotid gland and can be divided into low-grade and high-grade tumors\"Also know:Most common benign & overall tumor of parotid gland is pleomorphic adenomaSecond most common tumor of parotid gland is warthin's tumorMost common malignant tumor of parotidgland is mucoepidermoid carcinomaMost common tumor of parotid gland in children is hemangiomaParotid tumor ivhich spreads by perineural invasion is Adenoid cystic carcinoma" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, METHODS, METHODS, RESULTS. Meshes: Absorptiometry, Photon, Adult, Age Factors, Aged, Bone Density, Cross-Sectional Studies, Female, Humans, Interleukin-6, Middle Aged, Osteocalcin, Osteoporosis, Postmenopausal, Postmenopause." }, { "role": "user", "content": "Do elevated plasma levels of interleukin-6 in postmenopausal women correlate with bone density? Context: To determine if plasma levels of Interleukin-6 (IL-6) across the lifespan correlate with bone density or plasma osteocalcin. Cross-sectional study. Forty-five healthy community-dwelling volunteers aged 25-74 years. Exclusion criteria were smoking use of medications known to affect bone metabolism (corticosteroids, heparin, thyroxine, thiazides, and anticonvulsants), and presence of chronic inflammatory disease. Bone density was measured by dual-energy X-ray absorptiometry at the femoral neck and lumbar spine. Plasma levels of IL-6 and osteocalcin were determined by ELISA and RIA, respectively. Plasma levels of IL-6 increased with advancing age (P < .0001) and correlated with postmenopausal status (P < .0001). No correlation was observed between plasma IL-6 level and bone mineral density at either the lumbar spine or femoral neck, and none was observed with plasma osteocalcin." }, { "role": "assistant", "content": "The elevation of plasma IL-6 observed following menopause is consistent with the proposed importance of estrogen in the regulation of IL-6. These findings do not provide support for a role of IL-6 in determination of peak bone density or subsequent development of osteoporosis. However, it is possible that plasma levels of IL-6 differ from those in the bone microenvironment. Final Decision: no" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Animals, Biomechanical Phenomena, Coated Materials, Biocompatible, Diamond, Femur, Implants, Experimental, Osseointegration, Osteogenesis, Rats, Rats, Wistar, Titanium." }, { "role": "user", "content": "Is early bone growth on the surface of titanium implants in rat femur enhanced by an amorphous diamond coating? Context: Amorphous diamond (AD) is a durable and compatible biomaterial for joint prostheses. Knowledge regarding bone growth on AD-coated implants and their early-stage osseointegration is poor. We investigated bone growth on AD-coated cementless intramedullary implants implanted in rats. Titanium was chosen as a reference due to its well-known performance. We placed AD-coated and non-coated titanium implants (R(a) ≈ 0.2 μm) into the femoral bone marrow of 25 rats. The animals were divided in 2 groups according to implant coating and they were killed after 4 or 12 weeks. The osseointegration of the implants was examined from hard tissue specimens by measuring the new bone formation on their surface. 4 weeks after the operation, the thickness of new bone in the AD-coated group was greater than that in the non-coated group (15.3 (SD 7.1) μm vs. 7.6 (SD 6.0) μm). 12 weeks after the operation, the thickness of new bone was similar in the non-coated group and in the AD-coated group." }, { "role": "assistant", "content": "We conclude that AD coating of femoral implants can enhance bone ongrowth in rats in the acute, early stage after the operation and might be an improvement over earlier coatings. 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, METHOD, RESULTS. Meshes: Adult, Age Factors, Aged, Coronary Disease, Cross-Sectional Studies, Diabetes Mellitus, Electrocardiography, Female, Humans, Incidence, Iran, Kidney Failure, Chronic, Male, Middle Aged, Prognosis, Risk Factors." }, { "role": "user", "content": "Is chronic kidney disease comparable to diabetes as a coronary artery disease risk factor? Context: Chronic kidney disease (CKD) is one of the known risk factors for coronary heart disease (CHD). Though electrocardiograms (ECGs) have limited accuracy in determining the true prevalence of CHD, we wondered whether CKD and diabetes mellitus (DM) controlled for hypertension (HTN), had similar prevalences of ECG abnormalities that could reflect underlying coronary heart disease. Data were collected for 5,942 men and women aged 30 to 69 years in the Tehran Lipid and Glucose Study (TLGS), a crosssectional phase of a large epidemiologic study first initiated in 1999. ECG findings of all subjects were coded according to Minnesota ECG coding criteria. The Whitehall criteria for abnormal ECG findings that could represent ischemia were utilized. Creatinine clearance (Crcl) was estimated using the Cockroft-Gault equation and diabetes was defined according to the American Diabetic Association (ADA) criteria. Subjects with moderate CKD and without DM were compared with the patients with DM without CKD. HTN prevalence was similar. The analysis was performed for all Whitehall ECG ischemia abnormalities combined, and separately for pathologic Q waves. In spite of an overall similar prevalence of smoking, and a lower incidence of dyslipidemia and HTN, moderate CKD patients had a higher prevalence of Whitehall criteria abnormal ECG findings compared with the patients with DM. Over 19% of patients with CKD had abnormal ECG findings while 14.7% of diabetic patients had abnormal ECGs (P = 0.02). The prevalence of Q waves was 11.5% in patients with CKD and 10.8% in patients with DM. In an age-matched subgroup of patients with DM and no CKD, the prevalence of ECG abnormalities was 19.3%, similar to the patients with moderate CKD and no DM (19.7%) (P = 0.9). The prevalence of pathologic Q waves in an age-matched group was 11.45%, compared with 11.5%, respectively." }, { "role": "assistant", "content": "Moderate CKD is a major risk factor for the development of the Whitehall ECG criteria which have been associated with ischemic heart disease. The importance of CKD as a risk factor for ECG abnormalities is comparable with DM. Patients with moderate CKD probably are candidates for aggressive CHD risk modification." } ]

[ { "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": "Increased level of 5 HIAA is seen in which disease?" }, { "role": "assistant", "content": "The correct answer is (C) Carcinoid tumor[?]SPECIFIC MARKERS FOR CARCINOID TUMORSoBiochemical Markers: Often elevated in NETs and can be a surrogate marker of symptoms of hormone excess or tumor growth.oChromogranin A levels are elevated in approximately 80% of patients with GI NETs.-Sensitivity is 75% and specificity 85%-Falsely positive elevated - PPI or H2 receptor antagonist, hepatic or renal failure.oUrine 5-hydroxyindoleacetic acid (5-HIAA), the primary metabolite of serotonin, is elevated in carcinoid syndrome.-Sensitivity of 35% & Specificity of 100%.-Abnormal levels (>5mg/24 hours) of 5-HIAA are diagnostic of carcinoid syndrome.-To avoid false positive results - avoid some diet & medications[?]ACTHoLaboratory Evaluation-Carcinoid: 24 hour urinary 5-HIAA raised in carcinoid tumours of the fore-gut and mid-gut but not generally raised in tumors of the hind-gut.-Gastrinoma: Raised basal serum gastrin, high gastric acid secretion.-Insulinoma: Raised fasting insulin/glucose ratio, proinsulin or C-peptide.[?]Carcinoid Syndrome:oCause: Excess serotonin level when the metabolic pathway to 5-HIAA is bypassed.-With extensive liver metastasis-With 1.... Pulmonary/ovarian carcinoidsoRecurrent diarrhea (70%)oRight sided endocardial fibroelastosis (35%), resulting in tricuspid regurgitation and right heart failure.oDesquamative skin lesions / pellagra / nausea / vomiting / fever / cutaneous flushing .... (5%).oPrognosis: Carcinoid Syndrome has a higher morbidity and mortality than does the tumour itself.oNeuroendocrine cells tumor of intestine especially the appendix. Mostly, asymptomatic. When secrete serotonin result in carcinoid syndrome. Serotonin metabolites (urinary 5-HIAA) used in screening & help in diagnosis along with CT. Primary managed surgically & chemotherapy used in secondary.INCREASED LEVEL OF 5 HIAA IS SEEN IN CARCINOID TUMOR-5 Secreted peptide hormone(s)Pancreatic NETClinical manifestation / syndromeIslet CellAlpha (a)GlucagonGlucagonomaDiabetes, dermatitis, NMEBeta (b)InsulinInsulinomaFasting hypoglycemia, neuroglycopeniaDelta (d)SomatostatinSomatostatinomaSteatorrhea, cholelithiasis, mild diabetesA-DVIP, other WDHA5-HT ACTHMSHCarcinoidCushing SyndromeHyperpigmentationInteracinar cellFPancreatic polypeptide (PP)PomaNon-functional or various syndromeEC5-HTCarcinoidCarcinoid syndrome (facial flushing, secretory diarrhea, wheezing, right-sided heart valve abnormalities)VIP, Vasoactive intestinal peptide; 5-HT, serotonin; ACH, andrenocarticotropin; MSH, melanocyte stimulating hormone; WDHA, watery diarrhea, hypokalemia, achlorhydria; EC, enterochromaffin; Modified from: National cancer institute at the national institutes of health, pancreatic neuroendocrine tumors (islet cell tumors) Treatment (PDQ): Health professional version" } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND AND OBJECTIVES, MEASUREMENTS, RESULTS. Meshes: Adult, Aged, Alabama, Anticoagulants, Catheters, Indwelling, Chi-Square Distribution, Cost Savings, Dose-Response Relationship, Drug, Drug Costs, Equipment Design, Female, Fibrinolytic Agents, Heparin, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Proportional Hazards Models, Renal Dialysis, Retrospective Studies, Risk Assessment, Risk Factors, Thrombosis, Time Factors, Tissue Plasminogen Activator." }, { "role": "user", "content": "Does the heparin lock concentration affect hemodialysis catheter patency? Context: Concentrated heparin solutions are instilled into the catheter lumens after each hemodialysis session to prevent catheter thrombosis. The heparin lock concentration at many centers has been decreased recently to reduce the risk of systemic bleeding and contain costs. However, the effect of this change on catheter patency is unknown. We compared catheter patency between two heparin lock solutions: 1000 versus 5000 units/ml.DESIGN, SETTING, PARTICIPANTS, & With use of a prospective, computerized, vascular access database, 105 patients with newly placed tunneled hemodialysis catheters, including 58 patients receiving a 5000 units/ml heparin lock and 47 patients receiving a 1000 units/ml heparin lock, were retrospectively identified. The primary endpoint was cumulative catheter patency and the secondary endpoint was frequency of thrombolytic instillation. Cumulative catheter survival was similar in the two groups, being 71% versus 73% at 120 days in the low- and high-concentration heparin lock groups (hazard ratio of catheter failure, 0.97; 95% confidence interval, 0.45 to 2.09; P = 0.95). The frequency of tissue plasminogen activator instillation was significantly greater in the low-concentration heparin group (hazard ratio, 2.18; 95% CI, 1.26 to 3.86; P = 0.005). No major bleeding complications were observed in either treatment group. The overall drug cost for maintaining catheter patency was 23% lower with the low-concentration heparin lock ($1418 versus $1917) to maintain catheter patency for 1000 days." }, { "role": "assistant", "content": "Low-concentration heparin lock solutions do not decrease cumulative dialysis catheter patency, but require a twofold increase in thrombolytic instillation to maintain long-term patency." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical 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 AND RESULTS. Meshes: Adolescent, Adult, Blood Pressure, Cardiovascular Diseases, Cohort Studies, Follow-Up Studies, Humans, Hypertension, Incidence, Male, Myocardial Infarction, Obesity, Registries, Risk Factors, Stroke, Sweden." }, { "role": "user", "content": "Does obesity modify the effect of blood pressure on the risk of cardiovascular disease? Context: Some studies have suggested that increased blood pressure has a stronger effect on the risk of cardiovascular disease (CVD) in lean persons than in obese persons, although this is not a universal finding. Given the inconsistency of this result, we tested it using a large population-based cohort data set. Systolic and diastolic blood pressures (BPs) and body mass index were measured in 1 145 758 Swedish men born between 1951 and 1976 who were in young adulthood (median age 18.2 years). During the register-based follow-up, which lasted until the end of 2006, 65 611 new CVD events took place, including 6799 myocardial infarctions and 8827 strokes. Hazard ratios (HRs) per 1-SD increase in systolic and diastolic BP were computed within established body mass index categories (underweight, normal, overweight, or obese) with Cox proportional hazards models. The strongest associations of diastolic BP with CVD (HR 1.18), myocardial infarction (HR 1.22), and stroke (HR 1.13) were observed in the obese category. For systolic BP, the strongest associations were observed in the obese category with CVD (HR 1.16) and stroke (HR 1.29) but in the overweight category with myocardial infarction (HR 1.19). We observed statistically significant interactions (P<0.0001) with body mass index for diastolic BP in relation to CVD and for systolic BP in relation to CVD and stroke." }, { "role": "assistant", "content": "In contrast to the findings of previous studies, we observed a general increase in the magnitude of the association between blood pressure and subsequent CVD with increasing body mass index. Hypertension should not be regarded as a less serious risk factor in obese than in lean or normal-weight persons." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, BACKGROUND, METHODS, RESULTS. Meshes: Aged, Body Surface Potential Mapping, Cardiac Catheterization, Electrophysiologic Techniques, Cardiac, Female, Humans, Male, Middle Aged, Prospective Studies, Time Factors, Ventricular Fibrillation." }, { "role": "user", "content": "Does rotor stability separate sustained ventricular fibrillation from self-terminating episodes in humans? Context: This study mapped human ventricular fibrillation (VF) to define mechanistic differences between episodes requiring defibrillation versus those that spontaneously terminate. VF is a leading cause of mortality; yet, episodes may also self-terminate. We hypothesized that the initial maintenance of human VF is dependent upon the formation and stability of VF rotors. We enrolled 26 consecutive patients (age 64 ± 10 years, n = 13 with left ventricular dysfunction) during ablation procedures for ventricular arrhythmias, using 64-electrode basket catheters in both ventricles to map VF prior to prompt defibrillation per the institutional review board-approved protocol. A total of 52 inductions were attempted, and 36 VF episodes were observed. Phase analysis was applied to identify biventricular rotors in the first 10 s or until VF terminated, whichever came first (11.4 ± 2.9 s to defibrillator charging). Rotors were present in 16 of 19 patients with VF and in all patients with sustained VF. Sustained, but not self-limiting VF, was characterized by greater rotor stability: 1) rotors were present in 68 ± 17% of cycles in sustained VF versus 11 ± 18% of cycles in self-limiting VF (p < 0.001); and 2) maximum continuous rotations were greater in sustained (17 ± 11, range 7 to 48) versus self-limiting VF (1.1 ± 1.4, range 0 to 4, p < 0.001). Additionally, biventricular rotor locations in sustained VF were conserved across multiple inductions (7 of 7 patients, p = 0.025)." }, { "role": "assistant", "content": "In patients with and without structural heart disease, the formation of stable rotors identifies individuals whose VF requires defibrillation from those in whom VF spontaneously self-terminates. Future work should define the mechanisms that stabilize rotors and evaluate whether rotor modulation may reduce subsequent VF risk. 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": "Least chances of complication like dumping syndrome and diarrhoea are seen in the following condition:" }, { "role": "assistant", "content": "The correct answer is Vagal denervation of just the parietal cell area of the stomach is called parietal cell vagotomy or proximal gastric vagotomy. The technique spares the nerves of Latarjet but divides all vagal branches that terminate on the proximal two thirds of the stomach. Parietal cell vagotomy appears to have about the same effectiveness as truncal or selective vagotomy for curing the ulcer disease, but dumping and diarrhea are much less frequent. It is probably the procedure of choice for intractable and perforated duodenal ulcers and is relatively less useful for obstructing and bleeding ulcers. The principal disadvantage is recurrent ulceration in about 10% of patients. Ref: Dohey G.M., Way L.W. (2010). Chapter 23. Stomach & Duodenum. In G.M. Dohey (Ed), CURRENT Diagnosis & Treatment: Surgery, 13e." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Cells, Cultured, Electron Transport Complex I, Electron Transport Complex IV, Fibroblasts, Gene Expression, Gene Expression Profiling, Humans, Low-Level Light Therapy, Mitochondria, Mitochondrial Proton-Translocating ATPases, Transcription, Genetic, Up-Regulation." }, { "role": "user", "content": "Does low-intensity laser irradiation at 660 nm stimulate transcription of genes involved in the electron transport chain? Context: Low-intensity laser irradiation (LILI) has been shown to stimulate cellular functions leading to increased adenosine triphosphate (ATP) synthesis. This study was undertaken to evaluate the effect of LILI on genes involved in the mitochondrial electron transport chain (ETC, complexes I-IV) and oxidative phosphorylation (ATP synthase). Four human skin fibroblast cell models were used in this study: normal non-irradiated cells were used as controls while wounded, diabetic wounded, and ischemic cells were irradiated. Cells were irradiated with a 660 nm diode laser with a fluence of 5 J/cm(2) and gene expression determined by quantitative real-time reverse transcription (RT) polymerase chain reaction (PCR). LILI upregulated cytochrome c oxidase subunit VIb polypeptide 2 (COX6B2), cytochrome c oxidase subunit VIc (COX6C), and pyrophosphatase (inorganic) 1 (PPA1) in diabetic wounded cells; COX6C, ATP synthase, H+transporting, mitochondrial Fo complex, subunit B1 (ATP5F1), nicotinamide adenine dinucleotide (NADH) dehydrogenase (ubiquinone) 1 alpha subcomplex, 11 (NDUFA11), and NADH dehydrogenase (ubiquinone) Fe-S protein 7 (NDUFS7) in wounded cells; and ATPase, H+/K+ exchanging, beta polypeptide (ATP4B), and ATP synthase, H+ transporting, mitochondrial Fo complex, subunit C2 (subunit 9) (ATP5G2) in ischemic cells." }, { "role": "assistant", "content": "LILI at 660 nm stimulates the upregulation of genes coding for subunits of enzymes involved in complexes I and IV and ATP synthase. 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": "Spring catarrh is which type of hypersensitivity reaction -a) type Ib) type IIc) type IIId) type IVe) type V" }, { "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, MATERIAL AND METHODS, RESULTS. Meshes: Adult, Energy Metabolism, Female, Humans, Male, Middle Aged, Muscle, Skeletal, Occupational Diseases, Occupational Health, Occupations, Oxygen Consumption, Physical Exertion, Poland, Reference Values, Sex Factors, Women, Working, Work Capacity Evaluation, Workload." }, { "role": "user", "content": "Can heaviness of the work for women be the same as for men? Context: Considering recent suggestions that the same work heaviness should be made admissible for women and men, a study has been undertaken to assess to what extent does the fatigue, in terms of total index of physiological cost of work, differ in women and men performing a job of the same heaviness or at the same level of workload (%VO2 max). The study group consisted of 147 women and 114 men performing jobs with dominant share of physical effort employed in a post-office, a chemical plant and a cold store. Their energy expenditure during work were determined and their maximum oxygen intake were assessed from the results of stress test. A questionnaire survey was performed to collect information about self-assessed work heaviness, work fatigue (0-100 scores) and chronic fatigue (Checklist Individual Strength--CIS20R Questionnaire), and also about frequency of abandoning, because of fatigue, some daily chore or \"just for pleasure\" activity. Mean energy expenditure during a work day in the study group of women was 504 kcal, while for men the respective value was 1204 kcal; the workload (%VO2 max) being 17.8% and 20.6%, respectively. However, the distribution of self-assessed work severity, work fatigue and chronic fatigue was similar in both groups, while the increase in work fatigue and chronic fatigue with growing energy expenditure was higher in women than in men. The frequency at which women and men abandoned their pleasure-motivated activities was similar; as to the \"daily chore\" activities, women used to abandon these more frequently than men, and they did so at a lower level of fatigue." }, { "role": "assistant", "content": "Abolition of the regulations that prevent free accessibility of women to jobs requiring high physical effort is not advisable because it would result in their increased fatigue; it may also limit their ability to perform non-occupational duties as well as impair their health condition." } ]

[ { "role": "system", "content": "Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response. Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Angiopoietin-2, Arthritis, Rheumatoid, Biomarkers, Bone Resorption, Comorbidity, Female, Humans, Incidence, Male, Matrix Metalloproteinase 3, Middle Aged, RANK Ligand, Synovitis, Ultrasonography, Doppler, Vascular Endothelial Growth Factor A." }, { "role": "user", "content": "Are ultrasonographic examination of rheumatoid arthritis patients who free of physical synovitis : power Doppler subclinical synovitis is associated with bone erosion? Context: The aim of this study was to investigate the characteristics of power Doppler (PD) subclinical synovitis in patients with RA who achieve clinical remission free from physical synovitis. Twenty-nine RA patients were consecutively enrolled. All of the patients had achieved clinical remission [simplified disease activity index (SDAI) 3.3] for at least 6 months at the musculoskeletal ultrasound (MSKUS) examination. Additionally, none of the patients exhibited tender joints at 68 sites or swollen joints at 66 sites. MSKUS of bilateral wrist and finger joints, including the first to fifth MCP joints, the first IP joint and the second to fifth PIP joints, was performed and the findings obtained by grey scale (GS) and PD were graded on a semi-quantitative scale from 0 to 3. The median disease duration upon the introduction of DMARDs was 3 months and that at MSKUS examination was 21 months. The percentages of patients with PD synovitis in at least one joint were PD grade 1, 58.6%; PD grade 2, 31.0% and PD grade 3, 6.9%. The use of biological agents was low in patients with PD synovitis grade 2 (P < 0.05). The presence of US bone erosion was high by patient (P < 0.05) and by joint (P < 0.0001) with PD synovitis as compared with those without PD synovitis. However, no correlations were found between PD synovitis measures and serum biomarkers, including angiogenesis factors." }, { "role": "assistant", "content": "PD subclinical synovitis correlates with several clinical characteristics, whereas conventional serum biomarkers are not useful for indicating the presence of subclinical PD synovitis. Final Decision: yes" } ]