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As a virtual doctor, respond to the user's medical queries and provide relevant guidance. | I have an question regarding my diabetes. Iam 27 year old and i just got my test done like 20 days ago. Hemoglobin aic was 5.7% and mean plasma glucose was 126 mg/dl. my primary physician said that i have increased risk of diabetes. i was looking online they are saying that sugar level should be 70 to 130mg/dl before meal and less than 180mg/dl after meal. i just wanna tell you that day ate breakfast in the morning. so it means my glucose is under 180mg/dl. iam kinda confused.please help me. i think i dont have any risk. i did not tell my doctor that i ate that morning. | Hi, dairy have gone through your question. I can understand your concern. You should go for fasting blood glucose level and 2 hours after meal. Fasting level should be less than 100 mg/DL and post radial level should be less than 140 mg/DL. Your hemoglobin is very low. You should go for ultrasound abdomen and peripheral smear examination. Then take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ Chat Doctor. Thanks for using Chat Doctor. Wish you a very good health. |
You're a doctor, kindly address the medical queries according to the patient's account.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Do individual patients hold different beliefs to prescription medications to which they persist vs nonpersist and persist vs nonfulfill?
###Context: Our objective was to explore whether adults hold different beliefs about medications to which they persist vs nonpersist and persist vs nonfulfull. We conducted a cross-sectional survey of adults with asthma, hypertension, diabetes, hyperlipidemia, osteoporosis, or other cardiovascular disease from the Harris Interactive Chronic Illness Panel. A quota was set to obtain a sample of respondents who were persistent to a medication for one disease and nonpersistent or nonfulfilling to a medication for a second, different disease. Respondents completed 32 items yielding five multi-item scales: perceived need for medication (k = 12), side-effect concerns (k = 5), medication-safety concerns (k = 5), perceived disease severity (k = 3), and knowledge about the prescribed medication (k = 7). Respondents completed the 32 items twice - once for their persistent medication and a second time for their nonpersistent or nonfulfilling medication. Paired sample t-tests (bivariate) and generalized estimating equations (GEE) models (multivariate) were used to test the study hypotheses. Overall, 178 respondents were sampled for being persistent to one medication and nonpersistent to another, while 48 respondents were persistent to one medication and nonfulfilling to a second. For the medication to which an individual patient was persistent vs nonpersistent, there was significantly higher perceived need, fewer side-effect concerns, higher perceived disease severity, and better knowledge about the medication. For the medication to which an individual patient was persistent vs nonfulfilling, there was significantly higher perceived need, fewer side-effect concerns, and better knowledge about the medication. | Individual patients hold different beliefs about medications to which they persist vs nonpersist or nonfulfill. Patients exhibit different medication-taking behaviors for different medications because they weigh the perceived risks and benefits for each medication separately. These results suggest that adherence interventions should be tailored to patients' beliefs about specific medications.
###Answer: yes |
In the clinical text, your objective is to identify relationships between medical problems, treatments, and tests. Medical problems are tagged as @problem$, medical tests as @test$, and treatments as @treatment$. Classify the relationship between two entities as one of the following:
Treatment improves medical problem (TrIP)
Treatment worsens medical problem (TrWP)
Treatment causes medical problem (TrCP)
Treatment is administered for medical problem (TrAP)
Treatment is not administered because of medical problem (TrNAP)
Test reveals medical problem (TeRP)
Test conducted to investigate medical problem (TeCP)
Medical problem indicates medical problem (PIP)
No Relations | @problem$ , Hypertension , Hyperlipidemia , Diabetes Mellitus , Hypothyroid , h/o Bilateral DVT 's ( on chronic coumadin therapy ), Pleural disorder ? Sarcoidosis , Gastritis , @problem$ , Chronic renal insufficiency , s/p Appendectomy , s/p Lap cholectomy , s/p Total abdominal hysterectomy | No Relations |
Your role as a doctor requires you to answer the medical questions taking into account the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does increased serum sodium values in brain-dead donor 's influence its long-term kidney function?
###Context: Kidney transplantation in Poland predominantly (95%) involves brain dead donors that display associated endocrine disorders. Diabetes insipidus, the most common complication, results in hypernatremia, hypovolemia, and increased plasma osmolality. Hypernatremia in donors is one of the strongest risk factors for the loss of a transplanted liver or heart. However, the influence of donor hypernatremia on early and late kidney graft function has not been entirely established to date. We analyzed data for 80 kidney recipients from 54 brain dead donors during 2006-2008. Donors showed a positive correlation between serum sodium and creatinine concentrations (P = .001) and a negative correlation between serum sodium concentrations and creatinine clearances (P < .005). Donors divided into two groups based on a median sodium concentration of 155 mM revealed significantly lower values of glomerular filtration rate in recipients of the group with sodium concentrations >155 mM. No relationship was observed between donor serum sodium concentration and early or 1-year function. There was a negative correlation between donors serum sodium concentration and creatinine clearance in recipients at 2, 3, and 4 years after kidney transplantation (P = .008, .00033, and .02, respectively). Multivariate analysis confirmed the influence of donor sodium concentration on creatinine clearance at 2 and 3 years after renal transplantation (P < .05 and P > .01, respectively). | High serum sodium concentrations and increased plasma osmolality in brain dead kidney donors adversely affect long-term graft function probably due to initiation of an inflammation processes.
###Answer: yes |
As a medical professional, your responsibility is to address the medical questions using the patient's description.
Answer with the best option directly. | ###Question: A 67-year-old man comes to the emergency department because of decreased vision and black spots in front of his left eye for the past 24 hours. He states that it feels as if 'a curtain is hanging over his eye.' He sees flashes of light intermittently. He has no pain or diplopia. He underwent cataract surgery on the left eye 2 weeks ago. He has hypertension and type 2 diabetes mellitus. His sister has open-angle glaucoma. Current medications include metformin, linagliptin, ramipril, and hydrochlorothiazide. Vital signs are within normal limits. Examination shows a visual acuity in the right eye of 20/25 and the ability to count fingers at 3 feet in the left eye. The pupils are equal and reactive. The corneal reflex is present. The anterior chamber shows no abnormalities. The confrontation test is normal on the right side and shows nasal and inferior defects on the left side. Cardiopulmonary examination shows no abnormalities. The patient is awaiting dilation for fundus examination. Which of the following is the most likely diagnosis?
###Options:
A. Degenerative retinoschisis
B. Retinal detachment
C. Endophthalmitis
D. Hemorrhagic choroidal detachment
| ###Answer: OPTION B IS CORRECT. |
Your task is to determine the relationships between medical problems, treatments, and tests within the clinical text. Medical problems are marked as @problem$, medical tests are marked as @test$, and treatments are marked as @treatment$. Categorize the relationship between two entities in the text as one of the following options:
Treatment improves medical problem (TrIP)
Treatment worsens medical problem (TrWP)
Treatment causes medical problem (TrCP)
Treatment is administered for medical problem (TrAP)
Treatment is not administered because of medical problem (TrNAP)
Test reveals medical problem (TeRP)
Test conducted to investigate medical problem (TeCP)
Medical problem indicates medical problem (PIP)
No Relations | Adult-onset diabetes mellitus x 40 years , history of silent myocardial infarction , @treatment$ ( three vessels in 1987 ) , history of chronic , stable angina pectoris , Fournier 's gangrene versus necrotizing fasciitis , congestive heart failure in 03/97 while in the hospital for @problem$ , glaucoma , diabetic retinopathy with blindness in the right eye , history of gastric stapling , left rib fracture , right femur surgery . | No Relations |
You're a doctor, kindly address the medical queries according to the patient's account.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Are low circulating 25-hydroxyvitamin D concentrations associated with defects in insulin action and insulin secretion in persons with prediabetes?
###Context: Individuals with prediabetes mellitus (PreDM) and low circulating 25-hydroxyvitamin D [25(OH)D] are at increased risk of type 2 diabetes mellitus (T2DM). We aimed to determine whether low 25(OH)D concentrations are associated with defects in insulin action and insulin secretion in persons with PreDM. In this cross-sectional study, we stratified 488 nondiabetic subjects as having PreDM or normal fasting glucose (NFG) and a 25(OH)D concentration ≤20 ng/mL (deficient) or >20 ng/mL (sufficient). We determined insulin resistance by steady state plasma glucose (SSPG) concentration and homeostasis model assessment of insulin resistance (HOMA-IR) and insulin secretion by homeostasis model assessment of β-cell function (HOMA-β). We compared insulin resistance and secretion measures in PreDM and NFG groups; 25(OH)D-deficient and 25(OH)D-sufficient groups; and PreDM-deficient, PreDM-sufficient, NFG-deficient, and NFG-sufficient subgroups, adjusting for age, sex, race, body mass index, multivitamin use, and season. In the PreDM group, mean SSPG concentration and HOMA-IR were higher and mean HOMA-β was lower than in the NFG group (P < 0.001 for all comparisons). In the 25(OH)D-deficient group, mean SSPG concentration was higher (P < 0.001), but neither mean HOMA-IR nor HOMA-β was significantly different from that in the 25(OH)D-sufficient group. In the PreDM-deficient subgroup, mean (95% CI) SSPG concentration was higher (P < 0.01) than in the PreDM-sufficient, NFG-deficient, and NFG-sufficient subgroups [192 (177-207) mg/dL vs. 166 (155-177) mg/dL, 148 (138-159) mg/dL, and 136 (127-144) mg/dL, respectively]. Despite greater insulin resistance, mean HOMA-β was not significantly higher in the PreDM-deficient subgroup than in the PreDM-sufficient, NFG-deficient, and NFG-sufficient subgroups [98 (85-112) vs. 91 (82-101), 123 (112-136), and 115 (106-124), respectively]. | Subjects with PreDM and low circulating 25(OH)D concentrations are the subgroup of nondiabetic individuals who are the most insulin resistant and have impaired β-cell function, attributes that put them at enhanced risk of T2DM.
###Answer: yes |
As a medical professional, your responsibility is to address the medical questions using the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does point-of-care HbA1c screening predict diabetic status of dental patients?
###Context: Mutual production of proinflammatory cytokines causes a deleterious cyclic relationship between uncontrolled diabetes and periodontal disease. The prevalence of diabetes is escalating out of control. Early detection of pre-diabetes and diabetes may respectively prevent or delay disease onset and eliminate or decrease complications. The dental office offers an opportune site for diabetes screening. This study investigated the ability to precisely screen previously unidentified dental patients for diabetes and pre-diabetes. In this predictive correlational study, participants were chosen by convenience sampling, and were included based on self-proclaimed risk factors. A point-of-care (POC) fingerstick HbA1c screening identified participants for confirming venous HbA1c laboratory screenings. Kendall's tau analyzed the relationship between POC HbA1c results and classification as diabetic or pre-diabetic based on laboratory HbA1c results. Chi Square, Likelihood Ratio, Cramer's V and Lambda compared the expected and observed results. Of the 104 diabetes risk questionnaires completed, 75 participants were included in the POC screening. Of these, 34 (71% female and 29% male) had HbA1c levels at or above the American Diabetes Association's (ADA) recommended 5.7% cut-point for pre-diabetes. Three participants were less than age 44, 10 were 44 to 57, and 21 were over 57. Laboratory results categorized 6 participants as normoglycemic and 28 with HbA1c greater than or equal to 5.7%. Kendall's tau (p=0.004) determined POC results can predict diabetic or pre-diabetic laboratory group assignment. Pearson's chi-square (p=0.004), Likelihood ratio (p=0.004) and Cramer's V (p<0.001) concluded a relationship existed between group assignment based on POC HbA1c results and those of subsequent laboratory HbA1c results; Lambda (p=0.145) did not. | Within the limits of this study, it was established that a safe and minimally invasive dental chair-side POC HbA1c screening unveiled previously unidentified diabetic and pre-diabetic patients.
###Answer: yes |
Considering your role as a medical practitioner, please use the patient's description to answer the medical questions.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is high normal 2-hour plasma glucose associated with insulin sensitivity and secretion that may predispose to type 2 diabetes?
###Context: The aim of this study was to evaluate differences in insulin sensitivity, insulin secretion and risk factors for cardiovascular disease between subjects with a 2-h plasma glucose (2hPG) level within the normal range (NPG) and subjects with IGT, following a 75-g OGTT. We also aimed to determine the respective contributions made by 2hPG and fasting plasma glucose to the metabolic risk profile. We compared cardiovascular risk factors and insulin sensitivity and insulin secretion by using several indices calculated using measurements obtained during an OGTT. Subjects (n=643, age 18-71 years) were participants in the Quebec Family Study and were categorised according to 2hPG as having low NPG (2hPG <5.6 mmol/l, the group median for normal values), high NPG (2hPG 5.6-7.7 mmol/l) or IGT (2hPG 7.8-11.0 mmol/l). Subjects with type 2 diabetes were excluded from all analyses. Beta cell function and insulin sensitivity progressively decreased with increasing 2hPG. Compared with subjects with low NPG, subjects with high NPG were more insulin-resistant (p<0.05) and had reduced insulin secretion (adjusted for insulin resistance) (p<0.001). They also had higher plasma triglyceride concentrations (p<0.01) and cholesterol:HDL cholesterol ratios (p<0.05). These differences remained even after adjustment for age, sex, BMI and waist circumference. Multivariate analyses showed that 2hPG was closely associated with risk factors for diabetes and with cardiovascular variables, including triglycerides (p<0.0001) and apolipoprotein B (p<0.01). | These results show that deteriorations in glucose-insulin metabolism, which may predispose individuals to type 2 diabetes and cardiovascular disease, are already present in subjects with 2hPG concentrations within the high normal range. Independently of obesity, 2hPG was found to explain, in part, the variance observed in cardiovascular and diabetes risk factors. In addition, elevated 2hPG was associated with metabolic alterations that appear to be the most detrimental to metabolic health. Thus, 2hPG values within the high normal range may be an important marker for the identification of people at risk of complications related to type 2 diabetes.
###Answer: yes |
As a healthcare professional, please evaluate the patient's description and offer your expertise in answering the medical questions.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does pyruvate inhibit zinc-mediated pancreatic islet cell death and diabetes?
###Context: We have shown that zinc ion (Zn2+) in secretory granules of pancreatic beta cells could act as a paracrine death effector in streptozotocin-induced diabetes. As Zn2+ has been reported to perturb glycolysis, we studied if pyruvate could inhibit Zn(2+)-mediated islet cell death in vitro and streptozotocin-induced diabetes in vivo by normalizing intracellular energy metabolism. Cell death was measured by quantitative viable cell staining and Hoechst/propidium iodide staining. ATP was measured by bioluminescence determination. Pyruvate was infused through the tail vein 1 h before streptozotocin administration. Beta-cell volume was measured by point counting of the insulin-containing cells. Zn2+ induced classical necrosis on MIN6N8 insulinoma cells which was associated with a rapid decline of intracellular ATP levels. Pyruvate inhibited Zn(2+)-induced necrosis of insulinoma cells and depletion of intracellular ATP by Zn2+. Pyruvate did not inhibit other types of necrosis or apoptosis. Energy substrates such as oxaloacetate, alpha-ketoglutarate and succinic acid dimethylester also attenuated Zn(2+)-induced insulinoma cell death. Methylpyruvate that does not generate NAD+ in the cytoplasm or alpha-ketoisocaproate that stimulates ATP generation exclusively in mitochondria also protected insulinoma cells from Zn(2+)-induced necrosis. Pyruvate infusion inhibited the development of diabetes by protecting beta-cell mass after streptozotocin administration. | These results indicate that pyruvate inhibits Zn(2+)-induced necrosis of beta cells in vitro by protecting intracellular ATP levels and also streptozotocin-induced diabetes in vivo where Zn2+ has been reported to act as a paracrine death effector.
###Answer: yes |
Your task is to offer medical advice and answers to questions posed by users regarding their health. | mother is diagnosed with renal kidney failure with creatinine level of 4 and her diabetes is 265 fasting. is dialysis recommended now or not. also her glycosylated hb level is 10.6 and in her urine examination tells pusells - plenty. rbc - 0-1 cells/hpf and epithellal 15-20 cells ;;please help what needs to be done. | Hi, dairy have gone through your question. I can understand your concern. Your mother has heavy diabetes with heavy urinary tract infection. She needs to control her diabetes and urinary infection first. Sheet needs insulin to control diabetes. Levofloxacin or norfloxacin or cephalosporin can be used to control urinary tract infection. In most of the cases if we control sugar and infection, renal function is improved automatically. If kidney functions doesn't improve with these measures then only dialysis is needed depending on cause. Consult your doctor and plan accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health. |
As a healthcare professional, please evaluate the patient's description and offer your expertise in answering the medical questions.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does change in growth differentiation factor 15 concentrations over time independently predict mortality in community-dwelling elderly individuals?
###Context: Growth differentiation factor 15 (GDF-15) is emerging as a powerful risk indicator in both cardiovascular disease patients and community-dwelling individuals. We investigated GDF-15 concentrations and their changes over 5 years in elderly individuals from the community, together with the underlying conditions and prognostic implications of these measurements. We analyzed GDF-15 concentrations using a sandwich immunoassay in participants from the PIVUS (Prospective Investigation of the Vasculature in Uppsala Seniors) study. Measurements were performed at both 70 (n = 1004) and 75 (n = 813) years of age. Median follow-up was 8.0 years. Over time, GDF-15 concentrations increased by 11.0% (P < 0.001). These changes were related to male sex, hypertension, diabetes, heart failure, renal function, and concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP). Significant relationships also emerged between changes in GDF-15 and changes in concentrations of NT-proBNP and C-reactive protein (CRP) and renal function between ages 70 and 75. The R(2) value of the model including all covariates was 0.20. GDF-15 concentrations independently predicted all-cause mortality [hazard ratio 4.0 (95% CI 2.7-6.0)] with results obtained at ages 70 and 75 as updated covariates. Baseline GDF-15 concentrations improved prognostic discrimination and reclassification [C statistic 0.06 (P = 0.006); integrated discrimination improvement = 0.030 (P = 0.004); category-free net reclassification improvement = 0.281 (P = 0.006)]. The change in GDF-15 concentrations over time independently predicted even all-cause mortality occurring after age 75 [hazard ratio 3.6 (95% CI 2.2-6.0)]. | GDF-15 concentrations and their changes over time are powerful predictors of mortality in elderly community-dwelling individuals. GDF-15 concentrations increase with aging, and these changes are explained only partially by cardiovascular risk factors, indicators of neurohumoral activation and inflammation, and renal function. Thus GDF-15 reflects both cardiovascular and other biological processes closely related to longevity.
###Answer: yes |
Your role as a doctor requires you to answer the medical questions taking into account the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is high serum pentosidine but not esRAGE associated with prevalent fractures in type 1 diabetes independent of bone mineral density and glycaemic control?
###Context: Fracture risk in type 1 diabetes (T1D) is supposed to be underestimated by bone mineral density (BMD). Individuals with T1D had more prevalent fractures in a cross-sectional study. Serum levels of pentosidine, an advanced glycation end product, and poor glycaemic control were associated with prevalent fractures independent of BMD. Type 1 diabetes (T1D) is associated with increased fracture risk. Bone mineral density (BMD) underestimates the risk of fractures in some individuals. The accumulation of advanced glycation end products (AGEs) impairs bone matrix and reduces bone strength. In a cross-sectional study, 128 men and premenopausal women with T1D were evaluated. We compared traditional risk factors for fractures, BMD, parameters of bone metabolism and AGEs in individuals with and without prevalent fractures. An independent association of serum AGE levels with prevalent fractures was investigated. Individuals with prevalent fractures exhibited a longer duration of T1D, higher HbA1c and more diabetic-related complications. BMD at the femoral neck (z-score -0.76 ± 0.94 vs. -0.23 ± 1.02; p = 0.031) and total hip (z-score -0.54 ± 0.93 vs. 0.11 ± 1.11; p = 0.017) was lower in those with prevalent fractures. Individuals with fractures had higher pentosidine levels (164.1 ± 53.6 vs. 133.2 ± 40.4; p = 0.002). The levels of N-ε-(carboxymethyl)-lysine (CML) and endogenous secretory receptor for AGEs (esRAGE) did not significantly differ. Multivariate logistic regression analysis adjusted for age, BMI, family history of fractures, smoking, vitamin D deficiency, BMD at lumbar spine, femoral neck and total hip identified pentosidine levels and HbA1c as independent factors associated with prevalent fractures (odds ratio 1.02, 95% CI 1.00-1.03/pmol/ml increase of pentosidine; p = 0.008 and odds ratio 1.93, 95% CI 1.16-3.20 per percentage increase of HbA1c; p = 0.011). | The pentosidine levels but not BMD are independently associated with prevalent fractures. Impaired bone quality in T1D may result from increased AGE formation.
###Answer: yes |
Given your profession as a doctor, please provide responses to the medical questions using the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is eosinophil count positively correlated with albumin excretion rate in men with type 2 diabetes?
###Context: Patients with allergic disorders such as allergic rhinitis or asthma have been reported to be at increased risk for atherosclerosis. In this study, we evaluated the relationships between peripheral eosinophil count and degree of albumin excretion rate, which is a useful marker of cardiovascular mortality as well as diabetic nephropathy in patients with type 2 diabetes. We evaluated relationships of peripheral eosinophil count to degree of albumin excretion rate as well as to major cardiovascular risk factors, including age, BP, serum lipid concentration, and glycemic control (glycosylated hemoglobin); body mass index; current treatment for diabetes; smoking status; and presence of cardiovascular disease in 783 patients (416 men and 367 women) with type 2 diabetes. Log(eosinophil count) was positively associated with systolic BP (r = 0.124, P = 0.0108), serum triglyceride concentration (r = 0.108, P = 0.0284), and log(albumin excretion rate) (r = 0.301, P < 0.0001) in men; however, no association was found between log(eosinophil count) and log(albumin excretion rate) (r = 0.085, P = 0.1050) in women. Multivariate linear regression analysis demonstrated that log(eosinophil count) (beta = 0.260, P < 0.0001), duration of diabetes (beta = 0.203, P = 0.0003), glycosylated hemoglobin (beta = 0.117, P = 0.0238), systolic BP (beta = 0.205, P = 0.0001), and serum triglyceride concentration (beta = 0.162, P = 0.0038) were independent determinants of log(albumin excretion rate) in men. | Allergic disorders may be associated with microalbuminuria in men with type 2 diabetes.
###Answer: yes |
Your identity is a doctor, kindly provide answers to the medical questions with consideration of the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Are interleukin-6 and tumor necrosis factor-alpha increased in patients with Type 2 diabetes : evidence that plasma interleukin-6 is related to fat mass and not insulin responsiveness?
###Context: Our aim was to examine the possible direct relationship of interleukin-6 and TNFalpha with insulin sensitivity in humans. We carried out two series of euglycaemic-hyperinsulinaemic clamp experiments. In the first (CLAMP1), skeletal muscle mRNA expression and plasma concentrations of IL-6 and TNFalpha were examined in patients with Type 2 diabetes ( n=6), subjects matched for age (n=6), and young healthy (n=11) control subjects during a 120-min supra-physiological hyperinsulinaemic (40 mU.m(-2).min(-1)) euglycaemic clamp. In the second series of experiments (CLAMP2), patients with Type 2 diabetes (n=6) and subjects matched for age (n=7) were studied during a 240-min high-physiological hyperinsulinaemic (7 mU.m(-2).min(-1)) euglycaemic clamp, during which arterial and venous (femoral and subclavian) blood samples were measured for IL-6 and TNFalpha flux. In both experiments the glucose infusion rate in the patients was markedly lower than that in the other groups. In CLAMP1, basal skeletal muscle IL-6 and TNFalpha mRNA were the same in all groups. They were not affected by insulin and they were not related to the glucose infusion rate. In CLAMP2, neither cytokine was released from the arm or leg during insulin stimulation in either group. In both experiments plasma concentrations of these cytokines were similar in the patients and in the control subjects, although in CLAMP1 the young healthy control group had lower (p<0.05) plasma IL-6 concentrations. Using data from all subjects, a strong positive correlation (r=0.85; p<0.00001) was observed between basal plasma IL-6 and BMI. Conversely, a negative relationship (r=-0.345; p<0.05) was found between basal plasma TNFalpha and BMI, although this was not significant when corrected for BMI. When corrected for BMI, no relationship was observed between either basal plasma IL-6 or TNFalpha and GIR. | These data show that the increased circulating IL-6 concentrations seen in patients with Type 2 diabetes are strongly related to fat mass and not insulin responsiveness, and suggest that neither IL-6 nor TNFalpha are indicative of insulin resistance.
###Answer: no |
Your identity is a doctor, kindly provide answers to the medical questions with consideration of the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Do differences in mtDNA haplogroup distribution among 3 Jewish populations alter susceptibility to T2DM complications?
###Context: Recent genome-wide association studies searching for candidate susceptibility loci for common complex diseases such as type 2 diabetes mellitus (T2DM) and its common complications have uncovered novel disease-associated genes. Nevertheless these large-scale population screens often overlook the tremendous variation in the mitochondrial genome (mtDNA) and its involvement in complex disorders. We have analyzed the mitochondrial DNA (mtDNA) genetic variability in Ashkenazi (Ash), Sephardic (Seph) and North African (NAF) Jewish populations (total n = 1179). Our analysis showed significant differences (p < 0.001) in the distribution of mtDNA genetic backgrounds (haplogroups) among the studied populations. To test whether these differences alter the pattern of disease susceptibility, we have screened our three Jewish populations for an association of mtDNA genetic haplogroups with T2DM complications. Our results identified population-specific susceptibility factors of which the best example is the Ashkenazi Jewish specific haplogroup N1b1, having an apparent protective effect against T2DM complications in Ash (p = 0.006), being absent in the NAF population and under-represented in the Seph population. We have generated and analyzed whole mtDNA sequences from the disease associated haplogroups revealing mutations in highly conserved positions that are good candidates to explain the phenotypic effect of these genetic backgrounds. | Our findings support the possibility that recent bottleneck events leading to over-representation of minor mtDNA alleles in specific genetic isolates, could result in population-specific susceptibility loci to complex disorders.
###Answer: yes |
In the clinical text, your goal is to determine connections between medical problems, treatments, and tests. The markers @problem$, @test$, and @treatment$ are used to tag these entities in the text. Categorize the relation between two entities as one of the following options:
Treatment improves medical problem (TrIP)
Treatment worsens medical problem (TrWP)
Treatment causes medical problem (TrCP)
Treatment is administered for medical problem (TrAP)
Treatment is not administered because of medical problem (TrNAP)
Test reveals medical problem (TeRP)
Test conducted to investigate medical problem (TeCP)
Medical problem indicates medical problem (PIP)
No Relations | PMH : Hypertension , @problem$ , Diabetes Mellitus , Hypothyroid , h/o Bilateral DVT 's, @problem$ ? Sarcoidosis , Gastritis , B12 deficiency , Chronic renal insufficiency , s/p Appendectomy , s/p Lap cholectomy , s/p Total abdominal hysterectomy | No Relations |
In your capacity as a doctor, it is expected that you answer the medical questions relying on the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is caffeine ingestion associated with reductions in glucose uptake independent of obesity and type 2 diabetes before and after exercise training?
###Context: We investigated the effect of caffeine ingestion on insulin sensitivity in sedentary lean men (n = 8) and obese men with (n = 7) and without (n = 8) type 2 diabetes. We also examined whether chronic exercise influences the relationship between caffeine and insulin sensitivity in these individuals. Subjects underwent two hyperinsulinemic-euglycemic clamp procedures, caffeine (5 mg/kg body wt) and placebo, in a double-blind, randomized manner before and after a 3-month aerobic exercise program. Body composition was measured by magnetic resonance imaging. At baseline, caffeine ingestion was associated with a significant reduction (P < 0.05) in insulin sensitivity by a similar magnitude in the lean (33%), obese (33%), and type 2 diabetic (37%) groups in comparison with placebo. After exercise training, caffeine ingestion was still associated with a reduction (P < 0.05) in insulin sensitivity by a similar magnitude in the lean (23%), obese (26%), and type 2 diabetic (36%) groups in comparison with placebo. Exercise was not associated with a significant increase in insulin sensitivity in either the caffeine or placebo trials, independent of group (P > 0.10). | Caffeine consumption is associated with a substantial reduction in insulin-mediated glucose uptake independent of obesity, type 2 diabetes, and chronic exercise.
###Answer: yes |
As a medical professional, your responsibility is to address the medical questions using the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Do risk factors for cardiovascular disease fully explain differences in carotid intima-media thickness between Indigenous and European Australians without diabetes?
###Context: To investigate whether cardiovascular risk factors can explain the higher carotid intima-media thickness (CIMT) in Indigenous compared with European Australians. Cross-sectional study in three subgroups. Non-diabetic urban European (n = 86), urban Indigenous (n = 69), and remote Indigenous (n = 60) Australians aged 25-64 years. CIMT, age, sex, anthropometry, blood pressure, smoking status, fasting glucose and insulin, haemoglobin (Hb)A1c, homocysteine, C-reactive protein (CRP), lipids, urinary albumin and creatinine. CIMT and levels of risk factors, except fasting glucose and total cholesterol, worsened across the three groups. Log(n) fasting insulin [beta = 0.022, 95% confidence interval (CI) 0-0.0439], age (beta = 0.006, 95% CI 0.004-0.007), gender (female beta = -0.005 vs. male, 95% CI -0.084 to -0.026), mean arterial pressure (MAP) (beta = 0.001, 95% CI 0.001-0.002) and ethnicity/location [urban Indigenous (beta = 0.027, 95% CI -0.010 to 0.064 vs. European); remote Indigenous (beta = 0.083, 95% CI 0.042-0.123 vs. European)] explained 41% of variance in CIMT. Significant interactions were seen for ethnicity/location with age (P = 0.014) and MAP (P = 0.018). Age was consistently associated with CIMT across the three populations, and was associated with larger increments in CIMT for the Indigenous subgroups (beta = 0.007, 95% CI 0.005-0.009 urban; beta = 0.007, 95% CI 0.004-0.010 remote) compared with Europeans (beta = 0.003, 95% CI 0.002-0.006) in models including age, sex and MAP. MAP was only associated with CIMT in the remote Indigenous subgroup. | After adjusting for selected risk factors, CIMT in remote Indigenous participants was still higher than in Europeans. The slope of the association between age and CIMT steepened from urban Europeans to remote Indigenous.
###Answer: no |
Your task is to determine the relationships between medical problems, treatments, and tests within the clinical text. Medical problems are marked as @problem$, medical tests are marked as @test$, and treatments are marked as @treatment$. Categorize the relationship between two entities in the text as one of the following options:
Treatment improves medical problem (TrIP)
Treatment worsens medical problem (TrWP)
Treatment causes medical problem (TrCP)
Treatment is administered for medical problem (TrAP)
Treatment is not administered because of medical problem (TrNAP)
Test reveals medical problem (TeRP)
Test conducted to investigate medical problem (TeCP)
Medical problem indicates medical problem (PIP)
No Relations | This is a 47 - year-old male with a past medical history of type 2 diabetes , @treatment$ , hypertension , and coronary artery disease , status post percutaneous transluminal coronary angioplasty times two , who presented with acute coronary syndrome refractory to medical treatment and TNK , now status post Angio-Jet percutaneous transluminal coronary angioplasty and @problem$ and percutaneous transluminal coronary angioplasty of first diagonal with intra-aortic balloon pump placement . | No Relations |
Your task is to determine the relationships between medical problems, treatments, and tests within the clinical text. Medical problems are marked as @problem$, medical tests are marked as @test$, and treatments are marked as @treatment$. Categorize the relationship between two entities in the text as one of the following options:
Treatment improves medical problem (TrIP)
Treatment worsens medical problem (TrWP)
Treatment causes medical problem (TrCP)
Treatment is administered for medical problem (TrAP)
Treatment is not administered because of medical problem (TrNAP)
Test reveals medical problem (TeRP)
Test conducted to investigate medical problem (TeCP)
Medical problem indicates medical problem (PIP)
No Relations | Hypertension , CVA 2001 , 2002 diabetes , laryngeal cancer , right CEA , prostatectomy for BPH , @treatment$ , status post @treatment$ . | No Relations |
As a medical professional, your responsibility is to address the medical questions using the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Are elevated serum phosphate levels associated with decreased amputation-free survival after interventions for critical limb ischemia?
###Context: Elevated serum phosphate levels have been associated with increased risks of cardiovascular events and death in several patient populations. The effects of serum phosphate on outcomes in patients with critical limb ischemia (CLI) have not been evaluated. In this study, we assessed the effect of abnormal phosphate levels on mortality and major limb events after surgical intervention for CLI. A retrospective review was undertaken to identify all patients at a single institution who underwent a first-time open or endovascular intervention for CLI between 2005 and 2014. Patients without recorded postoperative phosphate levels were excluded. Postoperative phosphate levels ≤30 days of the initial operation were recorded, and the mean was calculated. Patients were stratified according to mean phosphate levels (low: <2.5 mg/dL, normal: 2.5-4.5 mg/dL, and high: >4.5 mg/dL). Patient demographics, comorbidities, and operative details were compared in univariate analysis. Multivariable regression and Cox proportional hazard modeling were used to account for patient demographics and comorbid conditions. We identified 941 patients, including 42 (5%) with low phosphate, 768 (82%) with normal phosphate, and 131 (14%) with high phosphate. Patients with elevated phosphate were younger and had higher rates of congestive heart failure, diabetes, and dialysis dependence. Bypass was more common among patients with normal phosphate compared with high or low phosphate levels. There was no difference in the Wound, ischemia, and Foot infection (WiFi) classification or TransAtlantic Inter-Society Consensus classification among the cohorts. There were significant differences in 1-year mortality (low: 19%, normal: 17%, high: 33%; P < .01) and 3-year mortality (low: 38%, normal: 34%, high: 56%; P < .01) between phosphate cohorts. Major amputation (low: 12%, normal: 12%, high: 15%) and restenosis (low: 21%, normal: 24%, high: 28%) tended toward worse outcomes among patients with elevated phosphate levels but did not reach statistical significance. After adjustment for baseline characteristics, mortality was higher (hazard ratio [HR], 1.7; 95% confidence interval [CI], 1.3-2.2) and amputation-free survival was lower (HR, 1.5; 95% CI, 1.2-1.9) among patients with elevated compared with normal phosphate levels. A subgroup analysis was then performed to assess dialysis and nondialysis patients separately. Patients with elevated serum phosphate levels maintained a significantly higher risk of mortality in each group (dialysis: HR, 1.8; 95% CI, 1.2-2.6; nondialysis: HR, 1.5; 95% CI, 1.04-2.10). | Elevated phosphate levels are associated with increased mortality and decreased amputation-free survival after interventions for CLI. Future studies evaluating the effects of phosphate reduction in patients with CLI are warranted.
###Answer: yes |
Given your background as a doctor, please provide your insight in addressing the medical questions based on the patient's account.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Are fasting and postprandial glycoxidative and lipoxidative stress increased in women with type 2 diabetes?
###Context: We studied acute changes in markers of glycoxidative and lipoxidative stress, including oxidized LDL, N(epsilon)-(carboxyethyl)-lysine (CEL), N(epsilon)-(carboxymethyl)-lysine (CML), and 3-deoxyglucosone (3DG), following two consecutive meals. Postmenopausal women (27 with normal glucose metabolism [NGM], 26 with type 2 diabetes) received two consecutive fat-rich meals and two consecutive carbohydrate-rich meals on two occasions. Glucose and triglyceride concentrations were measured at baseline and 1, 2, 4, 6, and 8 h following breakfast; lunch was given at 4 h. Oxidized LDL-to-LDL cholesterol ratio, CEL, CML, and 3DG were measured at baseline and at 8 h. Fasting oxidized LDL-to-LDL cholesterol ratio, 3DG, and CML were higher in women with type 2 diabetes compared with women with NGM and were comparable to the postprandial values at 8 h in NGM. Postprandial rises in the oxidized LDL-to-LDL cholesterol ratio and 3DG were similar in both groups. However, the oxidized LDL-to-LDL cholesterol ratio increased more after the fat-rich meals, whereas CML and 3DG increased more after the carbohydrate-rich meals. After the fat-rich meals, the increase in the oxidized LDL-to-LDL cholesterol ratio correlated with postprandial triglycerides, whereas the increase in 3DG was correlated with postprandial glucose. | The acute changes in markers of glycoxidative and lipoxidative stress in both type 2 diabetes and NGM suggest that postabsorptive oxidative stress may partly underlie the association of postprandial derangements and cardiovascular risk.
###Answer: yes |
As a healthcare professional, please evaluate the patient's description and offer your expertise in answering the medical questions.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is the coronary calcium score a more accurate predictor of significant coronary stenosis than conventional risk factors in symptomatic patients : Euro-CCAD study?
###Context: In this retrospective study we assessed the predictive value of the coronary calcium score for significant (>50%) stenosis relative to conventional risk factors. We investigated 5515 symptomatic patients from Denmark, France, Germany, Italy, Spain and the USA. All had risk factor assessment, computed tomographic coronary angiogram (CTCA) or conventional angiography and a CT scan for coronary artery calcium (CAC) scoring. 1539 (27.9%) patients had significant stenosis, 5.5% of whom had zero CAC. In 5074 patients, multiple binary regression showed the most important predictor of significant stenosis to be male gender (B=1.07) followed by diabetes mellitus (B=0.70) smoking, hypercholesterolaemia, hypertension, family history of CAD and age but not obesity. When the log transformed CAC score was included, it became the most powerful predictor (B=1.25), followed by male gender (B=0.48), diabetes, smoking, family history and age but hypercholesterolaemia and hypertension lost significance. The CAC score is a more accurate predictor of >50% stenosis than risk factors regardless of the means of assessment of stenosis. The sensitivity of risk factors, CAC score and the combination for prediction of >50% stenosis when measured by conventional angiogram was considerably higher than when assessed by CTCA but the specificity was considerably higher when assessed by CTCA. The accuracy of CTCA for predicting >50% stenosis using the CAC score alone was higher (AUC=0.85) than using a combination of the CAC score and risk factors with conventional angiography (AUC=0.81). | In symptomatic patients, the CAC score is a more accurate predictor of significant coronary stenosis than conventional risk factors.
###Answer: yes |
As a medical professional, your responsibility is to address the medical questions using the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is carbohydrate-responsive element-binding protein ( ChREBP ) a negative regulator of ARNT/HIF-1beta gene expression in pancreatic islet beta-cells?
###Context: Carbohydrate-responsive element-binding protein (ChREBP) is a transcription factor that has been shown to regulate carbohydrate metabolism in the liver and pancreatic beta-cells in response to elevated glucose concentrations. Because few genes have been identified so far as bona fide ChREBP-target genes, we have performed a genome-wide analysis of the ChREBP transcriptome in pancreatic beta-cells. Chromatin immunoprecipitation and high-density oligonucleotide tiling arrays (ChIP-chip; Agilent Technologies) using MIN6 pancreatic beta-cell extracts were performed together with transcriptional and other analysis using standard techniques. One of the genes identified by ChIP-chip and linked to glucose sensing and insulin secretion was aryl hydrocarbon receptor nuclear translocator (ARNT)/hypoxia-inducible factor-1beta (HIF-1beta), a transcription factor implicated in altered gene expression and pancreatic-islet dysfunction in type 2 diabetes. We first confirmed that elevated glucose concentrations decreased ARNT/HIF-1beta levels in INS-1 (832/13) cells and primary mouse islets. Demonstrating a role for ChREBP in ARNT gene regulation, ChREBP silencing increased ARNT mRNA levels in INS-1 (832/13) cells, and ChREBP overexpression decreased ARNT mRNA in INS-1 (832/13) cells and primary mouse islets. We demonstrated that ChREBP and Max-like protein X (MLX) bind on the ARNT/HIF-1beta promoter on the proximal region that also confers the negative glucose responsiveness. | These results demonstrate that ChREBP acts as a novel repressor of the ARNT/HIF-1beta gene and might contribute to beta-cell dysfunction induced by glucotoxicity.
###Answer: yes |
You're a doctor, kindly address the medical queries according to the patient's account.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Do micro- and macroalbuminuria predict hemorrhagic transformation in acute ischemic stroke?
###Context: Hemorrhagic transformation (HT) after cerebral ischemia seems to be related to the endothelial disruption secondary to the ischemic process. Albuminuria has recently been found to be a marker of chronic endothelial damage. To investigate the relationship between albuminuria and HT in patients with acute ischemic stroke. We studied 200 patients (51.5% men, age 72.5 +/- 8.5 years) with ischemic stroke within the first 24 hours of evolution. HT development was assessed on CT performed between days 4 and 7 of evolution and classified according to the ECASS II criteria. Urinary samples were collected within the first 3 hours after admission and the presence of albuminuria, which was considered to be present when the ratio albumin-to-creatinine was > or =30 mg/g creatinine, was determined by nephelometry within the first 24 hours of evolution. Forty-nine patients (24.5%) had albuminuria and 36 (18%) had HT on the second CT scan. After adjusting for potential confounders including a previous history of diabetes mellitus, hypertension and atrial fibrillation, stroke severity, the presence of early signs of ischemia and leukoaraiosis on the baseline CT scan, and IV anticoagulant treatment, logistic regression analysis showed that albuminuria was independently associated with HT (OR, 7.45; 95% CI 2.30 to 24.16). Moreover, albuminuria was also a significant and independent predictor of parenchymal hemorrhage type 1 and 2 (OR, 8.30; 95% CI 1.77 to 38.89). | Albuminuria is an independent predictor of hemorrhagic transformation, and particularly of the most severe bleedings, in patients with acute ischemic stroke. Due to the small number of events, the predictive capacity of albuminuria should be confirmed in larger studies.
###Answer: yes |
As a medical professional, your responsibility is to address the medical questions using the patient's description.
Analyze the question and answer with the best option. | ###Question: Tissue conditioning material is indicated when:
###Options:
A. Tissue symptoms are related to diabetes
B. Mucosa is inflamed due to ill fitting dentures
C. Mandibular tori is present
D. Large maxillary tori is present
| ###Rationale: Correction of ill-fitting dentures
Areas of denture causing trauma to the tissues (causing inflammation of oral mucosa) are trimmed and polished.
Generally rough areas on fitting surface are smoothed or relined with tissue conditioner.
Ref: Textbook of prosthodontics V Rangarajan Ed. 2nd
###Answer: OPTION B IS CORRECT. |
You're a doctor, kindly address the medical queries according to the patient's account.
Analyze the question and answer with the best option. | ###Question: Autonomic disturbances are seen in?
###Options:
A. Hypehyroidism
B. Diabetes
C. Hyperaldosteronism
D. Hyperparathyroidism
| ###Rationale: Diabetes REF: Harrison's Internal Medicine 17'h edition chapter 370 I. Autonomic disorders with brain involvement A. Associated with multisystem degeneration 1. Multisystem degeneration: autonomic failure clinically prominent Multiple system atrophy (MSA) Parkinson's disease with autonomic failure Diffuse Lewy body disease (some cases) 2. Multisystem degeneration: autonomic failure clinically not usually prominent Parkinson's disease Other extrapyramidal disorders (inherited spinocerebellar atrophies, progressive supranuclear palsy, coicobasal degeneration, Machado-Joseph disease) B. Unassociated with multisystem degeneration 1. Disorders mainly due to cerebral coex involvement Frontal coex lesions causing urinary/bowel incontinence Paial complex seizures 2. Disorders of the limbic and paralimbic circuits Shapiro's syndrome (agenesis of corpus callosum, hyperhidrosis, hypothermia) Autonomic seizures 3. Disorders of the hypothalamus Wernicke-Korsakoff syndrome Diencephalic syndrome Neuroleptic malignant syndrome Serotonin syndrome Fatal familial insomnia Antidiuretic hormone (ADH) syndromes (diabetes insipidus, inappropriate ADH) Disturbances of temperature regulation (hypehermia, hypothermia) Disturbances of sexual function Disturbances of appetite Disturbances of BP/HR and gastric function Horner's syndrome 4. Disorders of the brainstem and cerebellum Posterior fossa tumors Syringobulbia and Arnold-Chiari malformation Disorders of BP control (hypeension, hypotension) Cardiac arrhythmias Central sleep apnea Baroreflex failure Horner's syndrome H. Autonomic disorders with spinal cord involvement Traumatic quadriplegia Syringomyelia Subacute combined degeneration Multiple sclerosis Amyotrophic lateral sclerosis Tetanus Stiff-man syndrome Spinal cord tumors III. Autonomic neuropathies A. Acute/subacute autonomic neuropathies 1. Subacute autoimmune autonomic neuropathy (panautonomic neuropathy, pandysautonomia) Subacute paraneoplastic autonomic neuropathy Guillain-Barre syndrome Botulism Porphyria Drug induced autonomic neuropathies Toxic autonomic neuropathies B. Chronic peripheral autonomic neuropathies 1. Distal small fiber neuropathy 2. Combined sympathetic and parasympathetic failure Amyloid Diabetic autonomic neuropathy Autoimmune autonomic neuropathy (paraneoplastic and idiopathic) Sensory neuronopathy with autonomic failure Familial dysautonomia (Riley-Day syndrome)
###Answer: OPTION B IS CORRECT. |
You're a doctor, kindly address the medical queries according to the patient's account.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is hyperuricemia a risk factor for the onset of impaired fasting glucose in men with a high plasma glucose level : a community-based study?
###Context: It is not clear whether elevated uric acid is a risk factor for the onset of impaired fasting glucose after stratifying by baseline fasting plasma glucose levels. We conducted a community-based retrospective longitudinal cohort study to clarify the relationship between uric acid levels and the onset of impaired fasting glucose, according to baseline fasting plasma glucose levels. We enrolled 6,403 persons (3,194 men and 3,209 women), each of whom was 18-80 years old and had > 2 annual check-ups during 2003-2010. After excluding persons who had fasting plasma glucose levels ≥ 6.11 mM and/or were currently taking anti-diabetic agents, the remaining 5,924 subjects were classified into quartiles according to baseline fasting plasma glucose levels. The onset of impaired fasting glucose was defined as fasting plasma glucose ≥ 6.11 mM during the observation period. In the quartile groups, 0.9%, 2.1%, 3.4%, and 20.2% of the men developed impaired fasting glucose, respectively, and 0.1%, 0.3%, 0.5%, and 5.6% of the women developed impaired fasting glucose, respectively (P trend <0.001). After adjusting for age, body mass index, systolic blood pressure, triacylglycerols, high density lipoprotein-cholesterol, creatinine, fatty liver, family history of diabetes, alcohol consumption, and current smoking, uric acid levels were positively associated with onset of impaired fasting glucose in men with highest-quartile fasting plasma glucose levels (adjusted hazard ratio, 1.003; 95% confidence interval, 1.0001-1.005, P = 0.041). | Among men with high fasting plasma glucose, hyperuricemia may be independently associated with an elevated risk of developing impaired fasting glucose.
###Answer: yes |
You're a doctor, kindly address the medical queries according to the patient's account.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is combined glutathione S transferase M1/T1 null genotypes associated with type 2 diabetes mellitus?
###Context: Due to new genetic insights, a considerably large number of genes and polymorphic gene variants are screened and linked with the complex pathogenesis of type 2 diabetes (DM). Our study aimed to investigate the association between the two isoforms of the glutathione S-transferase genes (Glutathione S transferase isoemzyme type M1- GSTM1 and Glutathione S transferase isoemzyme type T1-GSTT1) and the prevalence of DM in the Northern Romanian population. We conducted a cross-sectional, randomized, case-control study evaluating the frequency of GSTM1 and GSTT1 null alleles in patients diagnosed with DM. A total of 106 patients diagnosed with DM and 124 healthy controls were included in the study. GSTM1 and GSTT1 null alleles genotyping was carried out using Multiplex PCR amplification of relevant gene fragments, followed by gel electrophoresis analysis of the resulting amplicons. Molecular analysis did not reveal an increased frequency of the null GSTM1 and GSTT1 alleles (mutant genotypes) respectively in the DM group compared to controls (p=0.171, OR=1.444 CI=0.852-2.447; p=0.647, OR=0.854, CI=0.436-1.673). Nevertheless, the combined GSTM1/GSTT1 null genotypes were statistically significantly higher in DM patients compared to control subjects (p=0.0021, OR=0.313, CI=0.149-0.655). | The main finding of our study is that the combined, double GSTM1/GSTT1 null genotypes are to be considered among the polymorphic genetic risk factors for type 2 DM.
###Answer: yes |
Your task is to determine the relationships between medical problems, treatments, and tests within the clinical text. Medical problems are marked as @problem$, medical tests are marked as @test$, and treatments are marked as @treatment$. Categorize the relationship between two entities in the text as one of the following options:
Treatment improves medical problem (TrIP)
Treatment worsens medical problem (TrWP)
Treatment causes medical problem (TrCP)
Treatment is administered for medical problem (TrAP)
Treatment is not administered because of medical problem (TrNAP)
Test reveals medical problem (TeRP)
Test conducted to investigate medical problem (TeCP)
Medical problem indicates medical problem (PIP)
No Relations | This is a 47 - year-old male with a past medical history of type 2 diabetes , high cholesterol , @treatment$ , and coronary artery disease , status post percutaneous transluminal coronary angioplasty times two , who presented with acute coronary syndrome refractory to @problem$ and TNK , now status post Angio-Jet percutaneous transluminal coronary angioplasty and stent of proximal left anterior descending artery and percutaneous transluminal coronary angioplasty of first diagonal with intra-aortic balloon pump placement . | No Relations |
In your capacity as a doctor, it is expected that you answer the medical questions relying on the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is high pulse pressure associated with increased risk of stroke in Japanese : the JMS Cohort Study?
###Context: The relationship between pulse pressure (PP) and stroke has been described in populations outside Japan. Here, we investigated the relationship between PP and stroke incidence in Japan. Study subjects were 11,097 people (4315 men and 6782 women) in 12 rural areas of Japan enrolled in the Jichi Medical School Cohort Study, a population-based prospective study. The subjects were divided into quintiles of PP. Baseline data were obtained by questionnaire and health checkups between April 1992 and July 1995, and the incidence of all strokes and stroke subtypes was monitored. A total of 412 strokes were observed during a mean follow-up period of 10.7 years. After adjusting for age, smoking status, drinking status, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, body mass index and diabetes mellitus, hazard ratios [HRs] in the second to fifth quintiles of PP for all strokes were 1.06 (95% confidence interval [CI] 0.69-1.64), 1.53 (CI 1.02-2.28), 2.02 (CI 1.38-2.96) and 2.22 (CI 1.53-3.20) compared with the first quintile using Cox's proportional hazard model, respectively. | Our findings suggest high PP is at an increased risk of stroke.
###Answer: yes |
Your task involves evaluating the connection between the two clinical sentences and classifying them into one of these categories:
Contradiction: If the sentences are in direct opposition or conflict.
Neutral: If there is no clear logical association between the sentences.
Entailment: If one sentence logically follows or implies the other. | Sentence 1: HISTORY: [**Known patient lastname **] is the former 5.060 kg product of a 39 week gestation born to a 31 year old A+, remaining prenatal screens noncontributory, gravida 4, para 2, now 3 female whose pregnancy was complicated by diet-controlled gestational diabetes.
Sentence 2: Pregnancy was uncomplicated | Contradiction |
Considering your role as a medical practitioner, please use the patient's description to answer the medical questions.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Do menarche delay and menstrual irregularities persist in adolescents with type 1 diabetes?
###Context: Menarche delay has been reported in adolescent females with type 1 diabetes (T1DM), perhaps due to poor glycemic control. We sought to compare age at menarche between adolescent females with T1DM and national data, and to identify factors associated with delayed menarche and menstrual irregularity in T1DM. This was a cross-sectional study and females ages 12- 24 years (n = 228) with at least one menstrual period were recruited during their outpatient diabetes clinic appointment. The National Health and Nutrition Examination Survey (NHANES) 2001-2006 data (n = 3690) for females 12-24 years were used as a control group. Age at menarche was later in adolescent females with T1DM diagnosed prior to menarche (12.81 +/- 0.09 years) (mean+/- SE) (n = 185) than for adolescent females diagnosed after menarche (12.17 0.19 years, p = 0.0015) (n = 43). Average age of menarche in NHANES was 12.27 +/- 0.038 years, which was significantly earlier than adolescent females with T1DM prior to menarche (p < 0.0001) and similar to adolescent females diagnosed after menarche (p = 0.77). Older age at menarche was negatively correlated with BMI z-score (r = -0.23 p = 0.0029) but not hemoglobin A1c (A1c) at menarche (r = 0.01, p = 0.91). Among 181 adolescent females who were at least 2 years post menarche, 63 (35%) reported usually or always irregular cycles. | Adolescent females with T1DM had a later onset of menarche than both adolescent females who developed T1DM after menarche and NHANES data. Menarche age was negatively associated with BMI z-score, but not A1c. Despite improved treatment in recent decades, menarche delay and high prevalence of menstrual irregularity is still observed among adolescent females with T1DM.
###Answer: yes |
In the clinical text, your objective is to identify relationships between medical problems, treatments, and tests. Medical problems are tagged as @problem$, medical tests as @test$, and treatments as @treatment$. Classify the relationship between two entities as one of the following:
Treatment improves medical problem (TrIP)
Treatment worsens medical problem (TrWP)
Treatment causes medical problem (TrCP)
Treatment is administered for medical problem (TrAP)
Treatment is not administered because of medical problem (TrNAP)
Test reveals medical problem (TeRP)
Test conducted to investigate medical problem (TeCP)
Medical problem indicates medical problem (PIP)
No Relations | PMH : Hypertension , Hyperlipidemia , Diabetes Mellitus , @problem$ , h/o Bilateral DVT 's, @problem$ ? Sarcoidosis , Gastritis , B12 deficiency , Chronic renal insufficiency , s/p Appendectomy , s/p Lap cholectomy , s/p Total abdominal hysterectomy | No Relations |
If you have medical expertise, assist the user by responding to their healthcare-related questions. | my boyfriend has type 1 diabetes and he just recently got terminated from his medical insurance. the doctor told him he cannot work anymore because of kidney failure and he has not insurance now. he cannot afford his insulin. i cannot see him suffer like this | DEAR OVERTHINKS FOR WRITING TO ChatDoctorI UNDERSTAND YOUR CONCERN. BUT THE MAIN TREATMENT IN PATIENTS WITH TYPE 1 DM IS INSULIN WITHOUT WHICH YOUR BF TREATMENT OF DM IS INCOMPLETE APART FROM THAT YOU TALKED ABOUT FAILING KIDNEY. I WOULD LIKE TO KNOW IF HE HAS ANY SWELLING IN BODY, HIS GREAT LEVELS. REGARDING THE AFFORDABILITY THERE ARE DIFFERENT SCHEMES FOR PATIENTS NOT AFFORDING COSTLY TREATMENT THAT THE GOVERNMENTS IN VARIOUS COUNTRIES ARE PROVIDING CAN TRY TO FIND ONSHORE I ANSWERED YOUR QUERY CAN MESSAGE ME FOR ANY FURTHER CONCERNS |
In your role as a medical professional, address the user's medical questions and concerns. | I was told by phone my lab work for kidney function was borderline but with no instructions from the dr of what I can do for it, can you give me any info. I am also uncontrolled diabetes type 2.blood pressure is controlled with meds . but I haven t been able to take insulin shots due to either bad side affects or lack of insurance. I am however taking 4 metformin and 2 glimepiride ( the limit of dose that can be given) daily. | Hi Welcome to Chat Doctor . Please see that borderline kidney function with diabetes should be taken seriously. You should have disclosed your blood urea and serum creatinine level. As Metformin is safe at up to creatinine 1.8 and your BP should be maintained below 140/90 and blood sugar should be below 140 mg / 100 ml. If your serum creatinine level is higher than 1.8 and GFR is low then you should go for insulin or Dynagliptin as it is safe in kidney impairment. If you have any further query then you can come back to Chat Doctor I will definitely help you and guide you appropriately. With Regards Chat Doctor. |
Your role involves answering medical questions and offering advice to users based on their descriptions. | My daughter is 19 years old and has recently been diagnosed with diabetes. She is taking 2 metformin in the morning and 1 metformin at night. Her meter reading has been over 300 consistently and she has been complaining about pain in her lower right side. What do you think is going on? | **1. Since the case is diagnosed and complaining of pain in lower limbs thus it is wise to check with a diabetes specialist, who will look clinically for:. Weight. Blood pressure. Examination of peripheral pulses on the legs. Examination of the feet: especially the inter digital spaces and soles, for infections, ulcer and sensory loss. Say NO to: Sugar, all sweets, cakes, sweetened biscuits- Chat Doctor. Eat in Plenty: all leafy vegetables, tomato, cucumber, brinjal, cauliflower, ladies finger, soup [tomato/vegetable], butter milk, sugar-free |
In your capacity as a doctor, it is expected that you answer the medical questions relying on the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Are diabetics less likely to develop thoracic aortic dissection : a 10-year single-center analysis?
###Context: Diabetes mellitus (DM) is an acknowledged risk factor for atherosclerosis, and diabetics are more likely to have hypertension. Atherosclerosis and hypertension are risk factors for aortic dissection. However, recent studies have shown that DM is associated with changes in aortic wall collagen. In this retrospective study we assess the relationship between DM and thoracic aortic dissection (TAD). Patients with a diagnosis of thoracic aortic dissection during the last 10 years were identified from our hospital records. The prevalence of DM in Stanford type A and B TAD was compared with that of two age- and gender-matched control groups. For every diabetic dissection case, 10 controls were selected from the hospital data. Two hundred nineteen patients (median age 61 years, male:female ratio 145:74) were identified with TAD, comprising 131 type A dissections and 88 type B dissections. Only 3 of 131 (2.3%) type A aortic dissections were diabetics, whereas, in control group 1, 241 of 1310 (18.4%) were diabetics and, in control group 2, 116 of 1310 (8.9%) were diabetics [odds ratios: 0.1 (0.03-0.32) and 0.24 (0.07-0.76), respectively] (P = 0.0001 and 0.007, respectively). Similarly, only 2 of 88 (2.3%) type B aortic dissections were diabetics, whereas 228 of 880 (26.0%) and 102 of 880 (11.6%) were diabetics in groups 1 and 2 [odds ratios: 0.07 (0.02-0.27) and 0.18 (0.04-0.73), respectively] (P = 0.0001 and 0.0035, respectively). All these odds ratios were statistically significant (P < 0.01). | Patients with thoracic aortic dissection are less likely to be diabetic. Although we identified association only, not causality, it is possible that DM, or its treatment, has a protective effect against aortic dissection.
###Answer: yes |
Considering your role as a medical practitioner, please use the patient's description to answer the medical questions.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does diabetes mellitus increase the in vivo activity of cytochrome P450 2E1 in humans?
###Context: Cytochrome P450 2E1 (CYP2E1) is thought to activate a number of protoxins, and has been implicated in the development of liver disease. Increased hepatic expression of CYP2E1 occurs in rat models of diabetes but it is unclear whether human diabetics display a similar up-regulation. This study was designed to test the hypothesis that human diabetics experience enhanced CYP2E1 expression. The pharmacokinetics of a single dose of chlorzoxazone (500 mg), used as an index of hepatic CYP2E1 activity, was determined in healthy subjects (n = 10), volunteers with Type I (n = 13), and Type II (n = 8) diabetes mellitus. Chlorzoxazone and 6-hydroxychlorzoxazone in serum and urine were analysed by high-performance liquid chromatography. The expression of CYP2E1 mRNA in peripheral blood mononuclear cells was quantified by reverse transcriptase-polymerase chain reaction. The mean +/- s.d. (90% confidence interval of the difference) chlorzoxazone area under the plasma concentration-time curve was significantly (P </= 0.05) reduced in obese Type II diabetics (15.7 +/- 11.3 micro g h ml-1; 9, 22) compared with healthy subjects (43.5 +/- 16.9 micro g h ml-1; 16, 40) and Type I diabetics (32.8 +/- 9.2 micro g h ml-1; 9, 25). There was a significant two-fold increase in the oral clearance of chlorzoxazone in obese Type II diabetics compared with healthy volunteers and Type I diabetics. The protein binding of chlorzoxazone was not significantly different between the three groups. In contrast, Type 1 diabetics and healthy volunteers demonstrated no difference in the oral clearance of chlorzoxazone. The urinary recovery of 6-hydroxychlorzoxazone as a percentage of the administered dose was not different between healthy, Type I and obese Type II diabetics. The elimination half-life of chlorzoxazone did not differ between the three groups. CYP2E1 mRNA was significantly elevated in Type I and obese Type II diabetics compared with healthy volunteers. The oral clearance of chlorzoxazone, elimination half-life, Tmax, and Cmax were not significantly influenced by weight, body mass index, serum glucose, serum cholesterol, or glycosylated haemoglobin. | There was a marked increase in hepatic CYP2E1 activity in obese Type II diabetics as assessed by chlorzoxazone disposition. Increased expression of CYP2E1 mRNA in peripheral blood mononuclear cells was found in both types of diabetes mellitus. Adverse hepatic events associated with Type II diabetes may be in part a result of enhanced CYP2E1 expression and activity.
###Answer: yes |
Your mission is to tag gene-related Named Entities in the text using the BIO labeling scheme. When you encounter a gene-related phrase, mark the start with B (Begin) and continue with I (Inner) for the subsequent words in that phrase. Words unrelated to gene-related entities should be labeled as O. | This study examined the role of cholesteryl ester transfer ( CET ) , cholesteryl ester transfer protein ( CETP ) activity , and phospholipid transfer protein ( PLTP ) activity in the increased prevalence of coronary artery calcification ( CAC ) in diabetic subjects compared with nondiabetic subjects and in the loss of the sex difference in CAC in diabetes . | This : O
study : O
examined : O
the : O
role : O
of : O
cholesteryl : O
ester : O
transfer : O
( : O
CET : O
) : O
, : O
cholesteryl : B
ester : I
transfer : I
protein : I
( : O
CETP : B
) : O
activity : O
, : O
and : O
phospholipid : B
transfer : I
protein : I
( : O
PLTP : B
) : O
activity : O
in : O
the : O
increased : O
prevalence : O
of : O
coronary : O
artery : O
calcification : O
( : O
CAC : O
) : O
in : O
diabetic : O
subjects : O
compared : O
with : O
nondiabetic : O
subjects : O
and : O
in : O
the : O
loss : O
of : O
the : O
sex : O
difference : O
in : O
CAC : O
in : O
diabetes : O
. : O |
You're a doctor, kindly address the medical queries according to the patient's account.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is a substantial level of donor hematopoietic chimerism required to protect donor-specific islet grafts in diabetic NOD mice?
###Context: Mixed chimerism can induce tolerance to alloantigens and restore self-tolerance to autoantigens, thereby permitting islet transplantation. However, the minimal level of donor chimerism that is required to prevent islet allograft rejection and recurrence of autoimmune diabetes has not been established. We investigated whether allogeneic Balb/c donor chimerism can be induced in C57BL/6 mice, in prediabetic NOD mice, and in diabetic NOD mice after transplantation of a modest dose of bone marrow by using purine nucleoside analogue, fludarabine phosphate and cyclophosphamide conditioning therapy, followed by short-term anti-CD40 ligand monoclonal antibody and rapamycin posttransplant treatment. We also investigated whether the induced donor chimerism is sufficient to prevent the onset of diabetes in prediabetic NOD mice and protect donor islet grafts in diabetic NOD mice. Allogeneic donor chimerism could be induced under the authors' approach that is nonmyeloablative and radiation-free. Diabetes onset was prevented in chimeric prediabetic NOD mice. The induction of mixed chimerism protected donor-specific islet grafts in diabetic NOD mice. At 60 days after islet transplantation, all donor Balb/c islet grafts survived in diabetic NOD mice whose level of donor-derived lymphocytes was higher than 30% at the time of islet transplantation (n=8). In contrast, Balb/c islet grafts were rejected in five of seven diabetic NOD mice whose level was lower than 30%. | Our data demonstrate that a donor lymphocyte chimerism (>30%) at the time of islet transplantation is required to protect donor-specific islet grafts, and indicate that a strictly non-irradiation-based protocol can be used to achieve this goal.
###Answer: yes |
Your role as a doctor requires you to answer the medical questions taking into account the patient's description.
Answer with the best option directly. | ###Question: A 62-year-old man is brought to the emergency department because of headache, blurring of vision, and numbness of the right leg for the past 2 hours. He has hypertension and type 2 diabetes mellitus. Current medications include enalapril and metformin. He is oriented only to person. His temperature is 37.3°C (99.1°F), pulse is 99/min and blood pressure is 158/94 mm Hg. Examination shows equal pupils that are reactive to light. Muscle strength is normal in all extremities. Deep tendon reflexes are 2+ bilaterally. Sensation to fine touch and position is decreased over the right lower extremity. The confrontation test shows loss of the nasal field in the left eye and the temporal field in the right eye with macular sparing. He is unable to read phrases shown to him but can write them when they are dictated to him. He has short-term memory deficits. Which of the following is the most likely cause for this patient's symptoms?
###Options:
A. Infarct of the right posterior cerebral artery
B. Infarct of the right anterior cerebral artery
C. Herpes simplex encephalitis
D. Infarct of the left posterior cerebral artery
| ###Answer: OPTION D IS CORRECT. |
Considering your role as a medical practitioner, please use the patient's description to answer the medical questions.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does reduced MMP-2 activity contribute to cardiac fibrosis in experimental diabetic cardiomyopathy?
###Context: To evaluate the regulation of matrix metalloproteinase (MMP)-2 in diabetic cardiomyopathy. Left ventricle (LV) function was determined by a micro-tip catheter in streptozotocin (STZ)-induced diabetic rats, 2 or 6 weeks (w) after STZ-application. LV total collagen, collagen type I and III content were immunohistologically analyzed and quantified by digital image analysis. LV collagen type I, III and MMP-2 mRNA expression was quantified by real-time RT-PCR. LV pro- and active MMP-2 levels were analyzed by zymography; Smad 7, membrane type (MT)1-MMP and tissue inhibitor metalloproteinase (TIMP)-2 protein levels by Western Blot. STZ-induced diabetes was associated with a time-dependent impairment of LV diastolic and systolic function. This was paralleled by a time-dependent increase in LV total collagen content, despite reduced LV collagen type I and III mRNA levels, indicating a role of post-transcriptional/post-translational changes of extracellular matrix regulation. Six weeks (w) after STZ-injection, MMP-2 mRNA expression and pro-MMP-2 levels were 2.7-fold (P < 0.005) and 1.3-fold (P < 0.05) reduced versus controls, respectively, whereas active MMP-2 was decreased to undetectable levels 6 w post-STZ. Concomitantly, Smad 7 and TIMP-2 protein levels were 1.3-fold (P < 0.05) and 10-fold (P < 0.005) increased in diabetics versus controls, respectively, whereas the 45 kDa form of MT1-MMP was undetectable in diabetics. | Under STZ-diabetic conditions, cardiac fibrosis is associated with a dysregulation in extracellular matrix degradation. This condition is featured by reduced MMP-2 activity, concomitant with increased Smad 7 and TIMP-2 and decreased MT1-MMP protein expression, which differs from mechanisms involved in dilated and ischemic heart disease.
###Answer: yes |
As a healthcare professional, please evaluate the patient's description and offer your expertise in answering the medical questions.
Answer with the best option directly. | ###Question: A 58-year-old man with a past medical history of diabetes, hypertension, and hyperlipidemia was brought into the emergency department by his wife after she observed him go without sleep for several days and recently open and max out several credit cards. She also reports that he has quit his bartending job and has been excessively talkative and easily annoyed for the last several weeks. The patient has no previous psychiatric history. Routine medical examination, investigations, and toxicology rule out a medical cause or substance abuse. Lab results are consistent with chronically impaired renal function. What is the single best treatment for this patient?
###Options:
A. Valproic acid
B. Lithium
C. Pregabalin
D. Lamotrigine
| ###Answer: OPTION A IS CORRECT. |
Your task is to determine the relationships between medical problems, treatments, and tests within the clinical text. Medical problems are marked as @problem$, medical tests are marked as @test$, and treatments are marked as @treatment$. Categorize the relationship between two entities in the text as one of the following options:
Treatment improves medical problem (TrIP)
Treatment worsens medical problem (TrWP)
Treatment causes medical problem (TrCP)
Treatment is administered for medical problem (TrAP)
Treatment is not administered because of medical problem (TrNAP)
Test reveals medical problem (TeRP)
Test conducted to investigate medical problem (TeCP)
Medical problem indicates medical problem (PIP)
No Relations | Adult-onset diabetes mellitus x 40 years , history of silent myocardial infarction , coronary artery bypass graft ( three vessels in 1987 ) , history of chronic , stable angina pectoris , Fournier 's gangrene versus @problem$ , congestive heart failure in 03/97 while in the hospital for a rib fracture , glaucoma , diabetic retinopathy with @problem$ , history of gastric stapling , left rib fracture , right femur surgery . | No Relations |
Your goal is to determine the relationship between the two provided clinical sentences and classify them into one of the following categories:
Contradiction: If the two sentences contradict each other.
Neutral: If the two sentences are unrelated to each other.
Entailment: If one of the sentences logically entails the other. | Sentence 1: She reports her history of type 1 diabetes mellitus starting when she was four years old.
Sentence 2: She has a history of hyperglycemia | Entailment |
You're a doctor, kindly address the medical queries according to the patient's account.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Do c-peptide and its C-terminal fragments improve erythrocyte deformability in type 1 diabetes patients?
###Context: Data now indicate that proinsulin C-peptide exerts important physiological effects and shows the characteristics of an endogenous peptide hormone. This study aimed to investigate the influence of C-peptide and fragments thereof on erythrocyte deformability and to elucidate the relevant signal transduction pathway. Blood samples from 23 patients with type 1 diabetes and 15 matched healthy controls were incubated with 6.6 nM of either human C-peptide, C-terminal hexapeptide, C-terminal pentapeptide, a middle fragment comprising residues 11-19 of C-peptide, or randomly scrambled C-peptide. Furthermore, red blood cells from 7 patients were incubated with C-peptide, penta- and hexapeptides with/without addition of ouabain, EDTA, or pertussis toxin. Erythrocyte deformability was measured using a laser diffractoscope in the shear stress range 0.3-60 Pa. Erythrocyte deformability was impaired by 18-25% in type 1 diabetic patients compared to matched controls in the physiological shear stress range 0.6-12 Pa (P < .01-.001). C-peptide, penta- and hexapeptide all significantly improved the impaired erythrocyte deformability of type 1 diabetic patients, while the middle fragment and scrambled C-peptide had no detectable effect. Treatment of erythrocytes with ouabain or EDTA completely abolished the C-peptide, penta- and hexapeptide effects. Pertussis toxin in itself significantly increased erythrocyte deformability. | C-peptide and its C-terminal fragments are equally effective in improving erythrocyte deformability in type 1 diabetes. The C-terminal residues of C-peptide are causally involved in this effect. The signal transduction pathway is Ca(2+)-dependent and involves activation of red blood cell Na(+), K(+)-ATPase.
###Answer: yes |
You're a doctor, kindly address the medical queries according to the patient's account.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is limbs ' postischemic revascularization improved by losartan treatment in diabetic rats?
###Context: Most physiological actions of angiotensin II (Ang II) on cardiovascular system are mediated by angiotensin type 1 receptor (AT1R). Since peripheral artery disease is one of the most important complications of diabetes, in this study, we aimed to investigate the effect of losartan, an AT1R blocker, on skeletal muscle angiogenesis in diabetic hind limb ischemic rats. Twenty four male Wistar rats were randomly divided into four groups as follow: diabetic sham; diabetic sham + losartan (15 mg/kg/day); diabetic hindlimb ischemia; diabetic hindlimb ischemia + losartan. For induction of diabetes, streptozotocin was injected (55 mg/kg; i.p.). The animals were sacrificed after 21 days and the serum concentrations of vascular endothelial growth factor (VEGF), soluble VEGF receptor-1 (sFlt-1), nitric oxide (NO), capillary density, and capillary to fiber (cap⁄fib) ratio in ischemic legs were evaluated. The serum NO concentrations were significantly decreased, sFlt-1 concentrations increased, and VEGF concentrations did not significantly change after experiment in diabetic sham and diabetic hind limb ischemic rats. Administration of losartan did not induce significant changes in serum NO, sFlt-1, and VEGF concentrations (p>0.05). Capillary density and cap⁄fib ratio in ischemic leg of diabetic rats were not affected by losartan treatment (p>0.05). | AT1R blocker, losartan, was not able to restore neovascularization in the ischemic leg of diabetic animals. Therefore, based on the present data, the losartan cannot be considered for treatment or prevention of peripheral artery disease in diabetic subjects.
###Answer: no |
In your capacity as a doctor, it is expected that you answer the medical questions relying on the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is low socioeconomic status associated with increased risk for hypoglycemia in diabetes patients : the Diabetes Study of Northern California ( DISTANCE )?
###Context: Social risk factors for hypoglycemia are not well understood. Cross-sectional analysis from the DISTANCE study, a multi-language, ethnically-stratified random sample of adults in the Kaiser Permanente Northern California diabetes registry, conducted in 2005-2006 (response rate 62%). Exposures were income and educational attainment; outcome was patient report of severe hypoglycemia. To test the association, we used multivariable logistic regression to adjust for demographic and clinical factors. 14,357 patients were included. Reports of severe hypoglycemia were common (11%), and higher in low-income vs. high-income (16% vs. 8.8) and low-education vs. high-education (11.9% vs. 8.9%) groups. In multivariable analysis, incomes of less than $15,000 (OR 1.51 95%CI 1.19-1.91), $15,000-$24,999 (OR 1.57 95%CI 1.27-1.94), and high school or less education (OR 1.42, 95% CI 1.24-1.63) were associated with increased hypoglycemia, similar to insulin use (OR 1.44 95%CI 1.19-1.74). | Low income and educational attainment are important risk factors for hypoglycemia.
###Answer: yes |
Given your profession as a doctor, please provide responses to the medical questions using the patient's description.
Answer with the best option directly. | ###Question: A 48-year-old woman with a history of type 2 diabetes mellitus presents to her primary care physician with complaints of headaches, fatigue, dry cough, and frequent episodes of bronchospasm. She was diagnosed with moderate nonproliferative diabetic retinopathy by an ophthalmologist last month. Her blood pressure measured in the clinic is 158/95 mmHg. A 24-hour urine collection is obtained and reveals 9.5 g of protein. On physical examination, the patient has diffuse wheezing, jugular venous distention, and 2+ pitting pretibial edema. Labs are notable for a potassium level of 5.2 mEq/L. Which of the following medications is most likely contributing to this patient’s current presentation?
###Options:
A. Amlodipine
B. Hydrochlorothiazide
C. Lisinopril
D. Losartan
| ###Answer: OPTION C IS CORRECT. |
Your task is to spot mentions of diseases in the text and apply the BIO labeling scheme. For each disease-related phrase, label the initial word as B (Begin), and label the rest of the words in the phrase as I (Inner). Any words unrelated to diseases should receive an O label. | To determine the molecular basis of autosomal dominant neurohypophyseal diabetes insipidus , the AVP genes of members of a large kindred were analyzed . | To : O
determine : O
the : O
molecular : O
basis : O
of : O
autosomal : B
dominant : I
neurohypophyseal : I
diabetes : I
insipidus : I
, : O
the : O
AVP : O
genes : O
of : O
members : O
of : O
a : O
large : O
kindred : O
were : O
analyzed : O
. : O |
In your capacity as a healthcare expert, offer insights and recommendations in response to users' medical inquiries. | I have very heavy swelling in my both foot & lower portion of legs for last 2 months. It reduces occasionally but flares up again . I am 54 years & weighing 130 kg. Lipid profile , LFT ,KFT blood tests are normal. No BP or Diabetes problem. What is the cause & treatment. FROM : M.K. VERMA | Hello, What I see with the history you mentioned is you have chronic lymphedema. As your other lab reports are turned to be normal, along with No High BP or Diabetic than you should check for any signs of varicose veins. You can get a Doppler done for checking out if there is any kind of obstruction in the lower limb lymph nodes. Also, using stocking should be of great help and doing some exercises to improve venous return would be helpful. As you are 54 and 130/KGS you need to shed down weight and do regular exercise. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor. |
Given your background as a doctor, please provide your insight in addressing the medical questions based on the patient's account.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is creatine kinase-MB enzyme elevation following successful saphenous vein graft intervention associated with late mortality?
###Context: Although the risk for development of creatine kinase (CK-MB) elevation after saphenous vein graft (SVG) intervention is high, its prognostic significance remains unknown. This study evaluated the impact of periprocedural CK-MB elevation on late clinical events following successful SVG angioplasty. We studied 1056 consecutive patients with successful (defined by angiographic success and absence of major complications) intervention of 1693 SVG lesions. These patients were grouped as normal CK-MB (n=556), minor CK-MB rise (CK-MB 1 to 5 times normal, n=339), and major CK-MB rise (CK-MB >5 times normal, n=161). There were no differences in major clinical events at 30-day follow-up among the 3 groups. However, 1-year mortality was 4.8%, 6.5%, and 11. 7%, respectively, P<0.05 (ANOVA). Even within a population without any intraprocedure or in-hospital complications (n=727, 69% of the overall cohort), 1-year mortality remained significantly higher with CK-MB elevation: 2.4%, 5.5%, and 10.7%, respectively, P<0.05 (ANOVA). Multivariate analysis revealed major CK-MB elevation as the strongest independent predictor of late mortality (odds ratio 3.3, with 95% CI 1.7 to 6.2), followed by diabetes mellitus (odds ratio 2. 6, with 95% CI 1.5 to 4.5). | Major CK-MB elevation occurs after 15% of otherwise successful SVG interventions and is associated with increased late mortality.
###Answer: yes |
You're a doctor, kindly address the medical queries according to the patient's account.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does endogenous GIP ameliorate impairment of insulin secretion in proglucagon-deficient mice under moderate beta cell damage induced by streptozotocin?
###Context: The action of incretin hormones including glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) is potentiated in animal models defective in glucagon action. It has been reported that such animal models maintain normoglycaemia under streptozotocin (STZ)-induced beta cell damage. However, the role of GIP in regulation of glucose metabolism under a combination of glucagon deficiency and STZ-induced beta cell damage has not been fully explored. In this study, we investigated glucose metabolism in mice deficient in proglucagon-derived peptides (PGDPs)-namely glucagon gene knockout (GcgKO) mice-administered with STZ. Single high-dose STZ (200 mg/kg, hSTZ) or moderate-dose STZ for five consecutive days (50 mg/kg × 5, mSTZ) was administered to GcgKO mice. The contribution of GIP to glucose metabolism in GcgKO mice was also investigated by experiments employing dipeptidyl peptidase IV (DPP4) inhibitor (DPP4i) or Gcg-Gipr double knockout (DKO) mice. GcgKO mice developed severe diabetes by hSTZ administration despite the absence of glucagon. Administration of mSTZ decreased pancreatic insulin content to 18.8 ± 3.4 (%) in GcgKO mice, but ad libitum-fed blood glucose levels did not significantly increase. Glucose-induced insulin secretion was marginally impaired in mSTZ-treated GcgKO mice but was abolished in mSTZ-treated DKO mice. Although GcgKO mice lack GLP-1, treatment with DPP4i potentiated glucose-induced insulin secretion and ameliorated glucose intolerance in mSTZ-treated GcgKO mice, but did not increase beta cell area or significantly reduce apoptotic cells in islets. | These results indicate that GIP has the potential to ameliorate glucose intolerance even under STZ-induced beta cell damage by increasing insulin secretion rather than by promoting beta cell survival.
###Answer: yes |
Your task is to offer medical advice and answers to questions posed by users regarding their health. | Starting 2 days ago, I experienced extreme fatigue and muscle pain & weakness, especially in my calves and legs. Saturday, yesterday, (and today my fingers, palms were numb with mottled red color, feet were also numb, more muscle pain and weakness in lower and upper arms, calves and thighs. Hard to make a fist in both hands, write, hold things or do productive movements in both hands. Joints are not swollen. Quick onset for tingling and muscle weakness. History of type 2 diabetes, on glipizide 10mg 2x/day and levermeir 18 unit IM at night. Got over sinisitis with antibiotics - a couple weeks ago, contracted it end of July. Lasted over 6 weeks. Had rheumatoid arthritis as young adult, no active issues for years. Do I need to take immediate action or wait and see if this passes. | Hi, Thanks for writing in. There is a possibility of diabetic neuropathy in you that must be investigated in detail. Diabetes itself starts affecting the nerves, eyes and kidneys in all patients having the condition for years. It is possible that you are experiencing the symptoms of diabetic neuropathy. Possibility of vitamin B 12 deficiencies must also be considered. In those taking oral glucose lowering medications like metformin, there is malabsorption of vitamin B 12 from the intestines. This can cause a chronic deficiency state and leads to symptoms like numbness and tingling in arms and feet. Please get examined by your doctor regularly and take vitamin B 12 supplements. This will restore vitamin B 12 levels to normal and prevent deficiency state. Please do not worry. |
Your role as a doctor requires you to answer the medical questions taking into account the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does time-restricted feeding improve insulin resistance and hepatic steatosis in a mouse model of postmenopausal obesity?
###Context: Menopause is associated with significant hormonal changes that result in increased total body fat and abdominal fat, amplifying the risk for metabolic syndrome and diseases such as diabetes, cardiovascular disease and cancer in postmenopausal women. Intermittent fasting regimens hold significant health benefit promise for obese humans, however, regimens that include extreme daytime calorie restriction or daytime fasting are generally associated with hunger and irritability, hampering long-term compliance and adoption in the clinical setting. Time-restricted feeding (TRF), a regimen allowing eating only during a specific period in the normal circadian feeding cycle, without calorie restriction, may increase compliance and provide a more clinically viable method for reducing the detrimental metabolic consequences associated with obesity. We tested TRF as an intervention in a mouse model of postmenopausal obesity. Metabolic parameters were measured using Clinical Laboratory Animal Monitoring System (CLAMS) and we carried out glucose tolerance tests. We also stained liver sections with oil red O to examine steatosis and measured gene expression related to gluconeogenesis. Preexisting metabolic disease was significantly attenuated during 7 weeks of TRF. Despite having access to the same high fat diet (HFD) as ad libitum fed (ALF) mice, TRF mice experienced rapid weight loss followed by a delayed improvement in insulin resistance and a reduced severity of hepatic steatosis by having access to the HFD for only 8h during their normal nocturnal feeding period. The lower respiratory exchange ratio in the TRF group compared with the ALF group early in the dark phase suggested that fat was the predominant fuel source in the TRF group and correlated with gene expression analyses that suggested a switch from gluconeogenesis to ketogenesis. In addition, TRF mice were more physically active than ALF fed mice. | Our data support further analysis of TRF as a clinically viable form of intermittent fasting to improve metabolic health due to obesity.
###Answer: yes |
In the clinical text, your objective is to identify relationships between medical problems, treatments, and tests. Medical problems are tagged as @problem$, medical tests as @test$, and treatments as @treatment$. Classify the relationship between two entities as one of the following:
Treatment improves medical problem (TrIP)
Treatment worsens medical problem (TrWP)
Treatment causes medical problem (TrCP)
Treatment is administered for medical problem (TrAP)
Treatment is not administered because of medical problem (TrNAP)
Test reveals medical problem (TeRP)
Test conducted to investigate medical problem (TeCP)
Medical problem indicates medical problem (PIP)
No Relations | PMH : Hypertension , Hyperlipidemia , Diabetes Mellitus , @problem$ , h/o Bilateral DVT 's, Pleural disorder ? Sarcoidosis , @problem$ , B12 deficiency , Chronic renal insufficiency , s/p Appendectomy , s/p Lap cholectomy , s/p Total abdominal hysterectomy | No Relations |
As a healthcare professional, please evaluate the patient's description and offer your expertise in answering the medical questions.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Do effects of the SOD mimic nitroxide 3-carbamoyl-PROXYL on oxidative stress markers and endothelial dysfunction in streptozotocin-induced diabetic rats?
###Context: To evaluate the effects of 3-carbamoyl-PROXYL (CP), a stable superoxide dismutase (SOD) mimic compound, on oxidative stress markers and endothelial dysfunction in diabetic rats. Rats were made diabetic by a single vein injection of streptozotocin (65 mg/kg) and diabetes was verified by the existence of excessive hyperglycemia a week after the treatment. Control and diabetic rats received vehicle or drug for eight weeks, after which the vascular tissue was examined for relaxation and oxidative stress markers. Diabetic rats showed increased vascular levels of superoxide that were accompanied by increased tissue levels of the oxidative stress markers malondialdehyde (MDA) and 8-iso-prostaglandin F2alpha (8-ISO). The vasorelaxant as well as the cyclic guanosine 5'-monophosphate (cGMP)-producing effects of acetylcholine (ACh) and nitroglycerine were reduced in diabetic rats. Treatment of diabetic rats with CP (50 mg/kg intraperitoneally, bid) abolished not only the differences in superoxide, MDA and 8-ISO levels, but also the differences in the relaxation and cGMP responses of vascular tissue between control and diabetic rats to both ACh and nitroglycerine. | These results support the involvement of reactive oxygen species in mediation of diabetes-induced endothelial dysfunction in vivo, and provide the rationale for the potential use of SOD mimics in the treatment of diabetes.
###Answer: yes |
Your identity is a doctor, kindly provide answers to the medical questions with consideration of the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is obstructive sleep apnoea associated with diabetes in sleepy subjects?
###Context: Although obstructive sleep apnoea (OSA) has been linked to insulin resistance and glucose intolerance, it is unclear whether there is an independent association between OSA and diabetes mellitus (DM) and whether all patients with OSA are at risk. The objective of this study was to determine the association between OSA and DM in a large cohort of patients referred for sleep diagnostic testing. A cross-sectional analysis of participants in a clinic-based study was conducted between July 2005 and August 2007. DM was defined by self-report and concurrent use of diabetic medications (oral hypoglycaemics and/or insulin). Sensitivity analysis was performed using a validated administrative definition of diabetes. OSA was defined by the respiratory disturbance index (RDI) using polysomnography or ambulatory monitoring. Severe OSA was defined as an RDI > or = 30/h. Subjective sleepiness was defined as an Epworth Sleepiness Scale score > or = 10. Complete data were available for 2149 patients. The prevalence of DM increased with increasing OSA severity (p<0.001). Severe OSA was associated with DM following adjustment for patient demographics, weight and neck circumference (odds ratio (OR) 2.18; 95% CI 1.22 to 3.89; p<0.01). Following a stratified analysis, this relationship was observed exclusively in sleepy patients (OR 2.59 (95% CI 1.35 to 4.97) vs 1.16 (95% CI 0.31 to 4.37) in non-sleepy patients). | Severe OSA is independently associated with DM in patients who report excessive sleepiness. Future studies investigating the impact of OSA treatment on DM may wish to focus on this patient population.
###Answer: yes |
Given your background as a doctor, please provide your insight in addressing the medical questions based on the patient's account.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is incidence of BK virus infection after kidney transplantation independent of type of immunosuppressive therapy?
###Context: BK polyomavirus (BKV) infection and BKV nephropathy (BKVN) are risk factors for allograft function and survival. We retrospectively analyzed BK viremia and BKVN in 348 patients who received a kidney transplantation donated after brain death (n=232) or living donation (n=116) between 2008 and 2013. A total of 266 patients were treated with standard immunosuppression consisting of basiliximab induction, calcineurin inhibitor (CNI), and mycophenolic acid (MPA, n=219) or everolimus (n=47); 82 patients received more intense immunosuppression with lymphocyte depletion, CNI and MPA (n=38) or everolimus (n=44). BK viremia occurred in 33 (9.5%) patients in the first year and in 7 (2.0%) recipients in the second year after transplantation. BKVN occurred in 4 (1.1%) patients in the first year. Donor and recipient age, diabetes, previous transplantation, and type of transplantation (donated after brain death vs living donation) were not risk factors (P>.05). BK incidence did not differ depending on induction or maintenance immunosuppression. | Incidence of BK viremia is independent of recipient characteristics, type of transplantation as well as induction and maintenance immunosuppression.
###Answer: yes |
Your goal is to determine the relationship between the two provided clinical sentences and classify them into one of the following categories:
Contradiction: If the two sentences contradict each other.
Neutral: If the two sentences are unrelated to each other.
Entailment: If one of the sentences logically entails the other. | Sentence 1: Type 1 diabetes mellitus for the last 33 years.
Sentence 2: The patient has no insulin requirements. | Contradiction |
Your mission is to identify the logical relationship between the two clinical sentences and categorize them as:
Contradiction: If the sentences contradict each other in their meaning.
Neutral: If there is no significant connection or logical inference between the sentences.
Entailment: If one sentence logically implies or entails the other. | Sentence 1: Type 2 DM 8.
Sentence 2: Type two diabetes is caused by an autoimmune process. | Contradiction |
In your capacity as a doctor, it is expected that you answer the medical questions relying on the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does extrarenal atherosclerotic disease blunt renal recovery in patients with renovascular hypertension?
###Context: Atherosclerotic renovascular disease (ARVD) is associated with high rates of coronary events and predicts mortality among patients with coronary artery disease (CAD). However, the impact of coronary atherosclerosis on renal outcomes after revascularization of ARVD is unclear. We hypothesized that CAD negatively impacts renal functional outcomes among patients with ARVD undergoing renal artery revascularization. Patients with ARVD who underwent echocardiography at Mayo Clinic, Rochester, Minnesota, USA between 2004 and 2012 were identified retrospectively and included if they had ejection fraction more than 50%. Renal and overall outcomes were compared among atherosclerotic renovascular disease patients with coronary artery disease (ARVD-C, n = 75) and without coronary artery disease (ARVD, n = 56), within 1 year from initial revascularization and included blood pressure control, renal function, and incident cardiovascular/cerebrovascular events. Degree of renal artery stenosis was similar in both groups. ARVD-C had higher prevalence of diabetes, peripheral artery disease (PAD), and cerebrovascular disease, and lower baseline renal function. Risk of developing end-stage renal disease was higher in ARVD-C (11 vs. 2%, P = 0.05). Despite better control of blood pressure and cholesterol levels, renal function postrevascularization worsened in 15% of ARVD-C compared with 2% of ARVD (P = 0.01). Differences in clinical outcomes remained statistically significant after adjustment for covariables, including sex, baseline blood pressure, renal function, underlying diabetes, cholesterol levels, and medications. Similar differences in clinical outcomes were also associated with PAD and cerebrovascular disease. | CAD in patients with ARVD is a predictor of worse outcomes after renal revascularization, likely reflecting diffuse atherosclerotic disease. Further studies are needed to develop strategies to manage patients with vascular comorbidities and improve their outcomes.
###Answer: yes |
Given your background as a doctor, please provide your insight in addressing the medical questions based on the patient's account.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does hyperglycaemia potentiate the teratogenicity of retinoic acid in diabetic pregnancy in mice?
###Context: We recently showed in mice that maternal diabetes increases embryonic susceptibility to caudal regression induced by vitamin A metabolite retinoic acid. Here we tested whether in the maternal diabetic milieu hyperglycaemia is the critical factor responsible for mediating this increased susceptibility. Non-diabetic pregnant mice were made hyperglycaemic by subcutaneous injections of glucose at regular intervals. Conversely, diabetic pregnant mice were treated with phlorizin to induce renal glucosuria and thus reduce blood glucose concentrations. Pregnant mice were treated with retinoic acid and the extent of caudal regression in mouse embryos, measured in terms of the ratio of tail length to crown-rump length was assessed. Embryos were also examined for Wnt-3a expression and cell death. Embryos of mice treated with glucose had a greater extent of caudal regression induced by retinoic acid than saline-treated controls, with enhanced down-regulation of Wnt-3a expression and exacerbated cell death specifically at the caudal end of the embryo. Embryos of diabetic mice treated with phlorizin had a similar extent of caudal regression to embryos of non-diabetic mice after treatment with retinoic acid. | Hyperglycaemia increases embryonic susceptibility to caudal regression induced by retinoic acid, with the underlying cellular and molecular changes closely mimicking those that occur in maternal diabetes. Reduction of blood glucose concentrations in diabetic mice completely abolishes this increased susceptibility to retinoic acid. These results suggest that in maternal diabetes hyperglycaemia is the critical factor responsible for potentiating the teratogenic effect of retinoic acid.
###Answer: yes |
As a medical professional, your responsibility is to address the medical questions using the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is total coronary artery plaque burden measured by cardiac computed tomography associated with metabolic syndrome?
###Context: Increased coronary plaque burden, which could be involved in the pathogenesis of atherothrombotic events, is difficult to evaluate in the three major coronary arteries. The purpose of this study was to quantify coronary plaque volume using 64-slice computed tomography (CT). We measured coronary plaque volume with our new protocol in 23 consecutive patients (48% men; 66 ± 11 years old) who underwent cardiac CT for suspicion of coronary artery disease and had noncalcified plaques. We counted the total pixel volume of noncalcified plaques in the three major coronary arteries. The coronary plaque volume was 1.29 ± 0.56 cm(3) in the right coronary artery, 1.29 ± 0.42cm(3) in the left main coronary artery and left anterior descending artery, and 0.88 ± 0.32 cm(3) in the left circumflex artery. The total coronary plaque burden (TCPB) was 3.45 ± 1.02 cm(3)/patient and had a positive correlation with waist circumference (r =0.44, p < 0.05) and insulin resistance (r = 0.46, p < 0.05). TCPB was significantly greater in men (3.89 ± 1.07 cm(3) vs. 3.06 ± 0.82 cm(3) in women, p < 0.05), patients with diabetes or impaired glucose tolerance (3.77 ± 0.94 cm(3) vs. 2.86 ± 0.92 cm(3) in non-diabetics, p < 0.05), and patients with metabolic syndrome (3.91 ± 0.95 cm(3) vs. 3.03 ± 0.91 cm(3) in patients without metabolic syndrome, p < 0.05). | Cardiac CT can provide a noninvasive assessment of TCPB, which was significantly associated with metabolic syndrome and its components. Measuring TCPB by CT could be an important strategy for identifying high-risk patients with suspected coronary artery disease.
###Answer: yes |
As a medical chatbot, your responsibility is to provide information and guidance on medical matters to users. | Submit answer to YYYY@YYYY No diagnosis yet. Age 54, weight 168, and medical history: 2001 lumbar and cervical degenerative discs with bulging and compromising cord with related issues; ? 2000 migraines; hysterectomy 2007; currently diagnosed with poor liver function, diabetes 2 (blood result= 95 fasting, considered boarerline.), and high cholesterol. (Dieting resulted in ten pound loss, hoping to control solely with diet as meds negatively affect the liver). ; septoplasty 12/1998, Twelve years post septoplasty, have suffered with scabbing on septum, given topical ointments to no avail; thick white excessive mucous; and cough. Scabbing feels as if it is spreading further back, could possibly be in sinus and throat; C.T. shows particles in sinus cavity and throat feels dry and raw (adequate fluids consumed).Phlegm thickness felt in sinus cavity with postnatal drip, heaviness in chest and chronic cough. Heart problems ruled out; pulmonary treatment, no avail; gastrologist ruled out stomach with endoscopy.Currently, on no medication, taking fish oil and milk thistle for one month, for diagnosis of poor liver function. Feeling very ill, no doctor takes this seriously. I feel my condition began with the scabbing after septoplasty and sores remain. I heard open sores in the nose can cause bacteria in the blood, could this have caused all my problems? If not, What could be the problem? | Dear friend, The simple answer is yes. Bacteria can migrate from infected open sore to the blood stream, a condition called Bacteremia. However, bacteremia will lead to SIRS (systemic inflammatory respond syn Chat Doctor. These will lead to fever/chill and the patient will be very ill. This condition are often very rapidly developing and associate with high mortality. Giving your current symptoms, it is unlikely that bacteremia can explain your symptoms. There are many cause for your symptoms and a comprehensive work up is needed. |
In the provided clinical sentences, your objective is to determine their relationship and assign one of the following labels:
Contradiction: If the sentences present conflicting information.
Neutral: If there is no apparent logical relationship between the sentences.
Entailment: If one sentence logically implies or necessitates the other. | Sentence 1: Status post cataract surgery.
Sentence 2: History of diabetes | Neutral |
Your identity is a doctor, kindly provide answers to the medical questions with consideration of the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Do c57BL/6J and A/J mice fed a high-fat diet delineate components of metabolic syndrome?
###Context: The aim of this study was to assess the suitability of A/J and C57BL/6J mice of both sexes as models of some components of the human metabolic syndrome (MetS) under nutritional conditions more comparable with the actual worldwide diet responsible for the increased incidence of the MetS. We fed large cohorts (n = 515) of two strains of mice, A/J and the C57BL/6J, and of both sexes a high-fat diet (HFD; 60% fat) that, in contrast with most previous reports using saturated fats, was enriched in mono- and polyunsaturated fatty acids, thus more closely mimicking most Western diets, or a control diet (10% fat), for 20 weeks. In sharp contrast to previous reports, weight gain and hyperleptinemia were similar in both strains and sexes. Hyperinsulinemia, glucose tolerance, insulin resistance, and hypercholesterolemia were observed, although with important differences between strains and sexes. A/J males displayed severely impaired glucose tolerance and insulin resistance. However, in contrast with C57BL6/J mice, which displayed overt type 2 diabetes, A/J mice of both sexes remained normoglycemic. | With important differences in magnitude and time course, the phenotypic and metabolic characteristics of both strains and both sexes on this HFD demonstrate that these models are very useful for identifying the mechanisms underlying progression or resistance to subsequent type 2 diabetes.
###Answer: yes |
Given your profession as a doctor, please provide responses to the medical questions using the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does mycophenolate mofetil prevent the development of glomerular injury in experimental diabetes?
###Context: Experimental and clinical evidence suggests that inflammation plays a role in the pathogenesis of diabetic nephropathy, in addition to, or in concert with, the associated hemodynamic and metabolic changes. The present study assessed the effects of chronic anti-inflammatory therapy in experimental diabetic nephropathy. Adult male Munich-Wistar rats were made diabetic with streptozotocin after uninephrectomy, kept moderately hyperglycemic by daily injections of NPH insulin and distributed among three groups: C, non-diabetic rats; DM, rats made diabetic and treated with insulin as described earlier; and DM+MMF, diabetic rats receiving insulin and treated with mycophenolate mofetil (MMF), 10 mg/kg once daily by gavage. Renal hemodynamic studies were performed 6 to 8 weeks after induction of diabetes. Additional rats were followed during 8 months, at the end of which renal morphological studies were performed. After 6 to 8 weeks, diabetic rats exhibited marked glomerular hyperfiltration and hypertension. Diabetic rats developed progressive albuminuria and exhibited widespread glomerulosclerotic lesions associated with macrophage infiltration at 8 months. Treatment with MMF had no effect on blood pressure, glomerular dynamics or blood glucose levels, but did prevent albuminuria, glomerular macrophage infiltration and glomerulosclerosis. Thus, the renoprotective effect of MMF was not associated with a metabolic or renal hemodynamic effect, and must have derived from its well-known anti-inflammatory properties, which include restriction of lymphocyte and macrophage proliferation and limitation of the expression of adhesion molecules. | These findings are consistent with the notion that inflammatory events are central to the pathogenesis of diabetic nephropathy and suggest that MMF may help prevent the progression of diabetic nephropathy.
###Answer: yes |
If you have medical expertise, assist the user by responding to their healthcare-related questions. | 53YOF, post-menaposal, Med Hx: Psoriatric Arthritis, High B/P & Non-Insulin dependent Diabetes. I have been taking Victoza for approx 4 months. Before that I had been taking Metformin for approx 1-1/2 years without any real change in BG levels. My last A1C a month ago was 6.2 - down from 7.1 before starting Victoza. I have also been able to lose 20 lbs which is helping me feel better. The last 2 weeks, I have been experiencing nausea in the mornings when I wake up. Sometimes it clears up but other days it lasts until the afternoon - it is just kind of there in the background at varying degrees of severity. I am wondering whether this would have anything to do with the Victoza. I did experience nausea at first until the dose was adjusted but not like this. I am also on diovan daily which has my b/p controlled, and ultram daily & humira bi-monthly for arthritis which is doing well. I have been on these meds for several years. I will be seing my arthritis doctor in 2 weeks but since this was available online, I thought I would ask. Any thoughts? | Dear Friend, greetings from Chat Doctor... I understand your problem s . Victory can cause nausea and vomiting in some patient s . Your HbA1c is now OK . But I do not know why did you stop metformin . You please meet your doctor and tell your problem s and take other class like glinting with metformin . Which is an excellent Chat Doctor. . Plus your lifestyle change s both dietary modification s and exercise is must which helps to keep your sugar and BP in check . Take more of green leafy vegetables, and fruits . . Thank you and do contact us for more questions . |
Being a doctor, your task is to answer the medical questions based on the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does niacin result in reduced monocyte adhesion in patients with type 2 diabetes mellitus?
###Context: Patients with type 2 diabetes have increased expression of cell adhesion molecules (CAMs). CAMs and monocyte adhesion mediate essential processes in atherogenesis. It remains unclear if monocytes from patients on niacin have reduced adhesion function. We studied the variation of monocyte adhesion in patients with type 2 diabetes and low HDL-cholesterol, taking either extended release niacin (Niaspan®, Abbott Laboratories) or controls not on niacin. Biochemical parameters including adiponectin, CAMs and fresh monocytes from whole blood for adhesion assays, were studied at baseline and 12-weeks. Niacin 1500 mg daily raised HDL-cholesterol from 0.8 mmol/l (95% CI: 0.7-0.9) to 0.9 mmol/l (95% CI: 0.8-1.1), p=0.10, and significantly reduced PECAM-1 by 24.9% (95% CI: 10.9-39.0; p<0.05), increased adiponectin by 30.5% (95% CI: 14.1-47.0; p<0.05), with monocyte adhesion reduced by 9.2% (95%CI: 0.7-17.7; p<0.05) in endothelial cells treated in basal conditions, and 7.8% (95% CI: 3.1-12.5; p<0.05) after TNF-α stimulation. | Monocytes isolated from patients on niacin had reduced adhesion to endothelial cells. Our findings suggest niacin has broad range of effects apart from lipid-modification, and these could be important in cardiovascular risk reduction.
###Answer: yes |
Your task is to identify and label Named Entities related to chemicals in the text. Utilize the BIO labeling scheme, marking the first word of a chemical-related phrase as B (Begin), and label the subsequent words within that phrase as I (Inner). Words unrelated to chemicals should be labeled as O. | Diabetes mellitus was the major cause of autonomic neuropathy . | Diabetes : O
mellitus : O
was : O
the : O
major : O
cause : O
of : O
autonomic : O
neuropathy : O
. : O |
Your mission is to identify the logical relationship between the two clinical sentences and categorize them as:
Contradiction: If the sentences contradict each other in their meaning.
Neutral: If there is no significant connection or logical inference between the sentences.
Entailment: If one sentence logically implies or entails the other. | Sentence 1: HISTORY: [**Known patient lastname **] is the former 5.060 kg product of a 39 week gestation born to a 31 year old A+, remaining prenatal screens noncontributory, gravida 4, para 2, now 3 female whose pregnancy was complicated by diet-controlled gestational diabetes.
Sentence 2: Mother of the infant had gestational diabetes | Entailment |
Your identity is a doctor, kindly provide answers to the medical questions with consideration of the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is lower verbal intelligence associated with diabetic complications and slower walking speed in people with Type 2 diabetes : the Maastricht Study?
###Context: To determine the association of verbal intelligence, a core constituent of health literacy, with diabetic complications and walking speed in people with Type 2 diabetes. This study was performed in 228 people with Type 2 diabetes participating in the Maastricht Study, a population-based cohort study. We examined the cross-sectional associations of score on the vocabulary test of the Groningen Intelligence Test with: 1) determinants of diabetic complications (HbA After full adjustment, lower verbal intelligence was associated with the presence of neuropathic pain [odds ratio (OR) 1.18, 95% CI 1.02;1.36], cardiovascular disease (OR 1.14, 95% CI 1.01;1.30), and slower walking speed (regression coefficient -0.011 m/s, 95% CI -0.021; -0.002 m/s). These associations were largely explained by education. Verbal intelligence was not associated with blood pressure, glycaemic control, lipid control, chronic kidney disease or carotid intima-media thickness. | Lower verbal intelligence was associated with the presence of some diabetic complications and with a slower walking speed, a measure of physical functioning. Educational level largely explained these associations. This implies that clinicians should be aware of the educational level of people with diabetes and should provide information at a level of complexity tailored to the patient.
###Answer: yes |
Given your profession as a doctor, please provide responses to the medical questions using the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is pineal calcification a novel risk factor for symptomatic intracerebral hemorrhage?
###Context: Pineal calcification is associated with symptomatic cerebral infarction in humans. However, there are limited data on the association of pineal calcification and intracerebral hemorrhage. We evaluated this association of symptomatic intracerebral hemorrhage and pineal calcification by computed tomography of the brain. We reviewed all computed tomographic (CT) scans of the brains of patients over 15 years of age during the year 2011 at a university teaching hospital. Symptomatic intracerebral hemorrhage was identified by having clinical syndrome of stroke and acute intracerebral hemorrhage from brain CT scans. Pineal calcification was also evidenced by brain CT scans. Other stroke risk factors were recorded. The association of various risk factors including pineal calcification and intracerebral hemorrhage was calculated using logistic regression analysis. There were 2140 CT scans of the brains during the study period. Of those, 1071 scans (50.05%) met the study criteria. Intracerebral hemorrhage and pineal calcification were found in 77 (7.2%) and 689 (64.3%) patients, respectively. Pineal calcification was a significant risk factor for intracerebral hemorrhage with an adjusted odds ratio of 2.36 (95% confidence interval of 1.22-4.54). Other significant factors were age>50 years, hypertension, and diabetes. | Pineal calcification is associated with symptomatic intracerebral hemorrhage.
###Answer: yes |
Your role involves answering medical questions and offering advice to users based on their descriptions. | My husbands gluslose levels have been high this last test it was 159. He has sweats and gets weak but the doctor can t seem to relate these symptoms to anything he has eaten right before. All the other numbers related to this battery of tests are perfect. He s been tested for diabetes its negative. Any clue | Hello, Your husband is not a diabetes patient, and the first time his reading was 159 gm/DL. First, I want to say you that relax and don't need to worry. Before going to the final diagnosis need some further investigation like located hemoglobin or HbA1C test which is the average blood sugar level of last three months, and need some physical examination like BMI (body mass index of your husband). Also, I want to advise to your husband that he may restrict his calorie in diet and starts lifestyle modification twenty minutes of a brisk walk. So kindly consult your general physician or endocrinologist for HbA1C. Hope I have answered your query. Let me know if I can assist you further. |
In the clinical text, your objective is to identify relationships between medical problems, treatments, and tests. Medical problems are tagged as @problem$, medical tests as @test$, and treatments as @treatment$. Classify the relationship between two entities as one of the following:
Treatment improves medical problem (TrIP)
Treatment worsens medical problem (TrWP)
Treatment causes medical problem (TrCP)
Treatment is administered for medical problem (TrAP)
Treatment is not administered because of medical problem (TrNAP)
Test reveals medical problem (TeRP)
Test conducted to investigate medical problem (TeCP)
Medical problem indicates medical problem (PIP)
No Relations | The patient is a 47 - year-old male with a past medical history of @problem$ , status post 2-vessel percutaneous transluminal coronary angioplasty in 2005 , 3-vessel percutaneous transluminal coronary angioplasty in 2009 , hypertension , new onset type 2 diabetes , and @problem$ who presents with the sudden onset of substernal chest pain status post exercise . | No Relations |
In your capacity as a doctor, it is expected that you answer the medical questions relying on the patient's description.
Answer with the best option directly. | ###Question: A 65-year-old woman presents with a complaint of a chronic, dry cough of insidious onset since working with her new primary care physician. She has a longstanding history of diabetes mellitus type 2, hypertension, and hyperlipidemia. She has a 10 pack-year smoking history, but does not currently smoke. What is the best next step?
###Options:
A. Review medication list
B. Monitor esophageal pH
C. Trial of decongestant and first-generation histamine H1 receptor antagonist
D. Spirometry
| ###Answer: OPTION A IS CORRECT. |
Your mission is to identify the logical relationship between the two clinical sentences and categorize them as:
Contradiction: If the sentences contradict each other in their meaning.
Neutral: If there is no significant connection or logical inference between the sentences.
Entailment: If one sentence logically implies or entails the other. | Sentence 1: Type 1 diabetes since age 13; with triopathy.
Sentence 2: The patient has had diabetes since childhood | Entailment |
Your goal is to detect disease-related Named Entities within the text and apply the BIO labeling scheme. Begin by labeling the first word of a disease-related phrase as B (Begin), and then label the subsequent words in that phrase as I (Inner). Any words not related to diseases should be labeled as O. | Familial neurohypophyseal diabetes insipidus ( FNDI ) is an inherited deficiency of the hormone arginine vasopressin ( AVP ) and is transmitted as an autosomal dominant trait . | Familial : B
neurohypophyseal : I
diabetes : I
insipidus : I
( : O
FNDI : B
) : O
is : O
an : O
inherited : O
deficiency : B
of : I
the : I
hormone : I
arginine : I
vasopressin : I
( : O
AVP : O
) : O
and : O
is : O
transmitted : O
as : O
an : O
autosomal : O
dominant : O
trait : O
. : O |
Being a doctor, your task is to answer the medical questions based on the patient's description.
Analyze the question and answer with the best option. | ###Question: Which of the following condition is not true about Hemochromatosis?
###Options:
A. Hypogonadism
B. Ahropathy
C. Diabetes mellitus
D. Desferrioxamine is treatment of choice
| ###Rationale: Phlebotomy is the treatment of choice of hemochromatosis. Chelating agent desferrioxamine is indicated when anemia or hypoproteinemia is severe enough to preclude phlebotomy. Hemochromatosis is a common inherited disorder of iron metabolism in which dysregulation of intestinal iron absorption results in deposition of excessive amounts of iron in parenchymal cells resulting in tissue damage and organ dysfunction. Liver is the first organ to be affected and hepatomegaly is seen in more than 95% of patients. Diabetes mellitus occur in 65% of patients with advanced disease. Ahropathy is seen in 20-25% of symptomatic patients. Second and third metacarpophalangeal joints are the first joints to be involved. Manifestations of hypogonadism includes loss of libido, impotence, amenorrhea, testicular atrophy and gynecomastia. Most common cardiac manifestation is congestive hea failure.
###Answer: OPTION D IS CORRECT. |
In your capacity as a doctor, it is expected that you answer the medical questions relying on the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does sustained production of spliced X-box binding protein 1 ( XBP1 ) induce pancreatic beta cell dysfunction and apoptosis?
###Context: Pro-inflammatory cytokines involved in the pathogenesis of type 1 diabetes deplete endoplasmic reticulum (ER) Ca2+ stores, leading to ER-stress and beta cell apoptosis. However, the cytokine-induced ER-stress response in beta cells is atypical and characterised by induction of the pro-apoptotic PKR-like ER kinase (PERK)-C/EBP homologous protein (CHOP) branch of the unfolded protein response, but defective X-box binding protein 1 (XBP1) splicing and activating transcription factor 6 activation. The purpose of this study was to overexpress spliced/active Xbp1 (XBP1s) to increase beta cell resistance to cytokine-induced ER-stress and apoptosis. Xbp1s was overexpressed using adenoviruses and knocked down using small interference RNA in rat islet cells. In selected experiments, Xbp1 was also knocked down in FACS-purified rat beta cells and rat fibroblasts. Expression and production of XBP1s and key downstream genes and proteins was measured and beta cell function and viability were evaluated. Adenoviral-mediated overproduction of Xbp1s resulted in increased XBP1 activity and induction of several XBP1s target genes. Surprisingly, XBP1s overexpression impaired glucose-stimulated insulin secretion and increased beta cell apoptosis, whereas it protected fibroblasts against cell death induced by ER-stress. mRNA expression of Pdx1 and Mafa was inhibited in cells overproducing XBP1s, leading to decreased insulin expression. XBP1s knockdown partially restored cytokine/ER-stress-driven insulin and Pdx1 inhibition but had no effect on cytokine-induced ER-stress and apoptosis. | XBP1 has a distinct inhibitory role in beta cell as compared with other cell types. Prolonged XBP1s production hampers beta cell function via inhibition of insulin, Pdx1 and Mafa expression, eventually leading to beta cell apoptosis.
###Answer: yes |
Your role involves answering medical questions and offering advice to users based on their descriptions. | My mother who is 87 and has diabetes had her leg removed in April due to gangrene. She has been in rehab and doing very well and was given a prosthetic leg and is walking with a walker, the problem is that out of the blue she will become confused, hallucinate,and dillousinal. It seems to last for different amounts of times. She was fine on Sunday and today when I spent two hours with her then later this afternoon, she was inconsolable ,confused etc. she is checked for uti every time she gets like this and only had one the first time. She has had cat scan by neurologist which did not show any stroke. She was never DX with dementia or Alzheimer s . Please help we are at our wits end! | Hello, Please get her electrolytes (Na, K, Cl, Mg) measured, blood sugar, renal function tests. This on and off presentation of psychosis/confusion is more in favor of organicism rather than psychiatric illness. So, we must first rule out any organic and if tests come to be normal, she needs psychiatric help. In psychiatric disorders of similar nature I have seen Chat Doctor. 5-1 mg showing good results. Apart from this one may need something to calm the patient during the episode for which Mizoram 0.5 mg appears to be quite helpful. Please get the tests and start the above meds after taking with your family doctor.Don't worry, she should be fine in few days. Donor leave her alone at home till she gets well. Wish you good health. |
As a medical professional, your responsibility is to address the medical questions using the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does early systemic microvascular damage in pigs with atherogenic diabetes mellitus coincide with renal angiopoietin dysbalance?
###Context: Diabetes mellitus (DM) is associated with a range of microvascular complications including diabetic nephropathy (DN). Microvascular abnormalities in the kidneys are common histopathologic findings in DN, which represent one manifestation of ongoing systemic microvascular damage. Recently, sidestream dark-field (SDF) imaging has emerged as a noninvasive tool that enables one to visualize the microcirculation. In this study, we investigated whether changes in the systemic microvasculature induced by DM and an atherogenic diet correlated spatiotemporally with renal damage. Atherosclerotic lesion development was triggered in streptozotocin-induced DM pigs (140 mg/kg body weight) by administering an atherogenic diet for approximately 11 months. Fifteen months following induction of DM, microvascular morphology was visualized in control pigs (n = 7), non-diabetic pigs fed an atherogenic diet (ATH, n = 5), and DM pigs fed an atherogenic diet (DM+ATH, n = 5) using SDF imaging of oral mucosal tissue. Subsequently, kidneys were harvested from anethesized pigs and the expression levels of well-established markers for microvascular integrity, such as Angiopoietin-1 (Angpt1) and Angiopoietin-2 (Angpt2) were determined immunohistochemically, while endothelial cell (EC) abundance was determined by immunostaining for von Willebrand factor (vWF). Our study revealed an increase in the capillary tortuosity index in DM+ATH pigs (2.31±0.17) as compared to the control groups (Controls 0.89±0.08 and ATH 1.55±0.11; p<0.05). Kidney biopsies showed marked glomerular lesions consisting of mesangial expansion and podocyte lesions. Furthermore, we observed a disturbed Angpt2/Angpt1 balance in the cortex of the kidney, as evidenced by increased expression of Angpt2 in DM+ATH pigs as compared to Control pigs (p<0.05). | In the setting of DM, atherogenesis leads to the augmentation of mucosal capillary tortuosity, indicative of systemic microvascular damage. Concomitantly, a dysbalance in renal angiopoietins was correlated with the development of diabetic nephropathy. As such, our studies strongly suggest that defects in the systemic microvasculature mirror the accumulation of microvascular damage in the kidney.
###Answer: yes |
Your role involves answering medical questions and offering advice to users based on their descriptions. | Hi sir,im Sandhya my husband was suffering with jaundice from one week who is affected by diabetes last year.and he was 28years old and he was taking homeo medicine for DM (from Homeo care international Hyderabad).along with jaundice medicine tab:hepamerg.is there any problem to glucose levels which are fasting glucose 124mg/dl after lunch 176mg/dl at present.with this jaundice and how he will be cured from these helrh issues and advice diet plan for jaundice along with diabetes. am very depressed pls help me sir. | Hi Sandy, Good day. Noted your question. At the age of 29 years, we would consider his fasting blood glucose as reasonably well controlled, however, his post lunch (post meals) glucose of 176 is suboptimal. However, we need serial glucose monitoring to decide further. A single reading is not enough. So kindly do regular blood glucose monitoring and maintain a chart. Please take the glucose reading chart to your doctor. In addition, your doctor need to do a HAC test as well. As far as jaundice and diabetes diet is concerned, it is best to discuss with a dietician. In general, in Jaundice, it is good to eat a diet which is low in fat. For diabetes, he should take a diet low in simple carboy Chat Doctor. Please do not get depressed, his blood sugar readings are not very bad and can be easily controlled. |
Being a doctor, your task is to answer the medical questions based on the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is 1,5-Anhydroglucitol in saliva a noninvasive marker of short-term glycemic control?
###Context: In most ethnicities at least a quarter of all cases with diabetes is assumed to be undiagnosed. Screening for diabetes using saliva has been suggested as an effective approach to identify affected individuals. The objective of the study was to identify a noninvasive metabolic marker of type 2 diabetes in saliva. In a case-control study of type 2 diabetes, we used a clinical metabolomics discovery study to screen for diabetes-relevant metabolic readouts in saliva, using blood and urine as a reference. With a combination of three metabolomics platforms based on nontargeted mass spectrometry, we examined 2178 metabolites in saliva, blood plasma, and urine samples from 188 subjects with type 2 diabetes and 181 controls of Arab and Asian ethnicities. We found a strong association of type 2 diabetes with 1,5-anhydroglucitol (1,5-AG) in saliva (P = 3.6 × 10(-13)). Levels of 1,5-AG in saliva highly correlated with 1,5-AG levels in blood and inversely correlated with blood glucose and glycosylated hemoglobin levels. These findings were robust across three different non-Caucasian ethnicities (Arabs, South Asians, and Filipinos), irrespective of body mass index, age, and gender. | Clinical studies have already established 1,5-AG in blood as a reliable marker of short-term glycemic control. Our study suggests that 1,5-AG in saliva can be used in national screening programs for undiagnosed diabetes, which are of particular interest for Middle Eastern countries with young populations and exceptionally high diabetes rates.
###Answer: yes |
As a medical professional, your responsibility is to address the medical questions using the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Do r-alpha-lipoic acid and acetyl-L-carnitine complementarily promote mitochondrial biogenesis in murine 3T3-L1 adipocytes?
###Context: The aim of the study was to address the importance of mitochondrial function in insulin resistance and type 2 diabetes, and also to identify effective agents for ameliorating insulin resistance in type 2 diabetes. We examined the effect of two mitochondrial nutrients, R-alpha-lipoic acid (LA) and acetyl-L-carnitine (ALC), as well as their combined effect, on mitochondrial biogenesis in 3T3-L1 adipocytes. Mitochondrial mass and oxygen consumption were determined in 3T3-L1 adipocytes cultured in the presence of LA and/or ALC for 24 h. Mitochondrial DNA and mRNA from peroxisome proliferator-activated receptor gamma and alpha (Pparg and Ppara) and carnitine palmitoyl transferase 1a (Cpt1a), as well as several transcription factors involved in mitochondrial biogenesis, were evaluated by real-time PCR or electrophoretic mobility shift (EMSA) assay. Mitochondrial complexes proteins were measured by western blot and fatty acid oxidation was measured by quantifying CO2 production from [1-14C]palmitate. Treatments with the combination of LA and ALC at concentrations of 0.1, 1 and 10 micromol/l for 24 h significantly increased mitochondrial mass, expression of mitochondrial DNA, mitochondrial complexes, oxygen consumption and fatty acid oxidation in 3T3L1 adipocytes. These changes were accompanied by an increase in expression of Pparg, Ppara and Cpt1a mRNA, as well as increased expression of peroxisome proliferator-activated receptor (PPAR) gamma coactivator 1 alpha (Ppargc1a), mitochondrial transcription factor A (Tfam) and nuclear respiratory factors 1 and 2 (Nrf1 and Nrf2). However, the treatments with LA or ALC alone at the same concentrations showed little effect on mitochondrial function and biogenesis. | We conclude that the combination of LA and ALC may act as PPARG/A dual ligands to complementarily promote mitochondrial synthesis and adipocyte metabolism.
###Answer: yes |
In the clinical text, your objective is to identify relationships between medical problems, treatments, and tests. Medical problems are tagged as @problem$, medical tests as @test$, and treatments as @treatment$. Classify the relationship between two entities as one of the following:
Treatment improves medical problem (TrIP)
Treatment worsens medical problem (TrWP)
Treatment causes medical problem (TrCP)
Treatment is administered for medical problem (TrAP)
Treatment is not administered because of medical problem (TrNAP)
Test reveals medical problem (TeRP)
Test conducted to investigate medical problem (TeCP)
Medical problem indicates medical problem (PIP)
No Relations | @problem$ , Hypertension , Hyperlipidemia , Diabetes Mellitus , Hypothyroid , h/o Bilateral DVT 's ( on chronic coumadin therapy ), Pleural disorder ? @problem$ , Gastritis , B12 deficiency , Chronic renal insufficiency , s/p Appendectomy , s/p Lap cholectomy , s/p Total abdominal hysterectomy | No Relations |
You're a doctor, kindly address the medical queries according to the patient's account.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does blood pressure directly correlate with blood viscosity in diabetes type 1 children but not in normals?
###Context: To determine the relationship between mean arterial blood pressure (MAP) and blood viscosity in diabetic type 1 children and healthy controls to investigate whether MAP is independent of blood viscosity in healthy children, and vice versa. Children with diabetes type 1 treated by insulin injection were studied. Controls were healthy children of both sexes. MAP was calculated from systolic and diastolic pressure measurements. Blood viscosity was determined indirectly by measuring blood hemoglobin (Hb) content. The relationship between Hb, hematocrit (Hct) and blood viscosity was determined in a subgroup of controls and diabetics selected at random. 21 (10.6+/-2.5 years) type 1 diabetic children treated with insulin and 25 healthy controls age 9.6+/-1.7 years were studied. Hb was 13.8+/-0.8 g/dl in normal children vs. 14.3+/-0.9 g/dl in the diabetic group (p<0.05). MAP was 71.4+/-8.2 in the normal vs. 82.9+/-7.2 mmHg in the diabetic group (p<0.001). Glucose was 89.3+/-10.6 vs. 202.4+/-87.4 mg/dl respectively. Diabetics had a positive MAP/Hb correlation (p=0.007), while normals showed a non significant (p=0.2) negative correlation. The blood viscosity/Hb relationship was studied in a subgroup of 8 healthy controls and 8 diabetic type 1 children. There was no significant difference in Hb and Hct between groups. Diabetics showed a trend of increasing blood viscosity (+7%, p=0.15). | Normal children compensate for the increase in vascular resistance due to increased blood viscosity (increased Hb and Hct) while diabetic children do not, probably due to endothelial dysfunction.
###Answer: yes |
In your role as a medical professional, address the user's medical questions and concerns. | hello doctor, i am having a serious problem which includes gas getting stuck in my chest and i feel better after i burp but the problem is i do not get burps so easily, also i tend to puke when this happens and then i feel relieved . this is happening since the past 9 months and i am worried. recently i am experiencing chest pain as well. i am under depression since then, this does not end here as my weight is 130 kgs along with diabetes and blood pressure issues. i need a cure please help. | Hello dear, thanks for your question on Chat Doctor. I can understand your situation and problem. In my opinion you are having mostly HERD (gastroesophageal reflux disease). But better to rule out cardiac cause first for your chest pain as you are obese, diabetic and hypertensive. So get done ECG and 2d echo to rule out cardiac cause. If these are normal then no need to worry much for cardiac cause. You are having HERD mostly. It is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause gaseous feeling, burping and burning chest pain. And depression and obesity worsen the HERD. So better to follow these steps. 1. Avoid hot and spicy food, stress and anxiety. 2. Avoid large meals, instead take frequent small meals. 3. Start Proton pump inhibitors. 4. Go for walk after meals. Lose weight by exercise and dieting. 5. Consult psychiatrist and start appropriate treatment for depression. |
Considering your role as a medical practitioner, please use the patient's description to answer the medical questions.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is microRNA-130a expression decreased in Xinjiang Uygur patients with type 2 diabetes mellitus?
###Context: MicroRNAs play important roles in energy metabolism, insulin synthesis, insulin transport and the development of diabetes. This study aims to investigate the expression and effect of microRNA-130a in Uygur patients with type 2 diabetes mellitus (T2DM). Peripheral blood and omental adipose tissues were collected from individuals with normal glucose tolerance and patients with T2DM. The microRNA expression profile of peripheral blood was established by microarray analysis. The differentially expressed microRNAs and possible target genes were identified by bioinformatics analysis. MicroRNA-130a mimics and inhibitors were transfected into 3T3-L1 preadipocytes. Our results showed that microRNA-130a expression level was significantly decreased in peripheral blood and omental adipose tissues of T2DM patients (P < 0.01). Peroxisome proliferator-activated receptors γ (PPARγ) were predicted as target genes of microRNA-130a. This prediction was verified by the results that PPARγ mRNA expression in omental adipose tissues of T2DM patients were significantly increased (P < 0.01). The glucose consumption level after microRNA-130a transfection was significantly decreased (P < 0.05). And, microRNA-130a mimics inhibited PPARγ expression at both mRNA and protein level, further suggesting that PPARγ is a target gene of microRNA-130a. Additionally, adiponectin, lipoprotein lipase, CCAAT enhancer binding protein α, and the downstream genes of PPARγ, were significantly decreased after microRNA-130a mimics transfection. | In conclusion, microRNA-130a is decreased in Uygur patients with T2DM and it may play a role in T2DM through targeting PPARγ.
###Answer: yes |
Given your profession as a doctor, please provide responses to the medical questions using the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is post-traumatic stress disorder ( PTSD ) a contraindication to gastric bypass in veterans with morbid obesity?
###Context: The veteran population is routinely screened for post-traumatic stress disorder (PTSD). The prevalence of obesity in this population continues to increase. We examined whether weight loss outcomes in veterans with PTSD is comparable to results in veterans who do not suffer from PTSD, after gastric bypass. We also examined the effect of bariatric surgery on PTSD symptoms. This retrospective review of prospective data compares veterans with and without PTSD who underwent laparoscopic gastric bypass. Differences between the means of age, initial BMI, and percent excess weight loss were compared between the groups using a Student's t test. Pearson's chi(2) was used to evaluate the relationship between a diagnosis of PTSD, major depressive disorder (MDD), and other Axis I psychiatric disorders. A similar analysis was done to assess for a relationship between PTSD and obesity-related comorbidities, including diabetes mellitus (DM), hypertension (HTN), hyperlipidemia, and GERD. We identified 24 patients who had gastric bypass and a diagnosis of PTSD before surgery and compared them to those without PTSD. Both groups had a similar mean age and initial BMI. There was no significant difference between the percent excess weight lost after 1 year follow-up between the PTSD group (66%) and the non-PTSD group (72%) (p = 0.102). In assessing comorbid conditions, we found a significant association between the diagnosis of PTSD and MDD (p = 0.002), PTSD and other Axis I disorders (p = 0.004), and PTSD and GERD (p = 0.002). However, we saw no significant association between PTSD and DM (p = 0.977), HTN (p = 0.332), and obstructive sleep apnea (OSA) (p = 0.676). The severity of PTSD symptoms fluctuated in the postoperative period. | Veterans with PTSD have comparable weight loss to those without PTSD after gastric bypass. In addition, surgery does not seem to have an adverse effect on PTSD symptoms, although PTSD symptomatology tends to fluctuate over time. Further study in this patient population is warranted.
###Answer: no |
If you have expertise in healthcare, assist users by addressing their medical questions and concerns. | my brother suffering kidney problem which findout 15 days ago he aiso diabetes patient since 15 years .his age is 56, height 5 feet & 2 inch, weight 58 kg. his creatinine result is 2.3, hba1c is 6.75. i want know that is it possiable to improve kidney faunction or suggest me where is best treatment in chanyai or banglor. some of my friends are advise to go to cmc vellor. we are in bangladeshi so i need cheepest treatment because we are not solvent.we are not relay with our doctor in our country. | Since your brother is a diabetic patient since 15 years, kidney problem is most probably due to poor diabetes control. He needs to be hospitalized since creatinine levels are high. Treatment is good in both Chennai and Bangalore, but I would prefer Bangalore. Go for a Govt setup(treatment will be cheap). Medicines taken for diabetes need to be reviewed and do all the relevant kidney function tests and blood glucose test. |
If you possess medical knowledge, assist users by addressing their health-related questions. | Hi, yes, I m asking for my boyfriend. He is 52 years old and has been experiencing pain in one testicle at the beginning of intercourse. He likens it to a sharp pain (like when a guy gets racked ). This started a week ago. In addition, he has been suffering from light headedness, chills, headaches and no energy for about 6 months off and on. Could the two be related? He s under a tremendous about of stress, never eats breakfast, and drinks diet coke all day long instead of water, so I thought the latter could be diabetes-type symptoms. Welcome your input. Thanks! | Hi Dear!! Thanks for your query to Chat Doctor. Read your query and understood your health concern. I feel concerned about your health issues. Based on the facts of your query, Your boyfriend seem to suffer from-Orchitis with epididymitis ? TB with diabetes. Treatment Suggested-You need to Consult Urologist and evaluate for the cause of it. Usg and Color Doppler is suggested to rule out accompanied Varicocele with it. After tests and physical check he may treat it by - antibiotics/ anti-inflammatory cover - 10 days course and would wait for response after it. If no response investigated for TB / or Chronic Prostatitis with old STD which needs to be ruled out. Urologist would treat it with antibiotics with intraprostatic injections if need be for the early recovery from this testicle pain and headache during intercourse. Hope this reply would help you to plan further treatment with your doctors there. Welcome for further query in this regard if any. Good Day!! Chat Doctor. N. Senior Surgical Specialist. S. Genl-CVTS |
In the provided clinical sentences, your objective is to determine their relationship and assign one of the following labels:
Contradiction: If the sentences present conflicting information.
Neutral: If there is no apparent logical relationship between the sentences.
Entailment: If one sentence logically implies or necessitates the other. | Sentence 1: Poorly controlled with past DKA.
Sentence 2: History of diabetes | Entailment |
Considering your role as a medical practitioner, please use the patient's description to answer the medical questions.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Are nonsteroidal anti-inflammatory drugs associated with reduced risk of early hepatocellular carcinoma recurrence after curative liver resection : a nationwide cohort study?
###Context: The efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) in reducing the risk of various de novo cancers has been reported; however, its role in reducing hepatocellular carcinoma (HCC) recurrence after liver resection still remains unknown. We have conducted a nationwide cohort study by recruiting all patients with a newly diagnosed HCC who had received curative liver resection as their initial treatment. The use of NSAIDs and the risk of early HCC recurrence have been examined by multivariate and stratified analyses. To avoid immortal time bias, the use of NSAIDs has been treated as a time-dependent variable in Cox proportional hazard ratio models. Between January 1997 and December 2010, a total of 15,574 HCC patients who had received liver resection were enrolled in this study. The 1-, 3-, and 5-year overall survival rates were 90.4%, 73.2%, and 59.8%, respectively. The 1-, 3-, and 5-year disease-free survival rates were 80.5%, 59.4%, and 50.2%, respectively. NSAID use (hazard ratio, 0.81; 95% confidence interval, 0.73-0.90) and minor liver resection (hazard ratio, 0.83; 95% confidence interval, 0.78-0.89) were independently associated with a reduced risk of early HCC recurrence after liver resection. In the stratified analyses, NSAID usage was universally associated with reduced risks in most subgroups, particularly for those aged younger than 65 years, male, with underlying diabetes mellitus and receiving major liver resection. | The use of NSAIDs can be associated with a reduced risk of early HCC recurrence within 2 years after curative liver resection, regardless of patients' age, extent of liver resection, viral hepatitis status, underlying diabetes, and liver cirrhosis.
###Answer: yes |
Given your profession as a doctor, please provide responses to the medical questions using the patient's description.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Is 4-Heptanone a metabolite of the plasticizer di ( 2-ethylhexyl ) phthalate ( DEHP ) in haemodialysis patients?
###Context: There is an ongoing discussion about the risks of di(2-ethylhexyl) phthalate (DEHP) exposure for the general population as well as for specific subgroups in various medical settings. Haemodialysis patients certainly belong to the group with the highest exposure taking into account the repeated treatments over a long period of time. Many studies have shown that DEHP metabolites are more active with regard to cellular responses than DEHP itself. Although 4-heptanone has been shown to be a DEHP metabolite in rats, this has never been tested in humans. On the other hand, 4-heptanone was reported to be associated with diabetes mellitus. After establishing analytical methods for all postulated metabolites, we analysed (i) plasma samples from 50 patients on haemodialysis and 50 controls; (ii) urine samples from 100 diabetic patients and 100 controls; and (iii) urine samples from 10 controls receiving DEHP intravenously. 4-Heptanone concentrations in urine did not differ between controls (128.6+/-11.4 micro g/l, mean+/- SEM) and diabetic patients (131.2+/-11.6 micro g/l) but were significantly elevated in plasma from haemodialysis patients (95.9+/-9.6 micro g/l) compared with controls (10.4+/-0.5 micro g/l). Exposure to DEHP led to a significant increase (P<0.001) of the metabolite 4-heptanone and all the proposed intermediates in urine of healthy persons within 24 h. | These studies show that 4-heptanone is not associated with diabetes but is a major DEHP metabolite in humans. Studies concerning the toxicity of DEHP in haemodialysis patients and other highly exposed groups should therefore include 4-heptanone together with DEHP and its primary metabolites mono(2-ethylhexyl) phthalate (MEHP) and 2-ethylhexanol.
###Answer: yes |
As a healthcare professional, please evaluate the patient's description and offer your expertise in answering the medical questions.
Analyze the question given its context. Give both long answer and yes/no decision. | ###Question: Does impairment of anorectal function in diabetes mellitus parallel duration of disease?
###Context: The aim of this study was to investigate any possible relation between the severity of anorectal dysfunction in diabetes mellitus and duration of disease and presence of microangiopathy or neuropathy or both. Standard multiport anorectal manometry was performed in 25 healthy control subjects (10 males; age (mean +/- 1 standard deviation), 62 +/- 14 years) and 38 patients with diabetes mellitus. Patients were divided into two groups according to the duration of the disease: Group A (19 patients) with a duration less than 10 years (7.2 +/- 2.5; 8 males; age, 57 +/- 18) and Group B (19 patients) with a duration longer than 10 years (19.8 +/- 5.6; 6 males; age, 62 +/- 15). Results are reported as mean +/- one standard deviation. Patients showed lower resting and squeeze anal pressures (P < 0.01), impaired rectoanal inhibitory and anocutaneous reflexes, and reduced sensitivity in rectal distention (P = 0.004) as compared with controls. In addition, Group B showed a significantly increased incidence of microangiopathy (P = 0.04) and autonomic and peripheral neuropathy (P = 0.002), significantly reduced basal and squeeze anal pressures (52 +/- 16 vs. 64 +/- 24 mmHg; P = 0.03 and 98 +/- 39 vs. 124 +/- 54 mmHg; P = 0.04, respectively), reduced amplitude of slow waves (7.3 +/- 3 ts. 9.5 +/- 3.7 mmHg; P = 0.03), anal leak in smaller rectal volumes (P = 0.003), and reduced response of the anal sphincter at the anocutaneous reflexes (29 +/- 14 vs. 39 +/- 14 mmHg; P = 0.05) compared with Group A. The former group of patients exhibited a significantly higher incidence of fecal incontinence (P = 0.008). | Patients with long-standing diabetes mellitus have increased incidence of fecal incontinence and severely impaired function of both the anal sphincters and the rectum. These findings could be attributed to the increased incidence of microangiopathy and autonomic and peripheral neuropathy observed in this subset of diabetic patients.
###Answer: yes |
Your role as a doctor requires you to answer the medical questions taking into account the patient's description.
Answer with the best option directly. | ###Question: A 71-year-old woman with a past medical history of type 2 diabetes, hypercholesterolemia, and hypertension was admitted to the hospital 8 hours ago with substernal chest pain for management of acute non-ST-elevated myocardial infarction (NSTEMI). The ECG findings noted by ST-depressions and T-wave inversions on anterolateral leads, which is also accompanied by elevated cardiac enzymes. Upon diagnosis, management with inhaled oxygen therapy, beta-blockers and aspirin, and low-molecular-weight heparin therapy were initiated, and she was placed on bed rest with continuous electrocardiographic monitoring. Since admission, she required 2 doses of sublingual nitric oxide for recurrent angina, and the repeat troponin levels continued to rise. Given her risk factors, plans were made for early coronary angiography. The telemetry nurse calls the on-call physician because of her concern with the patient’s mild confusion and increasing need for supplemental oxygen. At bedside evaluation, The vital signs include: heart rate 122/min, blood pressure 89/40 mm Hg, and the pulse oximetry is 91% on 6L of oxygen by nasal cannula. The telemetry and a repeat ECG show sinus tachycardia. She is breathing rapidly, appears confused, and complains of shortness of breath. On physical exam, the skin is cool and clammy and appears pale and dull. She has diffuse bilateral pulmonary crackles, and an S3 gallop is noted on chest auscultation with no new murmurs. She has jugular venous distention to the jaw-line, rapid and faint radial pulses, and 1+ dependent edema. She is immediately transferred to the intensive care unit for respiratory support and precautions for airway security. The bedside sonography shows abnormal hypodynamic anterior wall movement and an ejection fraction of 20%, but no evidence of mitral regurgitation or ventricular shunt. The chest X-ray demonstrates cephalization of pulmonary veins and pulmonary edema. What is the most appropriate next step in the stabilization of this patient?
###Options:
A. Insert two large-bore intravenous catheters and start rapid fluid resuscitation
B. Initiate dopamine therapy and diuresis
C. Obtain blood cultures and start preliminary broad-spectrum antibiotics
D. Intubate the patient and perform an emergency cardiocentesis
| ###Answer: OPTION B IS CORRECT. |
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