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You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- In literature there are only few data which describe the influence of occupation on the development of rotator cuff disease.
- In a retrospective study, 760 open rotator cuff repairs were analysed and related to the profession and occupational load. Exclusion criteria were traumatic tears and sports injuries. All male persons were statistically analysed and the data compared with occupational patterns of the region, obtained from the Federal Statistical State Office.
- Rotator cuff repairs were performed in 472 males who had no evidence for a traumatic origin. After statistical analysis (p<0.001) we found significantly more patients working in agriculture and forestry (6.38% versus 1.07% in Bavaria) and in the building industry (35.11% versus 13.40% in Bavaria).
Question: Rotator cuff tear--an occupational disease?
Options:
A. yes
B. no
C. maybe
|
Our data suggest that working exposure increases the risk or leads to the clinical manifestation of rotator cuff tears. Although a detailed analysis of individual physical exposure is not available yet, the statistical results indicate that rotator cuff tears must be taken into consideration as a result of ergonomic exposure. The answer is: A
|
A
|
Rotator cuff tear--an occupational disease?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Multiple sclerosis (MS) is an immune-mediated inflammatory demyelinating disease of uncertain etiology. Although the mechanisms of inducting autoimmunity by some of the infectious agents have been investigated, there is not yet enough research on streptococcal infections.MATERIAL/
- To understand the effect of past group A streptococcal infection on MS, antistreptolysin O (ASO) and antideoxyribonuclease B (ADNase B) were measured in 21 patients with relapsing-remitting MS and 21 healthy blood donors by nephelometric assay.
- ADNase B levels in the patients with MS were found to be significantly higher than in the controls (p<0.001); however, ASO levels were similar in both groups.
Question: Is there any relationship between streptococcal infection and multiple sclerosis?
Options:
A. yes
B. no
C. maybe
|
These findings indicate that a relationship between multiple sclerosis and streptococcal infections may exist, but to acquire a better understanding of the role of group A streptococci in the pathogenesis of multiple sclerosis, more studies with animal models are necessary. The answer is: A
|
A
|
Is there any relationship between streptococcal infection and multiple sclerosis?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Interference from irrelevant negative material might be a key mechanism underlying intrusive ruminative thoughts in depression. Considering commonalities between depression and social anxiety and the presence of similar intrusive thoughts in social anxiety, the current study was designed to assess whether interference from irrelevant material in working memory is specific to depression or is also present in social anxiety disorder.
- To examine the effects of irrelevant emotional material on working memory performance, participants memorized two lists of words on each trial and were subsequently instructed to ignore one of the lists. Participants were then asked to indicate whether a probe word belonged to the relevant list or not.
- Compared to control and social anxiety groups, the depression groups (both pure and comorbid with social anxiety disorder) exhibited greater difficulties removing irrelevant emotional material from working memory (i.e., greater intrusion effects). Greater intrusion effects were also associated with increased rumination.
- Although we included three clinical groups (depression, social anxiety, and the comorbid groups), the results are based on a relatively small number of participants.
Question: Updating emotional content in working memory: a depression-specific deficit?
Options:
A. yes
B. no
C. maybe
|
The results indicate that difficulties removing irrelevant material from working memory might be unique to depression, and the ability to inhibit irrelevant information is relatively preserved in social anxiety disorder. The answer is: A
|
A
|
Updating emotional content in working memory: a depression-specific deficit?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Web search engines are an important tool in communication and diffusion of knowledge. Among these, Google appears to be the most popular one: in August 2008, it accounted for 87% of all web searches in the UK, compared with Yahoo's 3.3%. Google's value as a diagnostic guide in general medicine was recently reported. The aim of this comparative cross-sectional study was to evaluate whether searching Google with disease-related terms was effective in the identification and diagnosis of complex immunological and allergic cases.
- Forty-five case reports were randomly selected by an independent observer from peer-reviewed medical journals. Clinical data were presented separately to three investigators, blinded to the final diagnoses. Investigator A was a Consultant with an expert knowledge in Internal Medicine and Allergy (IM&A) and basic computing skills. Investigator B was a Registrar in IM&A. Investigator C was a Research Nurse. Both Investigators B and C were familiar with computers and search engines. For every clinical case presented, each investigator independently carried out an Internet search using Google to provide a final diagnosis. Their results were then compared with the published diagnoses.
- Correct diagnoses were provided in 30/45 (66%) cases, 39/45 (86%) cases, and in 29/45 (64%) cases by investigator A, B, and C, respectively. All of the three investigators achieved the correct diagnosis in 19 cases (42%), and all of them failed in two cases.
Question: Search engine as a diagnostic tool in difficult immunological and allergologic cases: is Google useful?
Options:
A. yes
B. no
C. maybe
|
This Google-based search was useful to identify an appropriate diagnosis in complex immunological and allergic cases. Computing skills may help to get better results. The answer is: A
|
A
|
Search engine as a diagnostic tool in difficult immunological and allergologic cases: is Google useful?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Chronic low back pain (CLBP) is often accompanied by an abnormal motor performance. However, it has not been clarified yet whether these deviations also occur during motor tasks not involving the back and whether the performance is influenced by pain and pain-related cognitions. Therefore, the aim of the present study is to get insight in the contribution of both pain experience and pain-related cognitions to general motor task performance in CLBP.
- 13 CLBP patients and 15 healthy subjects performed a hand-function task in three conditions: sitting, lying prone (lying) and lying prone without trunk support (provoking). The last condition was assumed to provoke pain-related cognitions, which was considered successful when a patients' pain expectancy on a numeric rating scale was at least 1 point higher than actual pain experienced. Subjects' performance was expressed in reaction time and movement time. Repeated measures analysis of variance was performed to detect main effect for group and condition. Special interest was given to group*condition interaction, since significant interaction would indicate that patients and healthy subjects performed differently throughout the three conditions.
- Patients were slower throughout all conditions compared to healthy subjects. With respect to the provoking condition, patients showed deteriorated performance compared to lying while healthy subjects' performance remained equal between these two conditions. Further analysis of patients' data showed that provocation was successful in 54% of the patients. Especially this group showed deteriorated performance in the provoking condition.
Question: Motor performance in chronic low back pain: is there an influence of pain-related cognitions?
Options:
A. yes
B. no
C. maybe
|
It can be concluded that CLBP patients in general have worse motor task performance compared to healthy subjects and that provoking pain-related cognitions further worsened performance. The answer is: A
|
A
|
Motor performance in chronic low back pain: is there an influence of pain-related cognitions?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Dryness of the mouth is one of the most distressing chronic toxicities of radiation therapy in head and neck cancers. In this study, parotid function was assessed in patients with locally advanced head and neck cancers undergoing intensity-modulated radiotherapy (IMRT) with or without chemotherapy. Parotid function was assessed with the help of a questionnaire and parotid scintigraphy, especially with regards to unilateral sparing of the parotid gland.
- In total, 19 patients were treated with compensator-based IMRT between February 2003 and March 2004. The dose to the clinical target volume ranged between 66 and 70 Gy in 30-35 fractions to 95% of the isodose volume. Ipsilateral high-risk neck nodes received an average dose of 60 Gy and the contralateral low-risk neck received a dose of 54-56 Gy. Eight of 19 patients also received concomitant chemotherapy.
- Subjective toxicity to the parotid glands was assessed with the help of a questionnaire at 0, 3 and 6 months and objective toxicity was assessed with parotid scintigraphy at 0 and 3 months. The mean dose to the ipsilateral parotid gland ranged from 19.5 to 52.8 Gy (mean 33.14 Gy) and the mean dose to the contralateral gland was 11.1-46.6 Gy (mean 26.85 Gy). At a median follow-up of 13 months, 9/19 patients had no symptoms of dryness of the mouth (grade I), 8/19 had mild dryness of the mouth (grade II) and only 2/19 had grade III xerostomia, although the parotid gland could only be spared on one side in most of the patients.
Question: Can dose reduction to one parotid gland prevent xerostomia?
Options:
A. yes
B. no
C. maybe
|
Minimising the radiation dose to one of the parotid glands with the help of IMRT in patients with advanced head and neck cancers can prevent xerostomia in most patients and parotid scintigraphy is a useful method of documenting xerostomia. The answer is: A
|
A
|
Can dose reduction to one parotid gland prevent xerostomia?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The gluten-free diet has traditionally been accepted as a healthy diet, but there are articles advocating that it may have some nutritional deficiencies. The current study assesses whether there was any change in the contributions of calories, essential elements, proportion of fatty acids, vitamins, minerals and fiber in children who were diagnosed with celiac diseases, comparing the diet with gluten prior one year after diagnosis with the diet without gluten to the year of diagnosis. The level of clinical or analytical impact that nutritional deficits could have was also assessed.
- A prospective,descriptive, observational study in which information was collected from a dietary survey, anthropometric and analytical data at pre-diagnosis of celiac disease and following a gluten diet and one year after celiac disease diagnosis, under gluten-free diet.
- A total of 37 patients meet the study criteria. A decrease in the intake of saturated fatty acids was found, with an increase of monounsaturated fatty acids and an increase in the intake of phosphorus in the diet without gluten. A deficient intake of vitamin D was found in both diets. Clinically, at year of gluten-free diet there was an improvement in weight and size. Analytically, there was an improvement in hemoglobin, ferritin, vitamin D, and parathyroid hormone in plasma.
Question: Nutritional assessment of gluten-free diet. Is gluten-free diet deficient in some nutrient?
Options:
A. yes
B. no
C. maybe
|
The gluten-free diet has minimal deficiencies, similar to those present in the diet with gluten, with an improvement in the lipid profile by increasing the proportion of monounsaturated fatty acids to the detriment of saturated fatty acids. The answer is: A
|
A
|
Nutritional assessment of gluten-free diet. Is gluten-free diet deficient in some nutrient?
|
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You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Schools can play an important role in the prevention of obesity, e.g. by providing an environment that stimulates healthy eating habits and by developing a food policy to provide such an environment. The effectiveness of a school food policy is affected by the content of the policy, its implementation and its support by parents, teachers and principals. The aim of this study is to detect opportunities to improve the school food policy and/or implementation at Dutch primary schools. Therefore, this study explores the school food policy and investigates schools' (teachers and principals) and parents' opinion on the school food policy.
- Data on the schools' perspective of the food policy was collected from principals and teachers by means of semi-structured interviews. In total 74 principals and 72 teachers from 83 Dutch primary schools were interviewed. Data on parental perceptions about the school food policy were based on a cross-sectional survey among 1,429 parents from the same schools.
- Most principals (87.1%) reported that their school had a written food policy; however in most cases the rules were not clearly defined. Most of the principals (87.8%) believed that their school paid sufficient attention to nutrition and health. Teachers and principals felt that parents were primarily responsible to encourage healthy eating habits among children, while 49.8% of the parents believed that it is also a responsibility of the school to foster healthy eating habits among children. Most parents reported that they appreciated the school food policy and comply with the food rules. Parents' opinion on the enforcement of the school food policy varied: 28.1% believed that the school should enforce the policy more strongly, 32.1% was satisfied, and 39.8% had no opinion on this topic.
Question: School food policy at Dutch primary schools: room for improvement?
Options:
A. yes
B. no
C. maybe
|
Dutch primary schools could play a more important role in fostering healthy eating habits among children. The school food policy could be improved by clearly formulating food rules, simplifying supervision of the food rules, and defining how to enforce the food rules. In addition, the school food policy will only influence children's dietary behaviour if both the school and the parents support the policy. The answer is: A
|
A
|
School food policy at Dutch primary schools: room for improvement?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- In the prehospital setting, Emergency Medical Services (EMS) professionals rely on providing positive pressure ventilation with a bag-valve-mask (BVM). Multiple emergency medicine and critical care studies have shown that lung-protective ventilation protocols reduce morbidity and mortality. Our primary objective was to determine if a group of EMS professionals could provide ventilations with a smaller BVM that would be sufficient to ventilate patients. Secondary objectives included 1) if the pediatric bag provided volumes similar to lung-protective ventilation in the hospital setting and 2) compare volumes provided to the patient depending on the type of airway (mask, King tube, and intubation).
- Using a patient simulator of a head and thorax that was able to record respiratory rate, tidal volume, peak pressure, and minute volume via a laptop computer, participants were asked to ventilate the simulator during six 1-minute ventilation tests. The first scenario was BVM ventilation with an oropharyngeal airway in place ventilating with both an adult- and pediatric-sized BVM, the second scenario had a supraglottic airway and both bags, and the third scenario had an endotracheal tube and both bags. Participants were enrolled in convenience manner while they were on-duty and the research staff was able to travel to their stations. Prior to enrolling, participants were not given any additional training on ventilation skills.
- We enrolled 50 providers from a large, busy, urban fire-based EMS agency with 14.96 (SD = 9.92) mean years of experience. Only 1.5% of all breaths delivered with the pediatric BVM during the ventilation scenarios were below the recommended tidal volume. A greater percentage of breaths delivered in the recommended range occurred when the pediatric BVM was used (17.5% vs 5.1%, p<0.001). Median volumes for each scenario were 570.5mL, 664.0mL, 663.0mL for the pediatric BMV and 796.0mL, 994.5mL, 981.5mL for the adult BVM. In all three categories of airway devices, the pediatric BVM provided lower median tidal volumes (p<0.001).
Question: Can EMS Providers Provide Appropriate Tidal Volumes in a Simulated Adult-sized Patient with a Pediatric-sized Bag-Valve-Mask?
Options:
A. yes
B. no
C. maybe
|
The study suggests that ventilating an adult patient is possible with a smaller, pediatric-sized BVM. The tidal volumes recorded with the pediatric BVM were more consistent with lung-protective ventilation volumes. The answer is: A
|
A
|
Can EMS Providers Provide Appropriate Tidal Volumes in a Simulated Adult-sized Patient with a Pediatric-sized Bag-Valve-Mask?
|
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You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To ascertain whether hospital type is associated with differences in total cost and outcomes for inpatient tonsillectomy.
- Cross-sectional analysis of the 2006, 2009, and 2012 Kids' Inpatient Database (KID).
- Children ≤18 years of age undergoing tonsillectomy with/without adenoidectomy were included. Risk-adjusted generalized linear models assessed for differences in hospital cost and length of stay (LOS) among children managed by (1) non-children's teaching hospitals (NCTHs), (2) children's teaching hospitals (CTHs), and (3) nonteaching hospitals (NTHs). Risk-adjusted logistic regression compared the odds of major perioperative complications (hemorrhage, respiratory failure, death). Models accounted for clustering of patients within hospitals, were weighted to provide national estimates, and controlled for comorbidities.
- The 25,685 tonsillectomies recorded in the KID yielded a national estimate of 40,591 inpatient tonsillectomies performed in 2006, 2009, and 2012. The CTHs had significantly higher risk-adjusted total cost and LOS per tonsillectomy compared with NCTHs and NTHs ($9423.34/2.8 days, $6250.78/2.11 days, and $5905.10/2.08 days, respectively; P<.001). The CTHs had higher odds of complications compared with NCTHs (odds ratio [OR], 1.48; 95% CI, 1.15-1.91; P = .002) but not when compared with NTHs (OR, 1.19; 95% CI, 0.89-1.59; P = .23). The CTHs were significantly more likely to care for patients with comorbidities (P<.001).
Question: Inpatient Pediatric Tonsillectomy: Does Hospital Type Affect Cost and Outcomes of Care?
Options:
A. yes
B. no
C. maybe
|
Significant differences in costs, outcomes, and patient factors exist for inpatient tonsillectomy based on hospital type. Although reasons for these differences are not discernable using isolated claims data, findings provide a foundation to further evaluate patient, institutional, and system-level factors that may reduce cost of care and improve value for inpatient tonsillectomy. The answer is: A
|
A
|
Inpatient Pediatric Tonsillectomy: Does Hospital Type Affect Cost and Outcomes of Care?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- This study examined the extent to which ADHD was associated with risky sexual behaviors (RSBs) in a sample of 92 undergraduates with (n = 44) and without (n = 48) ADHD. Mother-child relationship quality was examined as a potential moderator.
- We conducted comprehensive assessments for ADHD and comorbid conditions and collected measures of RSB and mother-child relationship quality.
- Female students with ADHD were least likely to use condoms than males overall and females without ADHD. An interaction between ADHD and mother-child relationship quality accounted for significant variance in the number of past-year sexual partners, such that a high-quality relationship was protective only for students with ADHD. No other significant associations were found between ADHD and RSB.
Question: Risky sexual behavior among college students With ADHD: is the mother-child relationship protective?
Options:
A. yes
B. no
C. maybe
|
Results suggest that female college students with ADHD are at risk for unprotected sex. Moreover, a positive mother-child relationship may be protective for college students with ADHD in relation to RSB. The answer is: A
|
A
|
Risky sexual behavior among college students With ADHD: is the mother-child relationship protective?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Elevated resting heart rate (RHR) is a neglected marker in cardiovascular risk factor studies of sub-Saharan African populations. This study aimed to determine the prevalence of elevated RHR and other risk factors for cardiovascular disease (CVD) and to investigate any associations between RHR and these risk factors in a rural population in Ghana.
- Cross-sectional analysis.
- A total of 574 adults aged between 18-65 years were randomly sampled from a population register. Data collected included those on sociodemographic variables and anthropometric, blood pressure (BP), and RHR measurements. Within-person variability in RHR was calculated using data from repeat measurements taken 2 weeks apart.
- Of study participants, 36% were male. Prevalence of casual high BP was 19%. In the population, 10% were current cigarette smokers and habitual alcohol use was high at 56%. As measured by body mass index, 2% were obese and 14% had abdominal obesity. RHR was elevated (>90 bpm) in 19%. Overall, 79% of study participants were found to have at least one CVD risk factor. RHR was significantly associated with age, waist circumference, and BP. Individuals with an elevated RHR had a higher risk (OR 1.94, 95% CI 1.15-3.26%, p = 0.013) of casual high BP compared with participants with normal RHR independently of several established CVD risk factors. The regression dilution ratio of RHR was 0.75 (95% CI 0.62-0.89).
Question: Cardiovascular risk in a rural adult West African population: is resting heart rate also relevant?
Options:
A. yes
B. no
C. maybe
|
Significant associations were observed between RHR and several established cardiovascular risk factors. Prospective studies are needed in sub-Saharan African populations to establish the potential value of RHR in cardiovascular risk assessment. The answer is: A
|
A
|
Cardiovascular risk in a rural adult West African population: is resting heart rate also relevant?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To date, no prospective comparative study of the diagnostic value of STIR versus T1-weighted (T1w) sequences at both 1.5 T and 3 T has been performed with special focus on the detectability of bone metastases.
- 212 oncological patients had a whole-body MRI at 1.5 T and/or at 3 T. The standard protocol comprised STIR and T1w sequences. All patients who showed typical signs of bone metastases were included in the study. Evaluation of the images was performed by the calculation of the number of metastases by three independent readers and by visual assessment on a 4-point scale.
- 86 patients fulfilled the inclusion criteria. The total number of metastases was significantly higher on T1w than on STIR images at both field strengths (p<0.05). T1w revealed a sensitivity of 99.72% (3 T) and 100.00% (1.5 T) versus STIR with 70.99 % (3 T) and 79.34 % (1.5 T). In 53% (38/72) of all patients, STIR detected fewer bone metastases in comparison with T1w at 3 T. At 1.5 T, STIR showed inferior results in 37.5 % (18/48) of all patients. Qualitative analysis indicated a significantly better lesion conspicuity, lesion delineation and an improved image quality on T1w compared to STIR imaging at both field strengths (p<0.05) with similar results for T1w at 1.5 T and 3 T, but inferior results for STIR especially at 3 T.
Question: MR Diagnosis of Bone Metastases at 1.5 T and 3 T: Can STIR Imaging Be Omitted?
Options:
A. yes
B. no
C. maybe
|
The whole-body MRI protocol for the detection of bone metastases could safely be limited to the T1w sequence in adults, especially at 3 T. There is no need for an additional STIR sequence. These initial results will have a major impact on the department's workflow if confirmed by larger studies as they will help reduce examination time and therefore save financial resources. The answer is: A
|
A
|
MR Diagnosis of Bone Metastases at 1.5 T and 3 T: Can STIR Imaging Be Omitted?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The aim of this study was to assess the reproducibility of different measurement methods and define the most workable technique for measuring head and neck paragangliomas, to determine the best method for evaluating tumour growth. The evaluation of tumour growth is vital for a 'wait-and-scan' policy, a management strategy that became increasingly important.
- Method comparison study.
- Thirty tumours, including carotid body, vagal body, jugulotympanic tumours and conglomerates of multiple tumours, were measured in duplicate, using linear dimensions, manual area tracing and an automated segmentation method.
- Reproducibility was assessed using the Bland-Altman method.
- The smallest detectable difference using the linear dimension method was 11% for carotid body and 27% for vagal body tumours, compared with 17% and 20% for the manual area tracing method. Due to the irregular shape of paragangliomas in the temporal bone and conglomerates, the manual area tracing method showed better results in these tumours (26% and 8% versus 54% and 47%). The linear dimension method was significantly faster (median 4.27 versus 18.46 minutes, P<0.001). The automatic segmentation method yielded smallest detectable differences between 39% and 75%, and although fast (2.19 ± 1.49 minutes), it failed technically.
Question: Measurement of head and neck paragangliomas: is volumetric analysis worth the effort?
Options:
A. yes
B. no
C. maybe
|
Due to a relatively good reproducibility, fast and easy application, we found the linear dimension method to be the most pragmatic approach for evaluation of growth of carotid and vagal body paragangliomas. For jugulotympanic tumours, the preferred method is manual area tracing. However, volumetric changes of these tumours may be of less clinical importance than changes in relation to surrounding anatomical structures. The answer is: A
|
A
|
Measurement of head and neck paragangliomas: is volumetric analysis worth the effort?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Infliximab, a chimeric monoclonal anti-TNFα antibody, has been found to increase the risk of serious infections compared with the TNF receptor fusion protein etanercept in some studies. It is unclear whether the risk varies by patient characteristics. We conducted a study to address this question.
- We identified members of Kaiser Permanente Northern California who initiated infliximab (n = 793) or etanercept (n = 2692) in 1997-2007. Using a Cox model, we estimated the propensity-score-adjusted hazard ratio (HR) and 95% confidence interval (CI) of serious infections requiring hospitalization or opportunistic infections comparing infliximab initiators to etanercept initiators. We tested whether the adjusted HR differed by age, sex, race/ethnicity, body mass index, and smoking status.
- The crude incidence rate of serious infections per 100 person-years was 5.4 (95%CI: 3.8, 7.5) in patients<65 years and 16.0 (95%CI: 10.4, 23.4) in patients ≥ 65 years during the first 3 months following treatment initiation. Compared with etanercept, the adjusted HR during this period was elevated for infliximab in patients<65 years (HR: 3.01; 95%CI: 1.49, 6.07), but not in those ≥ 65 years (HR 0.94; 95%CI: 0.41, 2.13). Findings did not suggest that the HR varied by the other patient characteristics examined.
Question: Comparative safety of infliximab and etanercept on the risk of serious infections: does the association vary by patient characteristics?
Options:
A. yes
B. no
C. maybe
|
An increased risk of serious infections associated with infliximab relative to etanercept did not appear to be modified by patients' sex, race/ethnicity, body mass index, or smoking status. There was an indication that the increased risk might be limited to patients<65 years. Additional studies are warranted to verify or refute this finding. The answer is: A
|
A
|
Comparative safety of infliximab and etanercept on the risk of serious infections: does the association vary by patient characteristics?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The benefits of serologic screening for coeliac disease in asymptomatic individuals are debatable.AIM: To investigate dietary compliance, quality of life and bone mineral density after long-term treatment in coeliac disease patients found by screening in risk groups.
- The study comprised 53 consecutive screen-detected coeliac patients diagnosed 14 years (median) ago. Dietary compliance was assessed by interview, 4-day food record and serology. Quality of life was evaluated by the Psychological General Well-Being and SF-36 questionnaires, gastrointestinal symptoms by the Gastrointestinal Symptom Rating Scale and bone mineral density by dual-energy x-ray absorptiometry. Comparisons were made to 44 symptom-detected-treated coeliac patients, 110 non-coeliac subjects and the general population.
- A total of 96% of screen-detected and 93% of symptom-detected coeliac patients adhered to a strict or fairly strict gluten-free diet. In screen-detected patients, quality of life and gastrointestinal symptoms were similar to those in symptom-detected patients or non-coeliac controls and bone mineral density was similar to that in the general population.
Question: Is coeliac disease screening in risk groups justified?
Options:
A. yes
B. no
C. maybe
|
Long-term dietary compliance in screen-detected patients was good. Quality of life and bone mineral density were comparable with those in non-coeliac subjects and the general population. Active screening in coeliac disease risk groups seems to be reasonable rather than harmful. The answer is: A
|
A
|
Is coeliac disease screening in risk groups justified?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To determine whether TDP-43 type is associated with distinct patterns of brain atrophy on MRI in subjects with pathologically confirmed frontotemporal lobar degeneration (FTLD).
- In this case-control study, we identified all subjects with a pathologic diagnosis of FTLD with TDP-43 immunoreactive inclusions (FTLD-TDP) and at least one volumetric head MRI scan (n = 42). In each case we applied published criteria for subclassification of FTLD-TDP into FTLD-TDP types 1-3. Voxel-based morphometry was used to compare subjects with each of the different FTLD-TDP types to age- and gender-matched normal controls (n = 30). We also assessed different pathologic and genetic variants within, and across, the different types.
- Twenty-two subjects were classified as FTLD-TDP type 1, 9 as type 2, and 11 as type 3. We identified different patterns of atrophy across the types with type 1 showing frontotemporal and parietal atrophy, type 2 predominantly anterior temporal lobe atrophy, and type 3 predominantly posterior frontal atrophy. Within the FTLD-TDP type 1 group, those with a progranulin mutation had significantly more lateral temporal lobe atrophy than those without. All type 2 subjects were diagnosed with semantic dementia. Subjects with a pathologic diagnosis of FTLD with motor neuron degeneration had a similar pattern of atrophy, regardless of whether they were type 1 or type 3.
Question: Does TDP-43 type confer a distinct pattern of atrophy in frontotemporal lobar degeneration?
Options:
A. yes
B. no
C. maybe
|
Although there are different patterns of atrophy across the different FTLD-TDP types, it appears that genetic and pathologic factors may also affect the patterns of atrophy. The answer is: A
|
A
|
Does TDP-43 type confer a distinct pattern of atrophy in frontotemporal lobar degeneration?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The Pathway represents a longitudinal program for medical students, consisting of both domestic and international experiences with poor populations. A previous study reported no significant attitudinal changes toward the medically indigent between Pathway and non-Pathway students.
- The purpose of this study was to investigate and differentiate the skills and attitudes of Pathway and non-Pathway students in working with culturally diverse populations by conducting quantitative and qualitative analyses.
- Selected items from a cultural assessment were analyzed using independent t-tests and a proportional analysis using approximation of the binomial distribution. In addition, a qualitative assessment of non-Pathway and Pathway students was conducted.
- A statistically significant difference was found at the end of Years 2, 3, and 4 regarding student confidence ratings, and qualitative results had similar findings.
Question: Global Longitudinal Pathway: has medical education curriculum influenced medical students' skills and attitudes toward culturally diverse populations?
Options:
A. yes
B. no
C. maybe
|
Clear and distinct differences between the two studied groups were found indicating the root of this increased confidence may have developed due to exposure to the Pathway program. The answer is: A
|
A
|
Global Longitudinal Pathway: has medical education curriculum influenced medical students' skills and attitudes toward culturally diverse populations?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Laparoscopic colectomy has developed rapidly with the explosion of technology. In most cases, laparoscopic resection is performed for colorectal cancer. Intraoperative staging during laparoscopic procedure is limited. Laparoscopic ultrasonography (LUS) represents the only real alternative to manual palpation during laparoscopic surgery.
- We evaluated the diagnostic accuracy of LUS in comparison with preoperative staging and laparoscopy in 33 patients with colorectal cancer. Preoperative staging included abdominal US, CT, and endoscopic US (for rectal cancer). Laparoscopy and LUS were performed in all cases. Pre- and intraoperative staging were related to definitive histology. Staging was done according to the TNM classification.
- LUS obtained good results in the evaluation of hepatic metastases, with a sensitivity of 100% versus 62.5% and 75% by preoperative diagnostic means and laparoscopy, respectively. Nodal metastases were diagnosed with a sensitivity of 94% versus 18% with preoperative staging and 6% with laparoscopy, but the method had a low specificity (53%). The therapeutic program was changed thanks to laparoscopy and LUS in 11 cases (33%). In four cases (12%), the planned therapeutic approach was changed after LUS alone.
Question: Is laparoscopic sonography a reliable and sensitive procedure for staging colorectal cancer?
Options:
A. yes
B. no
C. maybe
|
The results obtained in this study demonstrate that LUS is an accurate and highly sensitive procedure in staging colorectal cancer, providing a useful and reliable diagnostic tool complementary to laparoscopy. The answer is: A
|
A
|
Is laparoscopic sonography a reliable and sensitive procedure for staging colorectal cancer?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Currently the choice of breast cancer therapy is based on prognostic factors. The proliferation marker Ki-67 is used increasingly to determine the method of therapy. The current study analyses the predictive value of Ki-67 in foreseeing breast cancer patients' responses to neoadjuvant chemotherapy.
- This study includes patients with invasive breast cancer treated between 2008 and 2013. The clinical response was assessed by correlating Ki-67 to histological examination, mammography, and ultrasonography findings.
- The average Ki-67 value in our patients collectively (n = 77) is 34.9 ± 24.6%. The average Ki-67 value is the highest with 37.4 ± 24.0% in patients with a pCR. The Ki-67 values do not differ significantly among the 3 groups: pCR versus partial pathological response versus stable disease/progress (P = 0.896). However, Ki-67 values of patients with luminal, Her2 enriched, and basal-like cancers differed significantly from each other. Furthermore, within the group of luminal tumors Ki-67 values of patients with versus without pCR also differed significantly.
Question: Can ki-67 play a role in prediction of breast cancer patients' response to neoadjuvant chemotherapy?
Options:
A. yes
B. no
C. maybe
|
Our data shows that the Ki-67 value predicts the response to neoadjuvant chemotherapy as a function of the molecular subtype, reflecting the daily routine concerning Ki-67 and its impressing potential and limitation as a predictive marker for neoadjuvant chemotherapy response. The answer is: A
|
A
|
Can ki-67 play a role in prediction of breast cancer patients' response to neoadjuvant chemotherapy?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- This retrospective study was carried out in the Ear Nose Throat (ENT) Unit of Giannina Gaslini Institute, Genoa, Italy on children operated for adenotonsillectomy (AT) or tonsillectomy (T) between January 2003 and February 2008. We considered in the study all the post-tonsillectomy late haemorrhages irrespective of their severity and for each case we evaluated whether they recurred in the day-time (B) (between 9.00 a.m. and 9.00 p.m.) or in the night-time (A) (between 9.00 p.m. and 9.00 a.m.). Finally we considered the number of haemorrhages per hour in the whole day.
- Out of 3306 patients undergoing elective adenotonsillectomy or tonsillectomy, post-operative late haemorrhage occurred in 59 (1.78%). We noted that 42 episodes (71.2%) occurred in the night-time and 17 (28.8%) in the day-time. The average time from the operation was 8.4 days. A statistically significant difference (p=0.002) was found when comparing the frequencies of night-time and day-time haemorrhages. We did not observe any significant difference in the distribution per hour of the haemorrhages.
Question: Post-tonsillectomy late haemorrhage: is it a preferably night-time event?
Options:
A. yes
B. no
C. maybe
|
The incidence of post-tonsillectomy late haemorrhage in our study population was 1.78%. A statistically significant difference was found between night-time and day-time haemorrhages. Even though no significant distribution of haemorrhages per hour was observed, we underline that we recorded 32 (54.2%) events in 2 periods of the day: from 10 p.m. to 1 a.m. and from 6 to 9 a.m. The answer is: A
|
A
|
Post-tonsillectomy late haemorrhage: is it a preferably night-time event?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- We evaluated the usefulness of a short stay or 23-hour ward in a pediatric unit of a large teaching hospital, Westmead Hospital, and an academic Children's hospital, The New Children's Hospital, to determine if they are a useful addition to the emergency service.
- This is a descriptive comparison of prospectively collected data on all children admitted to the short stay ward at Westmead Hospital (WH) during 1994 and the short stay ward at the New Children's Hospital (NCH) during 1997-98. These hospitals service an identical demographic area with the latter (NCH) a tertiary referral center. The following outcome measures were used: length of stay, appropriateness of stay, rate of admission to an in-hospital bed, and rate of unscheduled visits within 72 hours of discharge. Adverse events were reported and patient follow-up was attempted at 48 hours after discharge in all cases.
- The short stay ward accounted for 10.3% (Westmead Hospital) and 14.7% (New Children's Hospital) of admissions, with 56% medical in nature, 30% surgical, and the remainder procedural or psychological. Admission patterns were similar, with asthma, gastroenteritis, convulsion, pneumonia, and simple surgical conditions accounting for most short stay ward admissions. The short stay ward increased hospital efficiency with an average length of stay of 17.5 hours (Westmead Hospital) compared to 20.5 hours (New Children's Hospital). The users of the short stay ward were children of young age less than 2 years, with stay greater than 23 hours reported in only 1% of all admissions to the short stay ward. The rate of patient admission to an in-hospital bed was low, (4% [Westmead Hospital] compared to 6% [New Children's Hospital]), with the number of unscheduled visits within 72 hours of short stay ward discharge less than 1%. There were no adverse events reported at either short stay ward, with parental satisfaction high. The short stay ward was developed through reallocation of resources from within the hospital to the short stay ward. This resulted in estimated savings of $1/2 million (Westmead Hospital) to $2.3 million (New Children's Hospital) to the hospital, due to more efficient bed usage.
Question: A short stay or 23-hour ward in a general and academic children's hospital: are they effective?
Options:
A. yes
B. no
C. maybe
|
This data demonstrates the robust nature of the short stay ward. At these two very different institutions we have shown improved bed efficient and patient care in a cost-effective way. We have also reported on greater parental satisfaction and early return of the child with their family to the community. The answer is: A
|
A
|
A short stay or 23-hour ward in a general and academic children's hospital: are they effective?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To report three cases illustrating that it is not unusual for a primary eyelid tumour to metastasise to the parotid gland and vice versa.
- Two patients with malignant parotid tumours underwent radical parotidectomy and presented subsequently with eyelid lesions. Biopsy showed that both eyelid lesions were histologically similar to the primary parotid tumour. A third patient was noted to have ipsilateral upper eyelid and parotid gland tumours. Histology and immunocytochemistry were used to differentiate the primary tumour and the metastasis.
Question: Eyelid-parotid metastasis: do we screen for coexisting masses?
Options:
A. yes
B. no
C. maybe
|
These cases illustrate that tumours involving eyelids and parotid glands can present simultaneously or sequentially, and either of these structures could be the focus of primary or metastatic tumour. The important message for oculoplastic and parotid surgeons is to routinely assess both the periocular and parotid area when patients present with a mass in either structure. The answer is: A
|
A
|
Eyelid-parotid metastasis: do we screen for coexisting masses?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To assess the results of transsphenoidal pituitary surgery in patients with Cushing's disease over a period of 18 years, and to determine if there are factors which will predict the outcome.
- Sixty-nine sequential patients treated surgically by a single surgeon in Newcastle upon Tyne between 1980 and 1997 were identified and data from 61 of these have been analysed.
- Retrospective analysis of outcome measures.
- Patients were divided into three groups (remission, failure and relapse) depending on the late outcome of their treatment as determined at the time of analysis, i.e. 88 months (median) years after surgery. Remission is defined as biochemical reversal of hypercortisolism with re-emergence of diurnal circadian rhythm, resolution of clinical features and adequate suppression on low-dose dexamethasone testing. Failure is defined as the absence of any of these features. Relapse is defined as the re-emergence of Cushing's disease more than one year after operation. Clinical features such as weight, sex, hypertension, associated endocrine disorders and smoking, biochemical studies including preoperative and postoperative serum cortisol, urine free cortisol, serum ACTH, radiological, histological and surgical findings were assessed in relation to these three groups to determine whether any factors could reliably predict failure or relapse after treatment.
- Of the 61 patients included in this study, 48 (78.7%) achieved initial remission and 13 (21.3%) failed treatment. Seven patients suffered subsequent relapse (range 22-158 months) in their condition after apparent remission, leaving a final group of 41 patients (67.2%) in the remission group. Tumour was identified at surgery in 52 patients, of whom 38 achieved remission. In comparison, only 3 of 9 patients in whom no tumour was identified achieved remission. This difference was significant (P = 0.048). When both radiological and histological findings were positive, the likelihood of achieving remission was significantly higher than if both modalities were negative (P = 0.038). There were significant differences between remission and failure groups when 2- and 6-week postoperative serum cortisol levels (P = 0.002 and 0.001, respectively) and 6-week postoperative urine free cortisol levels (P = 0.026) were compared. This allowed identification of patients who failed surgical treatment in the early postoperative period. Complications of surgery included transitory DI in 13, transitory CSF leak in 8 and transitory nasal discharge and cacosmia in 3. Twelve of 41 patients required some form of hormonal replacement therapy despite achieving long-term remission. Thirteen patients underwent a second operation, of whom 5 achieved remission.
Question: Transsphenoidal pituitary surgery in Cushing's disease: can we predict outcome?
Options:
A. yes
B. no
C. maybe
|
Transsphenoidal pituitary surgery is a safe method of treatment in patients with Cushing's disease. Operative findings, radiological and histological findings, together with early postoperative serum cortisol and urine free cortisol estimates may identify failures in treatment. Alternative treatment might then be required for these patients. Because of the risk of late relapse, patients require life-long follow-up. The answer is: A
|
A
|
Transsphenoidal pituitary surgery in Cushing's disease: can we predict outcome?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Elevation of cardiac troponin (cTn) is considered specific for myocardial damage. Elevated cTn and echocardiogrpahic documentation of wall motion abnormalities (WMAs) that were recorded after extreme physical effort raise the question whether dobutamine stress echo (DSE), can also induce elevation of troponin.
- we prospective enrolled stable patients (age>18 years) referred to DSE. The exam was performed under standardized conditions. Blood samples for cTnI were obtained at baseline and 18-24 hours after the test. We aimed to compare between the clinical and echocardiographic features of patients with elevated cTnI and those without cTnI elevations.
- Fifty-seven consecutive patients were included. The average age was 64.4 ± 10.7, 73% of the patients were males, and nearly half of the patients were known to have ischemic heart disease. Two of the patients were excluded due to technical difficulty. No signs of ischemia were recorded in 25 (45.4%). Among the patients with established ischemia on DSE, 12 (22%) had mild ischemia, 13 (23.6%) had moderate and 5 (9%) had severe ischemia. Angiography was performed in 13 (26%) of the patients, of which 7 had PCI and one was referred to bypass surgery. None of the patients had elevated cTnI 18-24 hours after the DSE.
Question: Can dobutamine stress echocardiography induce cardiac troponin elevation?
Options:
A. yes
B. no
C. maybe
|
Our results indicate that there is no elevation of cTn despite the occurrence of significant WMAs on DSE. We conclude that cTnI cannot be used as an additional diagnostic tool during pharmacological stress test performed to evaluate the presence and severity of ischemia. The answer is: B
|
B
|
Can dobutamine stress echocardiography induce cardiac troponin elevation?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Cross-sectional.
- To identify the regional and global apexes of curves in adolescent idiopathic scoliosis and to compare the levels of those with the most rotated vertebral levels on computed tomography scans.
- The terminology regarding the terms and definitions had been arbitrary until being refined and standardized by the Scoliosis Research Society Working Group on Three-Dimensional Terminology of Spinal Deformity. Apical vertebra or disc is defined as the most laterally deviated vertebra or disc in a scoliosis curve, but the most rotated vertebra (or disc) has not been included in this terminology. One study suggested that the most rotated vertebral level was always located at the apex.
- Thirty-three structural curves of 25 consecutive patients scheduled for surgery for thoracic or thoracolumbar scoliosis were analyzed with standing anteroposterior radiographs and computed tomography scans covering the curve apexes and pelvis. Thoracic and lumbar curves were evaluated separately for all Type II curves. Vertebral rotations were normalized by the rotation of the pelvis. The most rotated vertebral (or disc) levels (transverse apex) were compared with the regional and global apex levels (vertebra or disc) (coronal apexes) of the corresponding curves separately.
- Regional and global apexes were at the same level in 18 (54.5%) curves, and within half a level in another 15 (45.4%), and the regional apex was one level higher in two curves (95% confidence levels: -0.82, +0.88). Comparison of the most rotated levels with regional and global apex levels revealed a higher variability, extending up to two levels for the global apex (95% confidence levels: -1.19, +1.54 levels for the global and -1.0, +1.41 levels for the regional apexes).
Question: Does transverse apex coincide with coronal apex levels (regional or global) in adolescent idiopathic scoliosis?
Options:
A. yes
B. no
C. maybe
|
This study demonstrated that the regional or global apex of a given curve is the most rotated level in only a minority of the curves. The most rotated level may be as far as two levels from the global apex and one level from the regional apex. The answer is: B
|
B
|
Does transverse apex coincide with coronal apex levels (regional or global) in adolescent idiopathic scoliosis?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To evaluate the accuracy of ultrasonographic examination in boys with an undescended testis.
- All patients who were referred to the paediatric surgeon after detection of an undescended testis were evaluated prospectively between November 2001 and November 2004. Among these 377 patients, 87 were referred with an ultrasonogram previously prescribed by the referring primary physician. The results of the ultrasonogram were compared to the results of the clinical examination of the paediatric surgeon and, in cases of no palpable testis, to the surgical findings.
- Ultrasonography did not detect the retractile testes. Ultrasonography detected 67% of the palpable undescended testes. In cases of no palpable testis, the ultrasonographic examination missed the abdominal testes and sometimes other structures were falsely interpreted as a testis.
Question: Is there any interest to perform ultrasonography in boys with undescended testis?
Options:
A. yes
B. no
C. maybe
|
Sonography has no place in the diagnosis of undescended testis. The answer is: B
|
B
|
Is there any interest to perform ultrasonography in boys with undescended testis?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The effect of neoadjuvant chemotherapy (NACT) on topographical distribution patterns of lymph node metastasis in cervical cancer was unknown.
- Patients with FIGO stage IB1-IIB who underwent radical surgery with or without NACT were enrolled (3527 patients). A matched-case comparison design was used to compare the effects of NACT on lymph node metastasis.
- We analyzed groups of 167 and 140 patients who were diagnosed with lymph node metastasis in the matched primary surgery group and NACT group, respectively, and no significant difference was observed (p = 0.081). The incidence of lymph node metastasis was significantly decreased in the NACT-responsive group compared to the non-responsive group (18.4% vs. 38.6%, P<0.001). The metastatic rates for every lymph node group also declined in the NACT-responsive group except for the deep inguinal and the para-aortic lymph node groups. Clinical response, deep stromal, parametrial and lymph vascular invasions were independent risk factors for lymph node metastasis in the NACT group. Furthermore, deep stromal invasion and lymph vascular invasion, but not the response to NACT, were independently associated with upper LNM. The number of lymph nodes involved, response to NACT, tumor histology and a positive vaginal margin were independent prognostic factors affecting DFS or OS rates in node-positive patients treated with NACT plus radical surgery.
Question: Could the extent of lymphadenectomy be modified by neoadjuvant chemotherapy in cervical cancer?
Options:
A. yes
B. no
C. maybe
|
The frequency and topographic distribution of LNM are not modified by NACT, and clinical non-responders showed more involved LNs. A systemic and extensive lymphadenectomy should be performed in patients treated with NACT plus surgery regardless of the response to NACT. The answer is: B
|
B
|
Could the extent of lymphadenectomy be modified by neoadjuvant chemotherapy in cervical cancer?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To prospectively evaluate the amount of tissue removed at loop electrosurgical excision procedure (LEEP) vs. cold knife conization.
- Forty consecutive LEEP or cold knife conization specimens were prospectively measured and weighed by a single pathology technician. Diameter, length and weight of the specimens were compared using Student's t test.
- Mean diameter of cold knife cone specimens was 2.6 vs. 2.2 cm for LEEP (P = .07). Mean length of cold knife cone specimens was 1.5 vs. 1.0 cm for LEEP (P = .001). Mean weight for cold knife cone specimens was 4.4 vs. 2.0 g for LEEP (P = .001).
Question: Cold knife conization vs. LEEP. Are they the same procedure?
Options:
A. yes
B. no
C. maybe
|
In a prospective evaluation, cold knife cone specimens were 50% longer and 100% heavier than LEEP specimens. The answer is: B
|
B
|
Cold knife conization vs. LEEP. Are they the same procedure?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Multislice helical computed tomography (CT), which can provide detailed 2-D and 3-D reconstructed images, is useful in imaging diagnosis for dental implant treatment. Therefore, in this study, it was performed to clarify the mandibular depiction of double-oblique reconstructed images when changing their thickness.
- A total of 38 sites in the mandibular molar region were examined using multislice helical CT. The thicknesses of the double-oblique images using multislice helical CT scans were reconstructed in 4 conditions: 0.3 mm, 0.9 mm, 1.6 mm, and 4.1 mm. In double-oblique images, mandibular depiction was evaluated by 5 oral radiologists using a subjective rating score.
- In the alveolar crest and the whole of the mandibular canal, the highest value was obtained with 0.9 mm-thick images; however, there was no significant difference between 0.3 mm and 0.9 mm-thick images.
Question: Can mandibular depiction be improved by changing the thickness of double-oblique computed tomography images?
Options:
A. yes
B. no
C. maybe
|
We concluded that depiction of the superior wall of the mandibular canal cannot be improved by changing the thickness of images. The answer is: B
|
B
|
Can mandibular depiction be improved by changing the thickness of double-oblique computed tomography images?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Ischemic preconditioning (IP) is initiated through one or several short bouts of ischemia and reperfusion which precede a prolonged ischemia. To test whether a reperfusion must precede the prolonged index ischemia, a series without reperfusion (intraischemic preconditioning: IIP) and a series with gradual onset of ischemia, i.e. ramp ischemia (RI), which is possibly related to the development of hibernation, was compared to conventional IP (CIP).
- Experiments were performed an 27 blood-perfused rabbit hearts (Langendorff apparatus) that were randomized into one of four series: (1) control (n = 7): 60 min normal flow - 60 min low flow (10%) ischemia - 60 min reperfusion. (2) CIP (n = 7): 4 times 5 min zero flow with 10 min reperfusion each - 60 min low flow (10%) - ischemia 60 min reperfusion. (3) IIP (n = 7): 50 min normal flow - 10 min no flow - 60min low flow (10%) ischemia -4 60min reperfusion. (4) RI (n=6): gradual reduction to 10% flow during 60min - 60min low flow (10%) ischemia - 60min reperfusion. At the end of each protocol, the infarcted area was assessed.
- The infarct area in control hearts was 6.7+/-1.4% (means+/-SEM) of LV total area, in CIP hearts 2.6+/-0.8%, in IIP hearts 3.1+/-0.5%, and in RI hearts 3.0+/-0.3% (all p<0.05 vs. control). The differences between the three protection protocols were statistically not significant, and no protective protocol reduced post-ischemic myocardial dysfunction.
Question: Does ischemic preconditioning require reperfusion before index ischemia?
Options:
A. yes
B. no
C. maybe
|
The preconditioning effect (infarct size reduction) appears not to depend on intermittent reperfusion. Thus, the protective mechanism of IP develops during the initial ischemia that precedes the index ischemia. Alternatively, low-flow ischemia is effectively a sort of reperfusion. The answer is: B
|
B
|
Does ischemic preconditioning require reperfusion before index ischemia?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Updated guidelines for the screening and management of cervical cancer in the United States recommend starting Papanicolaou (Pap) testing at age 21 and screening less frequently with less aggressive management for abnormalities. We sought to examine updated Pap test screening guidelines and how they may affect the detection of invasive cervical cancer, especially among women<30 years of age.
- Patients diagnosed at Brigham and Women's Hospital with invasive cervical cancer between 2002 and 2012 were retrospectively identified. Prior screening history was obtained and patients were divided into two groups based on age<30 years or age ≥30 years. The two groups were then compared with respect to demographics, pathological findings, and time to diagnosis.
- A total of 288 patients with invasive cervical carcinoma were identified. Among these patients, 109 had adequate information on prior screening history. Invasive adenocarcinoma (IAC) was diagnosed in 37 (33.94%) patients, whereas 64 (58.72%) patients were diagnosed with invasive squamous cell carcinoma (ISCC). The remaining eight patients were diagnosed with other types of cancers of the cervix. A total of 13 patients were younger than 30 while 96 patients were 30 or older. The mean time from normal Pap to diagnosis of IAC was 15 months in patients younger than 30 years of age compared to 56 months in patients aged 30 and older (p < 0.001). The mean time from normal Pap to diagnosis of ISCC was 38 months in patients younger than 30 years of age and 82 months in patients aged 30 and older (p = 0.018).
Question: Screening History Among Women with Invasive Cervical Cancer in an Academic Medical Center: Will We Miss Cancers Following Updated Guidelines?
Options:
A. yes
B. no
C. maybe
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In this small retrospective study, updated Pap test screening guidelines would not have missed invasive cancer on average among screened women age 30 and older. However, young patients aged 21-29 years may be at increased risk of developing IAC of the cervix between the recommended screening intervals. The answer is: B
|
B
|
Screening History Among Women with Invasive Cervical Cancer in an Academic Medical Center: Will We Miss Cancers Following Updated Guidelines?
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Electronic health records have the potential to facilitate family history use by primary care physicians (PCPs) to provide personalized care. The objective of this study was to determine whether automated, at-the-visit tailored prompts about family history risk change PCP behavior.
- Automated, tailored prompts highlighting familial risk for heart disease, stroke, diabetes, and breast, colorectal, or ovarian cancer were implemented during 2011 to 2012. Medical records of a cohort of community-based primary care patients, aged 35 to 65 years, who previously participated in our Family Healthware study and had a moderate or strong familial risk for any of the 6 diseases were subsequently reviewed. The main outcome measures were PCP response to the prompts, adding family history risk to problem summary lists, and patient screening status for each disease.
- The 492 eligible patients had 847 visits during the study period; 152 visits had no documentation of response to a family history prompt. Of the remaining 695 visits, physician responses were reviewed family history (n = 372, 53.5%), discussed family history (n = 159, 22.9%), not addressed (n = 155, 22.3%), and reviewed family history and ordered tests/referrals (n = 5, 0.7%). There was no significant change in problem summary list documentation of risk status or screening interventions for any of the 6 diseases.
Question: Prompting Primary Care Providers about Increased Patient Risk As a Result of Family History: Does It Work?
Options:
A. yes
B. no
C. maybe
|
No change occurred upon instituting simple, at-the-visit family history prompts geared to improve PCPs' ability to identify patients at high risk for 6 common conditions. The results are both surprising and disappointing. Further studies should examine physicians' perception of the utility of prompts for family history risk. The answer is: B
|
B
|
Prompting Primary Care Providers about Increased Patient Risk As a Result of Family History: Does It Work?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- We investigated the role of surgical ablation targeting the autonomous nervous system during a Cox-Maze IV procedure in the maintenance of sinus rhythm at long-term follow-up.
- The patient population consisted of 519 subjects with persistent or long-standing persistent atrial fibrillation (AF) undergoing radiofrequency Maze IV during open heart surgery between January 2006 and July 2013 at three institutions without (Group 1) or with (Group 2) ganglionated plexi (GP) ablation. Recurrence of atrial fibrillation off-antiarrhythmic drugs was the primary outcome. Predictors of AF recurrence were evaluated by means of competing risk regression. Median follow-up was 36.7 months.
- The percentage of patients in normal sinus rhythm (NSR) off-antiarrhythmic drugs did not differ between groups (Group 1-75.5%, Group 2-67.8%, p = 0.08). Duration of AF ≥ 38 months (p = 0.01), left atrial diameter ≥ 54 mm (0.001), left atrial area ≥ 33 cm(2) (p = 0.005), absence of connecting lesions (p= 0.04), and absence of right atrial ablation (p<0.001) were independently associated with high incidence of AF recurrence. In contrast the absence of GP ablation was not a significant factor (p = 0.12).
Question: Is ganglionated plexi ablation during Maze IV procedure beneficial for postoperative long-term stable sinus rhythm?
Options:
A. yes
B. no
C. maybe
|
GP ablation did not prove to be beneficial for postoperative stable NSR. A complete left atrial lesion set and biatrial ablation are advisable for improving rhythm outcomes. Randomized controlled trials are necessary to confirm our findings. The answer is: B
|
B
|
Is ganglionated plexi ablation during Maze IV procedure beneficial for postoperative long-term stable sinus rhythm?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To evaluate the effectiveness of feeding information on pharmacy back to primary care doctors in order to create awareness (knowledge) of pharmaceutical expenditure (PE).
- Retrospective cross-sectional study, through personal interview.
- Reformed PC, Sabadell, Barcelona.
- The 80 PC doctors working with primary care teams.
- As the personal feed-back on PE, each doctor was asked for the PE generated during 1997 and the mean cost of prescriptions to active and pensioner patients. The statistical test used was the t test to compare means for paired data, with p<0.05 the required level of significance.
- Out of the total doctors interviewed (80), 71 replies were obtained for the annual PE and 76 for the mean cost of prescriptions, for both active and pensioner patients. Significant differences were found between the annual PE in reality and doctors' estimates: around twelve million pesetas. The differences between the real mean costs of prescription and the estimates were also significant.
Question: Is there awareness of pharmaceutical expenditure in the reformed primary care system?
Options:
A. yes
B. no
C. maybe
|
In view of the results, it is concluded that there is no awareness of PE among the doctors in the reformed PC in our area. This poses a question over the efficacy of feed-back of pharmacy information in order to create this awareness. This information needs to be more frequent and richer in content, and to be complemented by other measures. The answer is: B
|
B
|
Is there awareness of pharmaceutical expenditure in the reformed primary care system?
|
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You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The present study aims to evaluate benefit of adding surgery to chemoradiotherapy alone in management of carcinoma esophagus.
- We retrospectively analyzed 45 eligible patients of squamous cell esophageal carcinoma which were enrolled from February 2008 to April 2009. All patients were treated with chemoradiotherapy (50.40 Gy with 40 mg/m(2) of weekly cisplatin). Tumor response was assessed after 6 weeks of treatment. Patients with resectable disease were subjected to surgical resection (arm A) and remaining was kept on regular clinical follow-up (arm B). Overall survival (OS) was selected as the primary endpoint. The secondary end points were disease-free survival (DFS) and clinical toxicities.
- Median follow-up was 13.6 months. Pathological complete response was seen in 60.9 % patients in arm A. In arm B, 77.3 % patients attained radiological complete response (p = 0.194). The median OS was 16.4 and 19.1 months (p = 0.388) and median DFS was 5.8 and 4.1 months (p = 0.347) in arm A and B, respectively. The 2-year survival probability was 39.1 and 36.4 % (p = 0.387) in arm A and B, respectively. The recurrence probability was 56.5 % (SE = 5.6 %) and 45.5 % (SE = 4.2 %) (p = 0.328) in arm A and B, respectively. The probability of loco regional recurrence was more in arm B than in arm A (p = 0.002).
Question: Chemoradiotherapy in the management of locally advanced squamous cell carcinoma esophagus: is surgical resection required?
Options:
A. yes
B. no
C. maybe
|
The study suggests that there is no difference in clinical toxicity profiles or survival outcomes with either definitive chemoradiotherapy or chemoradiation followed by surgery in management of locally advanced esophageal cancer. The answer is: B
|
B
|
Chemoradiotherapy in the management of locally advanced squamous cell carcinoma esophagus: is surgical resection required?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Tethering of the spinal cord is thought to increase the chance of neurological injury when scoliosis correction is undertaken. All patients with myelomeningocele (MM) are radiographically tethered, and untethering procedures carry significant morbidity risks including worsening neurological function and wound complications. No guidelines exist as regards untethering in patients with MM prior to scoliosis correction surgery. The authors' aim in this study was to evaluate their experience in patients with MM who were not untethered before scoliosis correction.
- Seventeen patients with MM were retrospectively identified and 1) had no evidence of a clinically symptomatic tethered cord, 2) had undergone spinal fusion for scoliosis correction, and 3) had not been untethered for at least 1 year prior to surgery. The minimum follow-up after fusion was 2 years. Charts and radiographs were reviewed for neurological or shunt complications in the perioperative period.
- The average age of the patients was 12.4 years, and the following neurological levels were affected: T-12 and above, 7 patients; L-1/L-2, 6 patients; L-3, 2 patients; and L-4, 2 patients. All were radiographically tethered as confirmed on MR imaging. Fourteen of the patients (82%) had a ventriculoperitoneal shunt. The mean Cobb angle was corrected from 82 degrees to 35 degrees , for a 57% correction. All patients underwent neuromonitoring of their upper extremities, and some underwent lower extremity monitoring as well. Postoperatively, no patient experienced a new cranial nerve palsy, shunt malfunction, change in urological function, or upper extremity weakness/sensory loss. One patient had transient lower extremity weakness, which returned to baseline within 1 month of surgery.
Question: A patient with myelomeningocele: is untethering necessary prior to scoliosis correction?
Options:
A. yes
B. no
C. maybe
|
The study results suggested that spinal cord untethering may be unnecessary in patients with MM who are undergoing scoliosis corrective surgery and do not present with clinical symptoms of a tethered cord, even though tethering is radiographically demonstrated. The answer is: B
|
B
|
A patient with myelomeningocele: is untethering necessary prior to scoliosis correction?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Vitamin D deficiency/insufficiency (VDDI) is common in CKD patients and may be associated with abnormal mineral metabolism. It is not clear whether the K/DOQI recommended doses of ergocalciferol are adequate for correction of VDDI and hyperparathyroidism.
- Retrospective study of 88 patients with CKD Stages 1 - 5 and baseline 25-hydroxyvitamin D level<30 ng/ml (<75 nmol/l). Patients treated with ergocalciferol as recommended by K/DOQI guidelines. Only 53 patients had elevated baseline PTH level for the CKD stage. Patients were excluded if they received vitamin D preparations other than ergocalciferol or phosphate binders. 25-hydroxyvitamin D level, intact PTH level (iPTH), and other parameters of mineral metabolism were measured at baseline and after completion of ergocalciferol course.
- 88 patients with CKD were treated with ergocalciferol. Mean age 56.8 +/- 9.5 years and 41% were males. The mean (+/- SD) GFR was 28.3 +/- 16.6 ml/min. At the end of the 6-month period of ergocalciferol treatment, the mean 25-hydroxyvitamin D level increased from 15.1 +/- 5.8 to 23.3 +/- 11.8 ng/ml (37.75 +/- 14.5 to 58.25 +/- 29.5 nmol/l) (p<0.001). Treatment led to>or = 5 ng/ml (12.5 nmol/l) increases in 25-hydroxyvitamin D level in 54% of treated patients, and only 25% achieved levels>or = 30 ng/ml (75 nmol/l). Mean iPTH level decreased from 157.9 +/- 125.9 to 150.7 +/- 127.5 pg/ml (p = 0.5). Only 26% of patients had>or = 30% decrease in their iPTH level after treatment with ergocalciferol.
Question: Treatment of vitamin D deficiency in CKD patients with ergocalciferol: are current K/DOQI treatment guidelines adequate?
Options:
A. yes
B. no
C. maybe
|
Current K/DOQI guidelines are inadequate for correcting VDDI or secondary hyperparathyroidism in CKD patients. Future studies should examine the effects of higher or more frequent dosing of ergocalciferol on these clinical endpoints. The answer is: B
|
B
|
Treatment of vitamin D deficiency in CKD patients with ergocalciferol: are current K/DOQI treatment guidelines adequate?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- In this prospective non randomized observational cohort study we have evaluated the influence of age on outcome of laparoscopic total fundoplication for GERD.
- Six hundred and twenty consecutive patients underwent total laparoscopic fundoplication for GERD. Five hundred and twenty-four patients were younger than 65 years (YG), and 96 patients were 65 years or older (EG). The following parameters were considered in the preoperative and postoperative evaluation: presence, duration, and severity of GERD symptoms, presence of a hiatal hernia, manometric and 24 hour pH-monitoring data, duration of operation, incidence of complications and length of hospital stay.
- Elderly patients more often had atypical symptoms of GERD and at manometric evaluation had a higher rate of impaired esophageal peristalsis in comparison with younger patients. The duration of the operation was similar between the two groups. The incidence of intraoperative and postoperative complications was low and the difference was not statistically significant between the two groups. An excellent outcome was observed in 93.0% of young patients and in 88.9% of elderly patients (p = NS).
Question: Is the advanced age a contraindication to GERD laparoscopic surgery?
Options:
A. yes
B. no
C. maybe
|
Laparoscopic antireflux surgery is a safe and effective treatment for GERD even in elderly patients, warranting low morbidity and mortality rates and a significant improvement of symptoms comparable to younger patients. The answer is: B
|
B
|
Is the advanced age a contraindication to GERD laparoscopic surgery?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The serum C-reactive protein (CRP) level correlates with the clinical prognosis in patients with kidney, penile and metastatic castration-resistant prostate cancer (PC). We prospectively evaluated the preoperative CRP level as a predictive marker for an advanced tumor stage or high-grade cancer in patients with clinically localized PC.
- The study evaluated 629 patients with clinically localized PC who underwent radical prostatectomy between 2010 and 2013. Exclusion criteria were signs of systemic infection, symptoms of an autoimmune disease or neoadjuvant androgen deprivation.
- Poorly differentiated PC tends to be more common in patients with elevated CRP levels (15.5 vs. 9.5%, p = 0.08). Analogously, patients with a Gleason score ≥8 PC had significantly higher median CRP levels than those with a Gleason score ≤7 PC (1.9 vs. 1.2 mg/l, p = 0.03). However, neither uni- nor multivariate analysis showed an association between the preoperative CRP level and the presence of a locally advanced tumor stage, lymph node metastases or a positive surgical margin. CRP also failed to correlate with the initial PSA level and the clinical tumor-associated findings. Moreover, multivariate analysis relativized the association between an elevated CRP level and poor tumor differentiation.
Question: Do preoperative serum C-reactive protein levels predict the definitive pathological stage in patients with clinically localized prostate cancer?
Options:
A. yes
B. no
C. maybe
|
In patients with clinically localized PC, CRP does not appear to possess the predictive value and it was shown to have patients with other tumor entities or advanced PC. The answer is: B
|
B
|
Do preoperative serum C-reactive protein levels predict the definitive pathological stage in patients with clinically localized prostate cancer?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The last 20 years has seen a marked improvement in skin cancer awareness campaigns. We sought to establish whether this has affected the presenting Breslow thickness of malignant melanoma in the South West.
- This is a retrospective study looking at the first presentation of melanomas from 2003 to 2011. Data was accessed using the local online melanoma database.
- A total of 2001 new melanomas presented from 2003 to 2012 (Male:Female = 1:1.062). The average yearly number of melanomas was 200.1 (range = 138-312). The mean age was 62.5 years (range 12-99). Data was analysed using a Chi² test. For 0-1 mm melanomas, there is a significant difference in the observed versus expected values over the 10 years (p = 0.0018). There is an increasing proportion of 0-1 mm (thin) melanomas presenting year on year, with a positive linear trend. This is very statistically significant (p<0.0001). The 1-2 mm melanomas are decreasing in proportion with a negative linear trend (p = 0.0013). The 2-4 mm are also decreasing in proportion (p = 0.0253). There is no significant change in the thick>4 mm melanomas (p = 0.1456).
Question: Are we seeing the effects of public awareness campaigns?
Options:
A. yes
B. no
C. maybe
|
The proportion of thin 0-1 mm melanomas presenting in South West England has significantly increased from 2003 to 2012. There is no significant change in the thick>4 mm melanomas. This may be a result of increased public awareness due to effective public health campaigns which has significant prognostic and financial implications. The answer is: C
|
C
|
Are we seeing the effects of public awareness campaigns?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Polyarteritis nodosa (PAN) is a systemic vasculitis involving mainly medium-sized arteries and, rarely, small-sized arteries. The diagnosis is principally based on clinical exams, biopsy of an affected organ, and/or arteriography of renal or mesenteric arteries. Once diagnosed, immunosuppressive agents, such as glucocorticoids and cyclophosphamide, are generally introduced as soon as possible. Whether spontaneous remission of PAN occurs is therefore largely unknown.
- We describe the case of a 51-year-old woman who presented with a 4-day-history of intense pain in her left flank, hypertension, fever, microscopic hematuria, and acute renal failure. Contrast-enhanced renal ultrasound strongly suggested bilateral renal infarction. Medical history and an extensive workup allowed to exclude systemic embolism, recreational drug abuse, cardiac arrhythmias, and thrombophilia. A possible diagnosis of PAN was considered; however, within 2 weeks of admission, spontaneous remission of her clinical and biological symptoms occurred without the use of any immunosuppressive treatment. Finally, 3 months later, renal arteriography confirmed the diagnosis of PAN. The patient remains free of symptoms 1 year after initial presentation.
Question: Does spontaneous remission occur in polyarteritis nodosa?
Options:
A. yes
B. no
C. maybe
|
This case illustrates the importance of considering PAN in the differential diagnosis of renal infarction with inflammatory syndrome and shows that spontaneous remission of renal PAN can occur.
. The answer is: A
|
A
|
Does spontaneous remission occur in polyarteritis nodosa?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- 48 cases of SbCC were analysed immunohistochemically using monoclonal β-catenin antibody and the results correlated with tumour size, histopathological differentiation, orbital invasion and pagetoid spread.
- Cytoplasmic overexpression of β-catenin was seen in 66% cases of SbCC which correlated positively with tumour size, orbital invasion and pagetoid spread. This correlation was found to be significant in tumour size>2 cm (p = 0.242). Nuclear staining was not observed in any of the cases.
Question: Does β-catenin have a role in pathogenesis of sebaceous cell carcinoma of the eyelid?
Options:
A. yes
B. no
C. maybe
|
Cytoplasmic overexpression of β-catenin was observed in the majority of the cases of SbCC of eyelid, and this correlated significantly with tumour size. The authors therefore hypothesise that β-catenin overexpression in SbCC of eyelid may be a result of Wnt/β-catenin pathway dysregulation. However, its role both in the development of sebaceous cell carcinoma of the eyelid as well as its prognosis needs to be explored further. The answer is: A
|
A
|
Does β-catenin have a role in pathogenesis of sebaceous cell carcinoma of the eyelid?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Microbial contamination can be a marker for faulty process and is assumed to play an important role in the collection of hematopoietic progenitor cell (HPC) and infusion procedure. We aimed to determine the microbial contamination rates and evaluate the success of hematopoietic cell transplantation (HCT) in patients who received contaminated products.PATIENTS-
- We analyzed microbial contamination records of HPC grafts between 2012 and 2015, retrospectively. Contamination rates of autologous donors were evaluated for at three steps: at the end of mobilization, following processing with dimethyl sulfoxide, and just before stem cell infusion. Grafts of allogeneic donors were assessed only before HCT.
- A total of 445 mobilization procedures were carried out on 333 (167 autologous and 166 allogeneic) donors. The microbiological contamination of peripheral blood (323/333 donations) and bone marrow (10/333 donations) products were analyzed. Bacterial contamination was detected in 18 of 1552 (1.15 %) culture bottles of 333 donors. During the study period 248 patients underwent HCT and among these patients microbial contamination rate on sample basis was 1.3 % (16/1212). Microbial contamination detected in nine patients (7 autologous; 2 allogeneic). In 8 of 9 patients, a febrile neutropenic attack was observed. The median day for the neutropenic fever was 4 days (0-9). None of the patients died within the post-transplant 30 days who received contaminated products.
Question: Does microbial contamination influence the success of the hematopoietic cell transplantation outcomes?
Options:
A. yes
B. no
C. maybe
|
The use of contaminated products with antibiotic prophylaxis may be safe in terms of the first day of fever, duration of fever, neutrophil, platelet engraftment and duration of hospitalization. The answer is: C
|
C
|
Does microbial contamination influence the success of the hematopoietic cell transplantation outcomes?
|
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You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Using murine models, we have shown that the lysosomotropic amine, chloroquine, is effective in the prevention of graft-versus-host disease (GVHD) mediated by donor T cells reactive with recipient minor histocompatibility antigens (MiHCs). Because lysosomotropic amines can suppress major histocompatibility complex (MHC) class II antigen presentation, their mechanism of action is potentially different from current immune suppressant drugs used to control GVHD such as cyclosporine.
- We investigated the use of cyclosporine and the lysosomotropic amines chloroquine and hydroxychloroquine in combination for additive or synergistic immunosuppression on T-cell responses in vitro to MiHC and MHC in mice.
- We found that similar concentrations of chloroquine and hydroxychloroquine suppress the T-cell response to MiHC in mice (C57BL/6 anti-BALB.B) and that lysosomotropic amines in combination with cyclosporine result in synergistic suppression of a proliferative response to MiHC. Similar suppression and synergy appear to be present in an alloreactive response (C57BL/6 anti-BALB/c). Direct inhibition by chloroquine of T-cell proliferative responses induced by anti-CD3epsilon in the absence of antigen-presenting cells is present at higher concentrations than that required to suppress responses to MiHC or MHC. Chloroquine appears to induce decreased T-cell viability at high concentrations. This effect does not appear to be due to decreased T-cell production of interleukin-2 or interferon-gamma. At lower concentrations (<25 microg/ml), chloroquine can also decrease the ability of antigen-presenting cells to stimulate an a C57BL/6 anti-BALB/c T-cell response and can inhibit MHC class II expression after activation with lipopolysaccharide.
Question: Immune suppression by lysosomotropic amines and cyclosporine on T-cell responses to minor and major histocompatibility antigens: does synergy exist?
Options:
A. yes
B. no
C. maybe
|
Lysosomotropic amines in combination with cyclosporine appear to be synergistic in the suppression of T-cell proliferation to MiHC and MHC. Use of chloroquine in combination with cyclosporine may result in improved control of GVHD. The answer is: A
|
A
|
Immune suppression by lysosomotropic amines and cyclosporine on T-cell responses to minor and major histocompatibility antigens: does synergy exist?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The aim of this study was to investigate the role of menopausal transition and menopausal symptoms in relation to quality of life in a cohort of middle-aged women in Kinmen.
- A total of 734 premenopausal women participated in the baseline study, and 579 women (78.9%) completed a follow-up 2 years later. Quality of life was assessed by the Medical Outcomes Study Short Form-36. Participating women were asked for demographic data, about vasomotor symptoms, and to complete the Medical Outcomes Study Short Form-36 and the Hospital Anxiety and Depression Scale.
- There was no demographic difference between women who remained premenopausal and those who entered perimenopause except for age. Vitality deteriorated no matter whether the women stayed in premenopause or entered perimenopause. In multivariate analysis, only vasomotor symptoms had an adverse influence on role limitation of emotion after adjusting for age, education, menopausal status, baseline cognitive score, and Hospital Anxiety and Depression Scale score. The menopausal transition did not influence the eight domains of the Short Form-36 in the multivariate regression model.
Question: Does menopausal transition affect the quality of life?
Options:
A. yes
B. no
C. maybe
|
This longitudinal study found no significant effect of menopausal transition on quality of life among Taiwanese women. The decline in the role limitations due to emotional problems was related to vasomotor symptoms. The answer is: B
|
B
|
Does menopausal transition affect the quality of life?
|
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You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- A growing body of research emphasizes the importance of contextual factors on health outcomes. Using postcode sector data for Scotland (UK), this study tests the hypothesis of spatial heterogeneity in the relationship between area-level deprivation and mortality to determine if contextual differences in the West vs. the rest of Scotland influence this relationship. Research into health inequalities frequently fails to recognise spatial heterogeneity in the deprivation-health relationship, assuming that global relationships apply uniformly across geographical areas. In this study, exploratory spatial data analysis methods are used to assess local patterns in deprivation and mortality. Spatial regression models are then implemented to examine the relationship between deprivation and mortality more formally.
- The initial exploratory spatial data analysis reveals concentrations of high standardized mortality ratios (SMR) and deprivation (hotspots) in the West of Scotland and concentrations of low values (coldspots) for both variables in the rest of the country. The main spatial regression result is that deprivation is the only variable that is highly significantly correlated with all-cause mortality in all models. However, in contrast to the expected spatial heterogeneity in the deprivation-mortality relationship, this relation does not vary between regions in any of the models. This result is robust to a number of specifications, including weighting for population size, controlling for spatial autocorrelation and heteroskedasticity, assuming a non-linear relationship between mortality and socio-economic deprivation, separating the dependent variable into male and female SMRs, and distinguishing between West, North and Southeast regions. The rejection of the hypothesis of spatial heterogeneity in the relationship between socio-economic deprivation and mortality complements prior research on the stability of the deprivation-mortality relationship over time.
Question: Does context matter for the relationship between deprivation and all-cause mortality?
Options:
A. yes
B. no
C. maybe
|
The homogeneity we found in the deprivation-mortality relationship across the regions of Scotland and the absence of a contextualized effect of region highlights the importance of taking a broader strategic policy that can combat the toxic impacts of socio-economic deprivation on health. Focusing on a few specific places (e.g. 15% of the poorest areas) to concentrate resources might be a good start but the impact of socio-economic deprivation on mortality is not restricted to a few places. A comprehensive strategy that can be sustained over time might be needed to interrupt the linkages between poverty and mortality. The answer is: B
|
B
|
Does context matter for the relationship between deprivation and all-cause mortality?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Poor bone quality and unstable fractures increase the cut-out rate in implants with gliding lag screws. The U-Blade (RC) lag screw for the Gamma3®nail was introduced to provide monoaxial rotational stability of the femoral head and neck fragment. The purpose of this study was to evaluate whether the use of the U-Blade (RC) lag screw is associated with reduced cut-out in patients with OTA/AO 31A1-3 fractures.MATERIAL &
- Between 2009 and 2014, 751 patients with OTA/AO 31A1-3 fractures were treated with a Gamma3®nail at our institution. Out of this sample 199 patients were treated with U-blade (RC) lag screws. A total of 135 patients (117 female, 18 male) with standard lag screw (treatment group A) were matched equally regarding age (±4 years) sex, fracture type and location to 135 patients with U-blade (RC) lag screw (treatment group B). Within a mean follow up of 9.2 months (range 6-18 months) we assessed the cut-out rate, the calTAD, lag screw migration, the Parker's mobility score and the Parker's ratio at postoperatively, six and 12 months following surgery. Furthermore we recorded all complications, ASA-Score, hospital stay and duration of surgery retrospectively.
- The most common fracture among group B with a cut-out of the lag screw were AO/OTA 2.3 and 3.2 fractures whereas in group A cut-out was most commonly seen in AO/OTA 2.1, 2.2 and 2.3 fractures, there was no significant reduction of the cut-out rate in group B 2.2% (n=3) compared to group A 3.7% (n=5). The duration of surgery was significantly shorter in group A (p<0.05). There was no significant difference in lag screw placement, the Parker's ratio and mobilization.
Question: Does an additional antirotation U-Blade (RC) lag screw improve treatment of AO/OTA 31 A1-3 fractures with gamma 3 nail?
Options:
A. yes
B. no
C. maybe
|
In our study the U-Blade (RC) lag screw did not reduce the cut-out in treatment of OTA/AO 31A1-3 fractures at all. Considering the longer duration of surgery and the higher costs of the U-Blade (RC) lag screw, our results do not justify its use. However, further prospective randomized studies will be necessary. The answer is: B
|
B
|
Does an additional antirotation U-Blade (RC) lag screw improve treatment of AO/OTA 31 A1-3 fractures with gamma 3 nail?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The data analysis was conducted to describe the rate of unsuccessful copper T380A intrauterine device (IUD) insertions among women using the IUD for emergency contraception (EC) at community family planning clinics in Utah.
- These data were obtained from a prospective observational trial of women choosing the copper T380A IUD for EC. Insertions were performed by nurse practitioners at two family planning clinics in order to generalize findings to the type of service setting most likely to employ this intervention. Adjuvant measures to facilitate difficult IUD insertions (cervical anesthesia, dilation, pain medication, and use of ultrasound guidance) were not utilized. The effect of parity on IUD insertion success was determined using exact logistic regression models adjusted for individual practitioner failure rates.
- Six providers performed 197 IUD insertion attempts. These providers had a mean of 14.1 years of experience (range 1-27, S.D. ±12.5). Among nulliparous women, 27 of 138 (19.6%) IUD insertions were unsuccessful. In parous women, 8 of 59 IUD insertions were unsuccessful (13.6%). The adjusted odds ratio (aOR) showed that IUD insertion failure was more likely in nulliparous women compared to parous women (aOR=2.31, 95% CI 0.90-6.52, p=.09).
Question: Failed IUD insertions in community practice: an under-recognized problem?
Options:
A. yes
B. no
C. maybe
|
The high rate of unsuccessful IUD insertions reported here, particularly for nulliparous women, suggests that the true insertion failure rate of providers who are not employing additional tools for difficult insertions may be much higher than reported in clinical trials. Further investigation is necessary to determine if this is a common problem and, if so, to assess if the use of adjuvant measures will reduce the number of unsuccessful IUD insertions. The answer is: A
|
A
|
Failed IUD insertions in community practice: an under-recognized problem?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To compare the characteristics and prognoses of gastric cancers by tumor location in Korean and U.S. subjects after curative-intent (R0) resection for gastric cancer (GC).
- Data were collected for all patients who had undergone R0 resection at one U.S. institution (n = 567) and one South Korean institution (n = 1,620). Patients with gastroesophageal junction tumors or neoadjuvant therapy were excluded. Patient, surgical, and pathologic variables were compared by tumor location. Factors associated with disease-specific survival (DSS) were determined via multivariate analysis.
- In the Korean cohort, significantly more upper third GC (UTG) patients had undifferentiated, diffuse type, and advanced stage cancers compared to lower third GC (LTG) and middle third GC (MTG) patients. In the U.S. cohort, however, T stage was relatively evenly distributed among UTG, MTG, and LTG patients. The independent predictors of DSS in the Korean cohort were T stage, tumor size, retrieved and positive lymph node counts, and age, but in the U.S. cohort, the only independent predictors were T stage and positive lymph node count. Tumor size significantly affected DSS of Korean UTG patients but not U.S. UTG patients.
Question: Is gastric cancer different in Korea and the United States?
Options:
A. yes
B. no
C. maybe
|
There were significant differences in tumor characteristics by tumor location within and between both national cohorts. On the basis of these findings, further study to investigate the biological difference between the two countries is needed. The answer is: A
|
A
|
Is gastric cancer different in Korea and the United States?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Cytokeratin 7/20 staining has been reported to be helpful in diagnosing Barrett's oesophagus and gastric intestinal metaplasia. However, this is still a matter of some controversy.
- To determine the diagnostic usefulness of cytokeratin 7/20 immunostaining for short-segment Barrett's oesophagus in Korea.
- In patients with Barrett's oesophagus, diagnosed endoscopically, at least two biopsy specimens were taken from just below the squamocolumnar junction. If goblet cells were found histologically with alcian blue staining, cytokeratin 7/20 immunohistochemical stains were performed. Intestinal metaplasia at the cardia was diagnosed whenever biopsy specimens taken from within 2 cm below the oesophagogastric junction revealed intestinal metaplasia. Barrett's cytokeratin 7/20 pattern was defined as cytokeratin 20 positivity in only the superficial gland, combined with cytokeratin 7 positivity in both the superficial and deep glands.
- Barrett's cytokeratin 7/20 pattern was observed in 28 out of 36 cases (77.8%) with short-segment Barrett's oesophagus, 11 out of 28 cases (39.3%) with intestinal metaplasia at the cardia, and nine out of 61 cases (14.8%) with gastric intestinal metaplasia. The sensitivity and specificity of Barrett's cytokeratin 7/20 pattern were 77.8 and 77.5%, respectively.
Question: Is cytokeratin immunoreactivity useful in the diagnosis of short-segment Barrett's oesophagus in Korea?
Options:
A. yes
B. no
C. maybe
|
Barrett's cytokeratin 7/20 pattern can be a useful marker for the diagnosis of short-segment Barrett's oesophagus, although the false positive or false negative rate is approximately 25%. The answer is: A
|
A
|
Is cytokeratin immunoreactivity useful in the diagnosis of short-segment Barrett's oesophagus in Korea?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The aim of this study was to evaluate the effectiveness of our surgical strategy for acute aortic dissection based on the extent of the dissection and the site of the entry, with special emphasis on resection of all dissected aortic segments if technically possible.
- Between January 1995 and March 2001, 43 consecutive patients underwent operations for acute aortic dissection. In all patients the distal repair was performed under circulatory arrest without the use of an aortic cross-clamp. Fifteen patients underwent aortic arch replacement with additional reconstruction of supra-aortic vessels in 3 patients. Complete replacement of all dissected tissue could be achieved in 21 patients (group 1). Because of the distal extent of the dissection beyond the aortic arch, replacement of all the dissected tissue was not possible in 22 patients (group 2).
- Early mortality was 4.7% (2 patients), and the incidence of perioperative cerebrovascular events was 7.0% (3 patients). All of these events occurred in group 2 (p<0.025). During the follow-up period of 6 years or less, 5 patients died, all from causes not related to the aorta or the aortic valve. A persisting patent false lumen was observed in 14 of the 36 surviving patients (39%).
Question: Is extended aortic replacement in acute type A dissection justifiable?
Options:
A. yes
B. no
C. maybe
|
Extended replacement of the dissected ascending aorta and aortic arch can be done with good early and midterm results, even though it requires a complex surgical technique. Therefore we advocate complete replacement of the dissected parts of the aorta in all patients in whom this is technically possible. The answer is: A
|
A
|
Is extended aortic replacement in acute type A dissection justifiable?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The aim of this study was to analyze the contribution of the double-balloon enteroscopy (DBE) for diagnosis of the small bowel disorders.
- Forty-four patients (20 women, 24 men; mean age 53.5 years-old, range 21-89 years) with chronic gastrointestinal bleeding, diarrhea, polyposis, weight-loss, Roux-en-Y surgery, and other indications underwent DBE.
- Twenty patients had occult or obscure gastrointestinal bleeding. The source of bleeding was identified in 15/20 (75%): multiple angiodysplasias in four, arterial-venous malformation beyond the ligament of Treitz in two that could be treated with injection successfully. Other diagnoses included: duodenal adenocarcinoma, jejunal tuberculosis, erosions and ulcer of the jejunum. Of 24 patients with other indications, the diagnosis could be achieved in 18 of them (75%), including: two lymphomas, plasmocytoma, Gardner's syndrome, Peutz-Jeghers' syndrome, familial adenomatous polyposis, Behçet's disease, jejunal submucosal lesion, lymphangiectasia due to blastomycosis and unspecific chronic jejunitis. Of three cases with Roux-en-Y reconstruction, two underwent DBE in order to perform biopsies of the excluded duodenum. Additionally, two patients underwent DBE to exclude Crohn's disease and lymphoma of the small bowel. The mean length of small bowel examination was 240 +/- 50 cm during a single approach. The diagnostic yield was 75% (33/44 cases) and therapeutic yield was 63.6%. No major complications were observed, only minor complication such as sore throat in 4/44 (9.1%).
Question: Is double-balloon enteroscopy an accurate method to diagnose small-bowel disorders?
Options:
A. yes
B. no
C. maybe
|
1. DBE is a safe and and accurate method to diagnose small bowel disorders; 2. this method permits chromoscopy, biopsies and treatment of the lesions. The answer is: A
|
A
|
Is double-balloon enteroscopy an accurate method to diagnose small-bowel disorders?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Desmopressin releases tissue-type plasminogen activator, which augments cardiopulmonary bypass--associated hyperfibrinolysis, causing excessive bleeding. Combined use of desmopressin with prior administration of the antifibrinolytic drug tranexamic acid may decrease fibrinolytic activity and might improve postoperative hemostasis.
- This prospective randomized study was carried out with 100 patients undergoing coronary artery bypass operations between April 1999 and November 2000 in Gülhane Military Medical Academy. Patients were divided into 2 groups. Desmopressin (0.3 microg/kg) was administrated just after cardiopulmonary bypass and after protamine infusion in group 1 (n = 50). Both desmopressin and tranexamic acid (before the skin incision at a loading dose of 10 mg/kg over 30 minutes and followed by 12 hours of 1 mg.kg(-1).h(-1)) were administrated in group 2 (n = 50).
- Significantly less drainage was noted in group 2 (1010 +/- 49.9 mL vs 623 +/- 41.3 mL, P =.0001). Packed red blood cells were transfused at 2.1 +/- 0.5 units per patient in group 1 versus 0.9 +/- 0.3 units in group 2 (P =.0001). Fresh frozen plasma was transfused at 1.84 +/- 0.17 units per patient in group 1 versus 0.76 +/- 0.14 units in group 2 (P =.0001). Only 24% of patients in group 2 required donor blood or blood products compared with 74% of those in the isolated desmopressin group (group 1, P =.00001). Group 1 and group 2 findings were as follows: postoperative fibrinogen, 113 +/- 56.3 mg/dL versus 167 +/- 45.8 mg/dL (P =.0001); fibrin split product, 21.2 +/- 2.3 ng/mL versus 13.5 +/- 3.4 ng/mL (P =.0001); and postoperative hemoglobin level, 7.6 plus minus 1.2 g/dL versus 9.1 plus minus 1.2 g/dL (P =.0001).
Question: Does tranexamic acid reduce desmopressin-induced hyperfibrinolysis?
Options:
A. yes
B. no
C. maybe
|
Tranexamic acid administration significantly reduces desmopressin and bypass-induced hyperfibrinolysis. Combined use of tranexamic acid and desmopressin decreases both postoperative blood loss and transfusion requirement. The answer is: A
|
A
|
Does tranexamic acid reduce desmopressin-induced hyperfibrinolysis?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Ascitis and undernutrition are frequent complications of cirrhosis, however ascitis volume and anthropometric assessment are not routinely documented or considered in prognostic evaluation. In a homogeneous cohort followed during two years these variables were scrutinized, aiming to ascertain relevance for longterm outcome.
- Population (N = 25, all males with alcoholic cirrhosis) was recruited among patients hospitalized for uncomplicated ascitis. Exclusion criteria were refractory or tense ascitis, cancer, spontaneous bacterial peritonitis, bleeding varices and critical illness. Measurements included ultrasonographically estimated ascitis volume, dry body mass index/BMI , upper arm anthropometrics, hematologic counts and liver function tests.
- Population (age 48.3 ± 11.3 years, BMI 21.1 ± 3.5 kg/m², serum albumin 2.5 ± 0.8 g/dL) was mostly in the Child-Pugh C category (77.8%) but clinically stable. During the follow-up period of 22.6 ± 3.8 months, additional hospitalizations numbered 1.7 ± 1.0 and more than one quarter succumbed. Admission ascitis volume corresponded to 7.1 ± 3.6 L and dry BMI to 18.3 ± 3.5 kg/m². Child Pugh index was relevant for both mortality and rehospitalization. Nevertheless, similar matches for mortality were documented with ascitis volume and dry BMI, and arm circumference below the 5th percentile was highly significantly associated with rehospitalization.
Question: Should ascitis volume and anthropometric measurements be estimated in hospitalized alcoholic cirrotics?
Options:
A. yes
B. no
C. maybe
|
A greater association than hitherto acknowledged, between ascitis volume and anthropometric measurements from one side, and long-term rehospitalization and mortality from the other, was demonstrated in male stable alcoholic cirrhotics. Further studies with alcoholic and other modalities of cirrhosis including women are recommended. The answer is: A
|
A
|
Should ascitis volume and anthropometric measurements be estimated in hospitalized alcoholic cirrotics?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Esophagogastric variceal hemorrhage is a life-threatening complication of portal hypertension. In this study, we compared the therapeutic effect of a novel surgical procedure, esophagogastric devascularization without splenectomy (EDWS), with the widely used modified esophagogastric devascularization (MED) with splenectomy for the treatment of portal hypertension.
- Fifty-five patients with portal hypertension were included in this retrospective study. Among them, 27 patients underwent EDWS, and the other 28 patients underwent MED. Patients' characteristics, perioperative parameters and long-term follow-up were analyzed.
- The portal venous pressure was decreased by 20% postoperatively in both groups. The morbidity rate of portal venous system thrombosis in the EDWS group was significantly lower than that in the MED group (P=0.032). The 1- and 3-year recurrence rates of esophagogastric variceal hemorrhage were 0% and 4.5% in the EDWS group, and 0% and 8.7% in the MED group, respectively (P=0.631).
Question: Esophagogastric devascularization without splenectomy in portal hypertension: safe and effective?
Options:
A. yes
B. no
C. maybe
|
EDWS is a safe and effective treatment for esophagogastric varices secondary to portal hypertension in selected patients. Patients treated with EDWS had a lower complication rate of portal venous system thrombosis compared with those treated with conventional MED. The answer is: A
|
A
|
Esophagogastric devascularization without splenectomy in portal hypertension: safe and effective?
|
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}
|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Injury severity score (ISS), Glasgow coma score (GCS), and revised trauma score (RTS) are the most frequently used methods to evaluate the severity of injury in blunt trauma patients. ISS is too complicated to assess easily and GCS and RTS are easy to assess but somewhat subjective. White blood cell count (WBC) is an easy, quick and objective test. This study was performed to evaluate the significance of the WBC count at presentation in the blunt trauma patients.
- 713 blunt trauma patients, who were admitted to the Uludag University Medical Center Emergency Department between 01.04.2000-31.12.2000, were retrospectively evaluated in terms of ISS, GCS, RTS and white blood cell count at presentation.
- Statistical analysis revealed that WBC was correlated positively with ISS, but negatively with GCS and RTS.
Question: Does the leukocyte count correlate with the severity of injury?
Options:
A. yes
B. no
C. maybe
|
The leukocyte count at presentation can be used as an adjunct in the evaluation of the severity of injury in blunt trauma patients. The answer is: A
|
A
|
Does the leukocyte count correlate with the severity of injury?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The elephant trunk technique for aortic dissection is useful for reducing false lumen pressure; however, a folded vascular prosthesis inside the aorta can cause haemolysis. The purpose of this study was to investigate whether an elephant trunk in a small-calibre lumen can cause haemolysis.
- Inpatient and outpatient records were retrospectively reviewed.
- Two cases of haemolytic anaemia after aortic surgery using the elephant trunk technique were identified from 2011 to 2013. A 64-year-old man, who underwent graft replacement of the ascending aorta for acute Stanford type A aortic dissection, presented with enlargement of the chronic dissection of the descending aorta and moderate aortic regurgitation. A two-stage surgery was scheduled. Total arch replacement with an elephant trunk in the true lumen and concomitant aortic valve replacement were performed. Postoperatively, he developed severe haemolytic anaemia because of the folded elephant trunk. The anaemia improved after the second surgery, including graft replacement of the descending aorta. Similarly, a 61-year-old man, who underwent total arch replacement for acute Stanford type A aortic dissection, presented with enlargement of the chronic dissection of the descending aorta. Graft replacement of the descending aorta with an elephant trunk inserted into the true lumen was performed. The patient postoperatively developed haemolytic anaemia because of the folded elephant trunk, which improved after additional stent grafting into the elephant trunk.
Question: Elephant trunk in a small-calibre true lumen for chronic aortic dissection: cause of haemolytic anaemia?
Options:
A. yes
B. no
C. maybe
|
A folded elephant trunk in a small-calibre lumen can cause haemolysis. Therefore, inserting an elephant trunk in a small-calibre true lumen during surgery for chronic aortic dissection should be avoided. The answer is: A
|
A
|
Elephant trunk in a small-calibre true lumen for chronic aortic dissection: cause of haemolytic anaemia?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Health care delivery has undertaken a major shift from inpatient management to ambulatory surgical care with increasing emphasis on quality assurance (QA) processes. Educational opportunities for medical undergraduate programmes are being sought in the day surgery environment. Our study was undertaken to explore ways in which senior medical students can actively contribute to QA processes as part of an undergraduate day surgery educational programme.
- Health care delivery has undertaken a major shift from inpatient management to ambulatory surgical care with increasing emphasis on quality assurance (QA) processes. Educational opportunities for medical undergraduate programmes are being sought in the day surgery environment. Our study was undertaken to explore ways in which senior medical students can actively contribute to the QA processes as part of an undergraduate day surgery educational programme.
- Fifty-nine final year medical students followed allocated patients with common surgical conditions through all phases of the day surgery process. Students kept records about each case in a log book and also presented their cases at weekly Problem Based Learning tutorials. An audit of student log books and review of tutorial records was conducted for the 1996 and 1997 academic years, in order to evaluate student contribution to QA.
- Students followed 621 cases, representing a sampling of 14. 1% day surgery cases. Categories of problems highlighted by students included inappropriate patient and procedure selection, inadequate pain management, discharge, communication and resource issues. Students made a number of recommendations including the development of multilingual videotapes and patient information sheets for non-English speaking patients, avoidance of bilateral surgical procedures and improved links with local medical officers. They also developed new guidelines and protocols.
Question: Can medical students contribute to quality assurance programmes in day surgery?
Options:
A. yes
B. no
C. maybe
|
Our study confirms that students are able to identify QA issues and propose solutions. We recommend that students have a formally recognized place in day surgery QA programmes, to close the QA loop and to adequately prepare them for medical practice in the 21st century. The answer is: A
|
A
|
Can medical students contribute to quality assurance programmes in day surgery?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Measurement of basal metabolic rate (BMR) is suggested as a tool to estimate energy requirements. Therefore, BMR prediction equations have been developed in multiple populations because indirect calorimetry is not always feasible. However, there is a paucity of data on BMR measured in overweight and obese adults living in Asia and equations developed for this group of interest. The aim of this study was to develop a new BMR prediction equation for Chinese adults applicable for a large BMI range and compare it with commonly used prediction equations.
- Subjects were 121 men and 111 women (age: 21-67 years, BMI: 16-41 kg/m(2)). Height, weight, and BMR were measured. Continuous open-circuit indirect calorimetry using a ventilated hood system for 30 min was used to measure BMR. A regression equation was derived using stepwise regression and accuracy was compared to 6 existing equations (Harris-Benedict, Henry, Liu, Yang, Owen and Mifflin). Additionally, the newly derived equation was cross-validated in a separate group of 70 Chinese subjects (26 men and 44 women, age: 21-69 years, BMI: 17-39 kg/m(2)).
- The equation developed from our data was: BMR (kJ/d) = 52.6 x weight (kg) + 828 x gender + 1960 (women = 0, men = 1; R(2) = 0.81). The accuracy rate (within 10 % accurate) was 78 % which compared well to Owen (70 %), Henry (67 %), Mifflin (67 %), Liu (58 %), Harris-Benedict (45 %) and Yang (37 %) for the whole range of BMI. For a BMI greater than 23, the Singapore equation reached an accuracy rate of 76 %. Cross-validation proved an accuracy rate of 80 %.
Question: Estimation of basal metabolic rate in Chinese: are the current prediction equations applicable?
Options:
A. yes
B. no
C. maybe
|
To date, the newly developed Singapore equation is the most accurate BMR prediction equation in Chinese and is applicable for use in a large BMI range including those overweight and obese. The answer is: A
|
A
|
Estimation of basal metabolic rate in Chinese: are the current prediction equations applicable?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Quality of Life (QoL) assessment remains integral in the investigation of women with lower urinary tract dysfunction. Previous work suggests that physicians tend to underestimate patients' symptoms and the bother that they cause. The aim of this study was to assess the relationship between physician and patient assessed QoL using the Kings Health Questionnaire (KHQ).
- Patients complaining of troublesome lower urinary tract symptoms (LUTS) were recruited from a tertiary referral urodynamic clinic. Prior to their clinic appointment they were sent a KHQ, which was completed before attending. After taking a detailed urogynecological history, a second KHQ was filled in by the physician, blinded to the patient responses, on the basis of their impression of the symptoms elicited during the interview. These data were analyzed by an independent statistician. Concordance between patient and physician assessment for individual questions was assessed using weighted kappa analysis. QoL scores were compared using Wilcoxons signed rank test.
- Seventy-five patients were recruited over a period of 5 months. Overall, the weighted kappa showed relatively poor concordance between the patient and physician responses; mean kappa: 0.33 (range 0.18-0.57). The physician underestimated QoL score in 4/9 domains by a mean of 5.5% and overestimated QoL score in 5/9 domains by a mean of 6.9%. In particular, physicians underestimated the impact of LUTS on social limitations and emotions (P<0.05).
Question: Is there a discrepancy between patient and physician quality of life assessment?
Options:
A. yes
B. no
C. maybe
|
This study confirms that physicians often differ from patients in the assessment of QoL. This is most likely due to a difference in patient-physician perception of "significant" LUTS and clearly demonstrates the importance of patient evaluated QoL in routine clinical assessment. The answer is: A
|
A
|
Is there a discrepancy between patient and physician quality of life assessment?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- There are few data concerning emergency double-balloon enteroscopy (DBE) and its usefulness in the management of severe acute obscure gastrointestinal bleeding (OGIB). The aim of this retrospective study was to evaluate emergency DBE and capsule endoscopy (CE) in patients with overt OGIB, analyzing the feasibility of this combined approach.
- Emergency DBE in patients with overt OGIB was defined as performance within 24 h of symptom onset. We reported 27 patients (16 men, mean age: 64.6 ± 17.9 years) with overt severe bleeding who underwent 29 emergency DBE (22 anterograde, 7 retrograde). Of 27 patients, 16 (59.3%) underwent CE with real time (RT) viewing.
- Patients were diagnosed with the following: Dieulafoy's lesion (DL; n = 11, 40.7%), angioectasia (n = 7, 25.9%), tumors (n = 4, 14.8%), diverticulum (n = 3, 11.1%), ulcers (n = 2, 7.4%). We diagnosed 23 lesions amenable to endoscopic hemostasis and successfully treated 21 of them (77.8%). DL detection rate was statistically higher in the emergency DBE group than in OGIB patients with DBE done 24 h after symptom onset (40.7% vs 0.9%, respectively, P < 0.001). Combined approach with RT viewing by CE correctly modified DBE management in four patients (25%).
Question: Emergency double-balloon enteroscopy combined with real-time viewing of capsule endoscopy: a feasible combined approach in acute overt-obscure gastrointestinal bleeding?
Options:
A. yes
B. no
C. maybe
|
Emergency DBE is feasible, safe and effective in acute OGIB and may avoid major surgery, diagnosing and successfully treating most patients. Combined approach with RT viewing by CE is especially useful to identify recurrent bleeding vascular lesions such as DL that may be easily misdiagnosed by non-emergency DBE. The answer is: A
|
A
|
Emergency double-balloon enteroscopy combined with real-time viewing of capsule endoscopy: a feasible combined approach in acute overt-obscure gastrointestinal bleeding?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To evaluate psychological distress as a predictor of disability due to common chronic disorders.
- A 10-year follow-up study was carried out among a representative cohort (N = 8655) of 18-64 year old Finnish farmers, who had participated in a health survey in 1979 and were able to work at baseline. A record linkage with the nationwide register of the Social Insurance Institution was made to identify disability pensions granted between 1980 and 1990 in the cohort. The medical certificates of 1004 (11.6%) prematurely retired farmers were reviewed to confirm and classify disabling conditions. A sum score based on self-reports of 11 symptoms at the baseline was used as a measure of psychological distress.
- After adjustment for age, sex, smoking and body mass index, the cause-specific relative risks (RR) (95% confidence intervals [CI]) of disability in the highest quartile of the psychological distress score as compared with the lowest quartile were for myocardial infarction 2.34 (95% CI: 1.17-4.69), for depression 2.50 (95% CI: 1.09-5.72), for neck-shoulder disorders 1.98 (95% CI: 1.26-3.11), for unspecified low-back disorders 1.76 (95% CI: 1.24-2.49), for knee osteoarthritis 1.55 (95% CI: 0.91-2.63) and for trip osteoarthritis 0.89 (95% CI: 0.42-1.85). The corresponding RR for overall disability was 1.76 (95% CI: 1.44-2.14) in the highest quartile of psychological distress score as compared with the lowest quartile.
Question: Does psychological distress predict disability?
Options:
A. yes
B. no
C. maybe
|
Psychological distress is an independent risk factor for disability. Its predictive significance varies between disorders leading to functional deterioration. The association mechanisms are likely to vary from one disorder to another. The answer is: A
|
A
|
Does psychological distress predict disability?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Acute fibrinous and organizing pneumonia (AFOP) is a recently described histologic pattern of diffuse pulmonary disease. In children, all cases reported to date have been fatal. In this study, we describe the first nonfatal AFOP in a child and review the literature.
- A 10-year-old boy developed very severe aplastic anemia (VSAA) after being admitted to our hospital with a fulminant hepatic failure of unknown origin. A chest computed tomography scan revealed multiple lung nodules and a biopsy of a pulmonary lesion showed all the signs of AFOP. Infectious workup remained negative. We started immunosuppressive therapy with antithymocyte globulin and cyclosporine to treat VSAA. Subsequent chest computed tomography scans showed a considerable diminution of the lung lesions but the VSAA did not improve until we performed hematopoietic stem cell transplantation 5 months later.
Question: Is acute fibrinous and organizing pneumonia the expression of immune dysregulation?
Options:
A. yes
B. no
C. maybe
|
Aplastic anemia is associated with a variety of autoimmune syndromes. The sequence of events in our patient suggests that the hepatic failure, AFOP, and the VSAA may all have been part of an autoimmune syndrome. AFOP could be the result of immune dysregulation in this pediatric case with favorable outcome after immunosuppressive therapy and hematopoietic stem cell transplantation. The answer is: A
|
A
|
Is acute fibrinous and organizing pneumonia the expression of immune dysregulation?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- This study aimed to evaluate the utility of risk stratification of gynecologic oncology patients with neutropenic fever (NF).
- A retrospective chart review of gynecologic cancer patients admitted with NF from 2007 to 2011 was performed, wherein demographic, oncologic, and NF characteristics (hospitalization length, complications, and death) were collected. The Multinational Association for Supportive Care in Cancer (MASCC) risk index score was calculated; low risk was considered ≥ 21. SAS 9.2 was used for statistical analyses.
- Eighty-three patients met the study criteria. Most (92%) were Caucasian and had advanced stage disease (71%). Primary tumors were 58% ovary, 35% endometrium, and 6% cervix. All patients were receiving chemotherapy on admission (72% for primary, 28% for recurrent disease). Forty-eight percent had a positive culture, and most (58%) positive cultures were urine. Seventy-six percent of patients were considered low risk. High-risk patients were more likely to have a severe complication (10% versus 50%, p=0.0003), multiple severe complications (3% versus 20%, p=0.0278), ICU admission (2% versus 40%, p<0.0001), overall mortality (2% versus 15%, p=0.0417), and death due to neutropenic fever (0% versus 15%, p=0.0124). MASCC had a positive predictive value of 50% and negative predictive value of 90%. The median MASCC score for all patients was 22 (range, 11-26), but the median MASCC score for those with death or a severe complication was 17 (range, 11-24).
Question: Inpatient versus outpatient management of neutropenic fever in gynecologic oncology patients: is risk stratification useful?
Options:
A. yes
B. no
C. maybe
|
Based on this pilot data, MASCC score appears promising in determining suitability for outpatient management of NF in gynecologic oncology patients. Prospective study is ongoing to confirm safety and determine impact on cost. The answer is: A
|
A
|
Inpatient versus outpatient management of neutropenic fever in gynecologic oncology patients: is risk stratification useful?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Acute pancreatitis is the major complication of endoscopic retrograde cholangiopancreatography (ERCP) procedure and there are some reports showing cytokine changes in ERCP-induced pancreatits.GOALS: To investigate the association between early changes (within 24 hours) in the serum interleukin (IL)-2, IL-4, tumor necrosis factor (TNF)alpha, and IL-6 levels and the development of post-ERCP pancreatitis.STUDY: Forty five consecutive patients who underwent therapeutic ERCP and 10 patients with acute pancreatitis without ERCP were enrolled to the study. Serum concentrations of IL-2, IL-4, TNFalpha, and IL-6 were determined immediately before, 12 hours and 24 hours after ERCP.
- Seven of the 45 patients (15.5%) developed post-ERCP pancreatitis. The levels of IL-4 at 24 hours after ERCP were significantly lower in the patients with post-ERCP pancreatitis than in those without pancreatitis, while TNFalpha levels at 12 hours after ERCP were higher in the complicated group than those of the uncomplicated group. The ratios of TNFalpha/IL-4 at 12 and 24 hours after ERCP were found significantly higher in the patients with post-ERCP pancreatitis than in those without pancreatitis. IL-6 in the complicated patients was found significantly increased at 24 hours after ERCP.
Question: Do the changes in the serum levels of IL-2, IL-4, TNFalpha, and IL-6 reflect the inflammatory activity in the patients with post-ERCP pancreatitis?
Options:
A. yes
B. no
C. maybe
|
The enhancement of serum TNFalpha and IL-6 levels in the patients with ERCP-induced pancreatitis reflects the inflammatory activity. Additionally, these cytokines together with IL-4 can be used in clinical laboratory monitoring of ERCP. The answer is: A
|
A
|
Do the changes in the serum levels of IL-2, IL-4, TNFalpha, and IL-6 reflect the inflammatory activity in the patients with post-ERCP pancreatitis?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To determine the advantages of scrotal incision in the treatment of undescended testis. Undescended testis is a common pediatric condition and is conventionally managed surgically by orchidopexy. A single scrotal incision orchidopexy has become accepted as a valid approach for patients with palpable undescended testicles. Because this approach also allows easy detection of atrophic testes or testicular remnants, it recently has also emerged as an alternative initial surgical approach to impalpable undescended testicles.
- All orchidopexies performed between 2004 and 2008 at our university hospital were prospectively included in this study. A total of 194 scrotal orchidopexies were performed in 154 patients (mean age, 71 months; range, 4-229 months). In all cases a scrotal approach was chosen irrespective of the initial position or presence of an open processus vaginalis. Testicular position was examined at follow-up after a mean period of 10 months (3-22 months).
- Overall, 36 of the 46 impalpable testicles (78%) could be diagnosed and treated accordingly, using only a scrotal incision. Conversion to laparoscopy was needed in 4 cases. A limited number of postoperative complications were seen. In all cases, the testes were palpable and remained in the scrotum on follow-up.
Question: Scrotal approach to both palpable and impalpable undescended testes: should it become our first choice?
Options:
A. yes
B. no
C. maybe
|
Initial single scrotal incision can be recommended for orchidopexy, even in the more difficult cases of impalpable undescended testes. Advantages seem to include shorter operative time, a cosmetically appealing single incision, and possibly less pain. The scrotal incision technique significantly reduces the need for laparoscopy in impalpable testes. Surprisingly, it even allows successful orchidopexy of abdominal testes, provided an open processus is present. The answer is: A
|
A
|
Scrotal approach to both palpable and impalpable undescended testes: should it become our first choice?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The purpose of this paper is to evaluate the efficacy of ultrasonographic screening for primary hepatocellular carcinoma.
- A total of 680 eligible cases were classified into three groups (surveillance, opportunistic, and symptomatic groups) according to their initial exposure. We used survival time, tumor morphology, and T staging as prognostic outcomes. The outcomes of screened/unscreened and sur veillance/nonsur veillance were compared with the use of the logistic regression model.
- The adjusted odds ratios for the screened group versus the unscreened group, with 1-, 2-, and 3-year survival time being used as outcomes, were 0.33 (95% confidence interval [CI], 0.21-0.52), 0.33 (95% CI, 0.21-0.53), and 0.37 (95% CI, 0.23-0.61), respectively. The adjusted odds ratios for surveillance versus nonsurveillance were 0.58 (95% CI, 0.35-0.97), 0.45 (95% CI, 0.27-0.74), and 0.44 (95% CI, 0.26-0.73). The odds ratios were even smaller when tumor morphology or T stage was taken as the main outcome. All these results were statistically significant. There were significant gradient relationships between prognostic outcomes and extent of screening history.
Question: Does screening or surveillance for primary hepatocellular carcinoma with ultrasonography improve the prognosis of patients?
Options:
A. yes
B. no
C. maybe
|
The significant impact of ultrasonographic screening on mortality reduction was demonstrated. These findings strongly suggest that early detection of hepatocellular carcinoma by ultrasound may improve the prognosis of patients with hepatocellular carcinoma. The answer is: A
|
A
|
Does screening or surveillance for primary hepatocellular carcinoma with ultrasonography improve the prognosis of patients?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The gap between evidence-based treatments and routine care has been well established. Findings from the Sequenced Treatments Alternatives to Relieve Depression (STAR*D) emphasized the importance of measurement-based care for the treatment of depression as a key ingredient for achieving response and remission; yet measurement-based care approaches are not commonly used in clinical practice.
- The Nine-Item Patient Health Questionnaire (PHQ-9) for monitoring depression severity was introduced in 19 diverse psychiatric practices. During the one-year course of the project the helpfulness and feasibility of implementation of PHQ-9 in these psychiatric practices were studied. The project was modeled after the Institute for Healthcare Improvement Breakthrough Series. Two of the 19 practices dropped out during the course of the project.
- By the conclusion of the study, all remaining 17 practices had adopted PHQ-9 as a routine part of depression care in their practice. On the basis of responses from 17 psychiatrists from those practices, PHQ-9 scores influenced clinical decision making for 93% of 6,096 patient contacts. With the additional information gained from the PHQ-9 score, one or more treatment changes occurred during 40% of these clinical contacts. Changing the dosage of antidepressant medication and adding another medication were the most common treatment changes recorded by psychiatrists, followed by starting or increasing psychotherapy and by switching or initiating antidepressants. In 3% of the patient contacts, using the PHQ-9 led to additional suicide risk assessment.
Question: Systematic use of patient-rated depression severity monitoring: is it helpful and feasible in clinical psychiatry?
Options:
A. yes
B. no
C. maybe
|
The study findings suggest that adopting measurement-based care, such as using the PHQ-9, is achievable, even in practices with limited resources. The answer is: A
|
A
|
Systematic use of patient-rated depression severity monitoring: is it helpful and feasible in clinical psychiatry?
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Most older drivers continue to drive as they age. To maintain safe and independent transport, mobility is important for all individuals, but especially for older drivers.
- The objective of this study was to investigate whether automatic transmission, compared with manual transmission, may improve the driving behavior of older drivers.
- In total, 31 older drivers (mean age 75.2 years) and 32 younger drivers - used as a control group (mean age 39.2 years) - were assessed twice on the same fixed route; once in a car with manual transmission and once in a car with automatic transmission. The cars were otherwise identical. The driving behavior was assessed with the Ryd On-Road Assessment driving protocol. Time to completion of left turns (right-hand side driving) and the impact of a distraction task were measured.
- The older group had more driving errors than the younger group, in both the manual and the automatic transmission car. However, and contrary to the younger drivers, automatic transmission improved the older participants' driving behavior as demonstrated by safer speed adjustment in urban areas, greater maneuvering skills, safer lane position and driving in accordance with the speed regulations.
Question: Does automatic transmission improve driving behavior in older drivers?
Options:
A. yes
B. no
C. maybe
|
Switching to automatic transmission may be recommended for older drivers as a means to maintain safe driving and thereby the quality of their transport mobility. The answer is: A
|
A
|
Does automatic transmission improve driving behavior in older drivers?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To study the efficiency and safety of holmium:YAG laser lithotripsy for ureteral stones.
- A series of 188 patients with 208 ureteral stones were treated with semirigid ureteroscopy and holmium:YAG laser lithotripsy from January 2003 to December 2005. Of the stones, 116 were lower ureteral, 37 middle ureteral, and 55 upper ureteral.
- The success rate was 92.7% at the time of ureteroscopy and 96.7% at 3 months. The failures were secondary to retropulsion of the stones (3.3%). There were no perforations and one stricture. Stenting was done in 90% of patients.
Question: Is the holmium:YAG laser the best intracorporeal lithotripter for the ureter?
Options:
A. yes
B. no
C. maybe
|
The Holmium:YAG laser is an ideal intracorporeal lithotripter for ureteral calculi, with a high success rate and low morbidity. The answer is: A
|
A
|
Is the holmium:YAG laser the best intracorporeal lithotripter for the ureter?
|
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{
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Despite rapid adoption of the Hirsch index (h-index) as a measure of academic success, the correlations between the h-index and other metrics of productivity remain poorly understood. The aims of this study were to determine whether h-indices were associated with greater National Institutes of Health (NIH) funding success among academic radiologists.
- Using the Scopus database, h-indices were calculated for a random sample of academic radiologists with the rank of professor. Using the NIH tool Research Portfolio Online Reporting Tools Expenditures and Reports, we determined the number, classification, and total years of NIH grant funding as principal investigator for each radiologist. Differences in h-index, sorted by funding status, were determined using Wilcoxon's tests. Associations between h-index and funding status were determined using logistic regression. Significant correlations between h-index and grant metrics were determined using Spearman's ρ.
- Among 210 professors of radiology, 48 (23%) secured at least one NIH grant. The mean h-index was significantly higher among individuals who secured at least one NIH grant (19.1) compared to those who did not (10.4) (P<.0001). Professors with h-indices<10 compared to those with h-indices>10 were significantly less likely to receive NIH funding (odds ratio, 0.07; P = .0321). However, h-indices>10 were not significantly predictive of greater funding. No significant relationships were observed between h-index and the number of grant awards, years of prior funding, the amounts of grant awards, or grant classification.
Question: Is the h-index predictive of greater NIH funding success among academic radiologists?
Options:
A. yes
B. no
C. maybe
|
Having obtained at least one NIH grant was associated with a higher h-index, yet multiple or large grants, such as those for program projects, were not predictive of higher h-indices. The answer is: A
|
A
|
Is the h-index predictive of greater NIH funding success among academic radiologists?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- We sought to determine the feasibility and assess the clinical outcomes associated with an early extubation strategy for all children undergoing congenital heart surgery, including neonates (age,<30 days).
- We performed a linked database analysis of all patients undergoing congenital heart surgery from July 1, 2010 to December 31, 2012. We collected data on the cardiac diagnoses, preoperative status, procedure, and postoperative course, including the duration of invasive and noninvasive ventilation, failure of extubation, hemodynamic data, length of stay, complications, and mortality. A multivariable model was used to assess the independent factors associated with an inability to extubate within the operating room and with delayed extubation (>24 hours).
- We operated on 613 children, including 97 neonates. Intraoperative extubation was achieved in 71% of the cases and early extubation (≤ 24 hours) was achieved in 89% of the cases. The overall mortality was 1.5% (9 of 613 patients). Early extubation was associated with lower mortality (1% vs 9%, P<.001) and a lower rate of reintubation (4% vs 23%, P<.001) compared with delayed extubation. Notably, 63% of the neonates were extubated within 24 hours, including 67% of arterial switch operations and 54% of total anomalous pulmonary venous return repairs. Norwood operations were the only procedure in which no patient was extubated within the first 24 hours. Multivariable logistic regression demonstrated that the predictors of delayed extubation included preoperative mechanical ventilation, weight<5 kg, a longer procedure time, and the need for postoperative inotrope support. Implementation of an early extubation strategy was associated with low rates of complications (5.1 per 10 procedures), short lengths of intensive care unit stay (median, 1 day; interquartile range, 1-3), and short hospital stays (median, 4 days; interquartile range, 3-6).
Question: Should early extubation be the goal for children after congenital cardiac surgery?
Options:
A. yes
B. no
C. maybe
|
Most children undergoing congenital heart surgery can be extubated in the operating room. Most neonates, including many undergoing complex procedures, can be extubated within the first 24 hours after surgery. Early extubation was associated with low morbidity rates and short lengths of intensive care unit and hospital stays. The answer is: A
|
A
|
Should early extubation be the goal for children after congenital cardiac surgery?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Laparoscopic adrenalectomy (LA) has become the gold standard treatment for small (less than 6 cm) adrenal masses. However, the role of LA for large-volume (more than 6 cm) masses has not been well defined. Our aim was to evaluate, retrospectively, the outcome of LA for adrenal lesions larger than 7 cm.
- 18 consecutive laparoscopic adrenalectomies were performed from 1996 to 2005 on patients with adrenal lesions larger than 7 cm.
- The mean tumor size was 8.3 cm (range 7-13 cm), the mean operative time was 137 min, the mean blood loss was 182 mL (range 100-550 mL), the rate of intraoperative complications was 16%, and in three cases we switched from laparoscopic procedure to open surgery.
Question: Is laparoscopic adrenalectomy safe and effective for adrenal masses larger than 7 cm?
Options:
A. yes
B. no
C. maybe
|
LA for adrenal masses larger than 7 cm is a safe and feasible technique, offering successful outcome in terms of intraoperative and postoperative morbidity, hospital stay and cosmesis for patients; it seems to replicate open surgical oncological principles demonstrating similar outcomes as survival rate and recurrence rate, when adrenal cortical carcinoma were treated. The main contraindication for this approach is the evidence, radiologically and intraoperatively, of local infiltration of periadrenal tissue. The answer is: A
|
A
|
Is laparoscopic adrenalectomy safe and effective for adrenal masses larger than 7 cm?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The use of a balloon expandable stent valve includes balloon predilatation of the aortic stenosis before valve deployment. The aim of the study was to see whether or not balloon predilatation is necessary in transcatheter aortic valve replacement (TAVI).
- Sixty consecutive TAVI patients were randomized to the standard procedure or to a protocol where balloon predilatation was omitted.
- There were no significant differences between the groups regarding early hemodynamic results or complication rates.
Question: Can predilatation in transcatheter aortic valve implantation be omitted?
Options:
A. yes
B. no
C. maybe
|
TAVI can be performed safely without balloon predilatation and with the same early results as achieved with the standard procedure including balloon predilatation. The reduction in the number of pacing periods required may be beneficial for the patient. The answer is: A
|
A
|
Can predilatation in transcatheter aortic valve implantation be omitted?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- There are various causes of halitosis, one of which is chronic renal failure. The objective of this study was to investigate halitosis levels in end-stage renal disease (ESRD) patients before and after peritoneal dialysis (PD) therapy.
- 42 subjects with ESRD were included in this study. The presence of halitosis was assessed using an organoleptic measurement and compared with blood urea nitrogen (BUN) levels and salivary flow rates. Decayed, missing, and filled teeth (DMFT) index and Community Periodontal Index (CPI) were calculated. All measurements were done before and after patients had received 3 months of PD therapy.
- Mean serum BUN level was found to be lower (46.05 ± 13.30 vs 91.24 ± 31.28 mg/dL), salivary flow rate higher (0.34 ± 0.07 vs 0.26 ± 0.04 mL/minute), and halitosis level lower (2.39 ± 0.60 vs 3.90 ± 0.37) at the end of 3 months of PD therapy than at the beginning of PD therapy. There was no significant difference in CPI or DMFT index before and after PD therapy (p>0.05). There was statistically significant positive correlation between the presence of halitosis and BUN levels (r = 0.702, p = 0.001 before PD; r = 0.45, p = 0.002 after PD) and a negative correlation between the presence of halitosis and salivary flow rates (r = -0.69, p = 0.000 before PD; r = -0.37, p = 0.01 after PD).
Question: Does peritoneal dialysis affect halitosis in patients with end-stage renal disease?
Options:
A. yes
B. no
C. maybe
|
High BUN levels and low salivary flow rates were found to be associated with halitosis. PD may play an important role in decreasing the level of halitosis in ESRD patients. The answer is: A
|
A
|
Does peritoneal dialysis affect halitosis in patients with end-stage renal disease?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To assess and compare the value of split-liver transplantation (SLT) and living-related liver transplantation (LRT).
- The concept of SLT results from the development of reduced-size transplantation. A further development of SLT, the in situ split technique, is derived from LRT, which itself marks the optimized outcome in terms of postoperative graft function and survival. The combination of SLT and LRT has abolished deaths on the waiting list, thus raising the question whether living donor liver transplantation is still necessary.
- Outcomes and postoperative liver function of 43 primary LRT patients were compared with those of 49 primary SLT patients (14 ex situ, 35 in situ) with known graft weight performed between April 1996 and December 2000. Survival rates were analyzed using the Kaplan-Meier method.
- After a median follow-up of 35 months, actual patient survival rates were 82% in the SLT group and 88% in the LRT group. Actual graft survival rates were 76% and 81%, respectively. The incidence of primary nonfunction was 12% in the SLT group and 2.3% in the LRT group. Liver function parameters (prothrombin time, factor V, bilirubin clearance) and surgical complication rates did not differ significantly. In the SLT group, mean cold ischemic time was longer than in the LRT group. Serum values of alanine aminotransferase during the first postoperative week were significantly higher in the SLT group. In the LRT group, there were more grafts with signs of fatty degeneration than in the SLT group.
Question: Is there still a need for living-related liver transplantation in children?
Options:
A. yes
B. no
C. maybe
|
The short- and long-term outcomes after LRT and SLT did not differ significantly. To avoid the risk for the donor in LRT, SLT represents the first-line therapy in pediatric liver transplantation in countries where cadaveric organs are available. LRT provides a solution for urgent cases in which a cadaveric graft cannot be found in time or if the choice of the optimal time point for transplantation is vital. The answer is: A
|
A
|
Is there still a need for living-related liver transplantation in children?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Recent evaluations of IT innovations in primary care have highlighted variations between centres and practices in uptake and use. We evaluated whether structural characteristics of a general practice were associated with variations in use of a web-based clinical information system underpinning a Managed Clinical Network in diabetes, between the years 2001 and 2003.
- Using a computerised audit trail, we calculated the numbers of web-based operations that occurred in each practice, stratified by staff type and year, and adjusted for the numbers of registered diabetic patients. In regression analyses, we determined whether total use was associated with structural characteristics of the practice (total list size, training status, numbers of GPs (general practitioners), mean age of the GPs, numbers of female GPs, level of deprivation of the population and whether staff had received advanced training in diabetes care).
- Initially there were a few practices which made very frequent use of the information system, with relatively high numbers of practices using the facility infrequently. However, overall use gradually became more evenly spread. This effect was particularly evident among nurse users. Frequent use by GPs was evident in only a small number of practices, with mean GP use decreasing over the three years. In linear regression analyses, none of the general practice variables were associated with online use, either overall or stratified by staff type, except for the numbers of diabetes-educated staff. This was consistently associated with increased use by nurses and GPs.
Question: Do general practice characteristics influence uptake of an information technology (IT) innovation in primary care?
Options:
A. yes
B. no
C. maybe
|
The analyses show that structural characteristics of a practice are not associated with uptake of a new IT facility, but that its use may be influenced by post-graduate education in the relevant clinical condition. For this diabetes system at least, practice nurse use was critical in spreading uptake beyond initial GP enthusiasts and for sustained and rising use in subsequent years. The answer is: B
|
B
|
Do general practice characteristics influence uptake of an information technology (IT) innovation in primary care?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Despite a previous meta-analysis that concluded that central venous pressure should not be used to make clinical decisions regarding fluid management, central venous pressure continues to be recommended for this purpose.AIM: To perform an updated meta-analysis incorporating recent studies that investigated indices predictive of fluid responsiveness. A priori subgroup analysis was planned according to the location where the study was performed (ICU or operating room).
- MEDLINE, EMBASE, Cochrane Register of Controlled Trials, and citation review of relevant primary and review articles.
- Clinical trials that reported the correlation coefficient or area under the receiver operating characteristic curve (AUC) between the central venous pressure and change in cardiac performance following an intervention that altered cardiac preload. From 191 articles screened, 43 studies met our inclusion criteria and were included for data extraction. The studies included human adult subjects, and included healthy controls (n = 1) and ICU (n = 22) and operating room (n = 20) patients.
- Data were abstracted on study characteristics, patient population, baseline central venous pressure, the correlation coefficient, and/or the AUC between central venous pressure and change in stroke volume index/cardiac index and the percentage of fluid responders. Meta-analytic techniques were used to summarize the data.
- Overall 57% ± 13% of patients were fluid responders. The summary AUC was 0.56 (95% CI, 0.54-0.58) with no heterogenicity between studies. The summary AUC was 0.56 (95% CI, 0.52-0.60) for those studies done in the ICU and 0.56 (95% CI, 0.54-0.58) for those done in the operating room. The summary correlation coefficient between the baseline central venous pressure and change in stroke volume index/cardiac index was 0.18 (95% CI, 0.1-0.25), being 0.28 (95% CI, 0.16-0.40) in the ICU patients, and 0.11 (95% CI, 0.02-0.21) in the operating room patients.
Question: Does the central venous pressure predict fluid responsiveness?
Options:
A. yes
B. no
C. maybe
|
There are no data to support the widespread practice of using central venous pressure to guide fluid therapy. This approach to fluid resuscitation should be abandoned. The answer is: B
|
B
|
Does the central venous pressure predict fluid responsiveness?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Mediastinal lymph node dissection is an essential component of lung cancer surgery; however, choosing mediastinal lymph nodes stations to be dissected is subjective. We carried out this research to investigate the need for dissection of station 9 lymph nodes during lung cancer surgery.
- Patients with primary lung cancer who underwent radical surgery between 2010 and 2014 were retrospectively reviewed. Clinical, pathologic, and prognosis data were obtained and analyzed.
- A total number of 1397 patients were included in this research. The metastasis rate of station 9 was 3.45%, which was significantly lower than other mediastinal stations. This metastasis rate was significantly correlated with pT stage, the lobe where the tumor was located, metastasis status of intrapulmonary lymph nodes, pTNM stage, and most of the other mediastinal lymph node stations. In males or ground glass opacity (GGO) patients, the metastasis of station 9 nodes was more unlikely to occur, even though there was no statistical significance. The staging results of most patients (99.63%) would not be impaired, even if station 9 nodes were not dissected, and the prognostic analysis showed that the metastasis status of station 9 had no significant influence on survival.
Question: Is routine dissection of the station 9 lymph nodes really necessary for primary lung cancer?
Options:
A. yes
B. no
C. maybe
|
The metastasis rate of station 9 lymph nodes was significantly lower than other mediastinal stations in lung cancer patients. The metastasis status of station 9 had no significant influence on tumor staging or prognosis. Routine dissection of station 9 lymph nodes may not be necessary, especially in patients with a low T stage, upper or middle lobe tumors, or without intrapulmonary lymph node metastasis. The answer is: B
|
B
|
Is routine dissection of the station 9 lymph nodes really necessary for primary lung cancer?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- In the Philippines, the current national control strategy for schistosomiasis is annual mass drug administration (MDA) with 40 mg/kg of praziquantel in all schistosomiasis-endemic villages with a prevalence ≥10%.
- A cross-sectional survey of schistosomiasis was conducted in 2012 on 18 221 individuals residing in 22 schistosomiasis-endemic villages in the province of Northern Samar. The prevalence of schistosomiasis, intensity of Schistosoma infection, and morbidity of disease were assessed.
- Despite an active schistosomiasis-control program in Northern Samar for>30 years, which included a MDA campaign in the last 5 years, the mean prevalence of schistosomiasis among 10 435 evaluated subjects was 27.1% (95% confidence interval [CI], 26.3%-28.0%), and the geometric mean intensity of infection among 2832 evaluated subjects was 17.2 eggs per gram of feces (95% CI, 16.4-18.1). Ultrasonography revealed high levels of schistosomiasis-induced morbidity in the schistosomiasis-endemic communities. Left lobe liver enlargement (≥70 mm) was evident in 89.3% of subjects. Twenty-five percent of the study population had grade II/III liver parenchyma fibrosis, and 13.3% had splenomegaly (≥100 mm).
Question: Can mass drug administration lead to the sustainable control of schistosomiasis?
Options:
A. yes
B. no
C. maybe
|
MDA on its own was insufficient to control the prevalence of schistosomiasis, intensity of Schistosoma infection, or morbidity of the disease. Alternative control measures will be needed to complement the existing national MDA program. The answer is: B
|
B
|
Can mass drug administration lead to the sustainable control of schistosomiasis?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Because of the inflammatory nature of Crohn's disease, ileocolic resections are often difficult to perform, especially if an abscess, phlegmon, or recurrent disease at a previous ileocolic anastomosis is present. Our goal was to determine whether the above factors are contraindications to a successful laparoscopic-assisted ileocolic resection.
- Between 1992 and 1996, 46 laparoscopic-assisted ileocolic resections were attempted. Fourteen patients had an abscess or phlegmon treated with bowel rest before operation (group I), 10 patients had recurrent Crohn's disease at the previous ileocolic anastomosis (group II), and 22 patients had no previous operation and no phlegmon or abscess associated with their disease (group III). These groups were compared with each other and with 70 consecutive open ileocolic resections for Crohn's disease during the same time period (group IV).
- Operative blood loss and time were greater in group IV than in groups I, II, and III (245 versus 151, 131, and 195 ml, respectively, and 202 versus 152, 144, and 139 minutes, respectively). Conversion to open procedure occurred in 5 patients (group I, 1 [7%]; group II, 2 [20%]; group III, 2 [9%]). Morbidity was highest in group IV (21% versus 0%, 10%, and 10%, respectively). Only one patient died (group IV, 1%). Length of hospital stay was longest in group IV (7.9 versus 4.8, 3.9, and 4.5 days, respectively).
Question: Laparoscopic-assisted ileocolic resections in patients with Crohn's disease: are abscesses, phlegmons, or recurrent disease contraindications?
Options:
A. yes
B. no
C. maybe
|
The laparoscopic-assisted approach to Crohn's disease is feasible and safe with good outcomes. Co-morbid preoperative findings such as abscess, phlegmon, or recurrent disease at the previous ileocolic anastomosis are not contraindications to a successful laparoscopic-assisted ileocolic resection in select patients. The answer is: B
|
B
|
Laparoscopic-assisted ileocolic resections in patients with Crohn's disease: are abscesses, phlegmons, or recurrent disease contraindications?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Although observational data support an inverse relationship between high-density lipoprotein (HDL) cholesterol and coronary heart disease (CHD), genetic HDL deficiency states often do not correlate with premature CHD.
- Carotid intima-media thickness (cIMT) measurements were obtained in cases comprising 10 different mutations in LCAT, ABCA1 and APOA1 to further evaluate the relationship between low HDL resulting from genetic variation and early atherosclerosis.
- In a 1:2 case-control study of sex and age-related (+/-5 y) subjects (n=114), cIMT was nearly identical between cases (0.66+/-0.17 cm) and controls (0.65+/-0.18 cm) despite significantly lower HDL cholesterol (0.67 vs. 1.58 mmol/l) and apolipoprotein A-I levels (96.7 vs. 151.4 mg/dl) (P<0.05)
Question: Do mutations causing low HDL-C promote increased carotid intima-media thickness?
Options:
A. yes
B. no
C. maybe
|
Genetic variants identified in the present study may be insufficient to promote early carotid atherosclerosis. The answer is: B
|
B
|
Do mutations causing low HDL-C promote increased carotid intima-media thickness?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Family caregivers of dementia patients are at increased risk of developing depression or anxiety. A multi-component program designed to mobilize support of family networks demonstrated effectiveness in decreasing depressive symptoms in caregivers. However, the impact of an intervention consisting solely of family meetings on depression and anxiety has not yet been evaluated. This study examines the preventive effects of family meetings for primary caregivers of community-dwelling dementia patients.
- A randomized multicenter trial was conducted among 192 primary caregivers of community dwelling dementia patients. Caregivers did not meet the diagnostic criteria for depressive or anxiety disorder at baseline. Participants were randomized to the family meetings intervention (n = 96) or usual care (n = 96) condition. The intervention consisted of two individual sessions and four family meetings which occurred once every 2 to 3 months for a year. Outcome measures after 12 months were the incidence of a clinical depressive or anxiety disorder and change in depressive and anxiety symptoms (primary outcomes), caregiver burden and quality of life (secondary outcomes). Intention-to-treat as well as per protocol analyses were performed.
- A substantial number of caregivers (72/192) developed a depressive or anxiety disorder within 12 months. The intervention was not superior to usual care either in reducing the risk of disorder onset (adjusted IRR 0.98; 95% CI 0.69 to 1.38) or in reducing depressive (randomization-by-time interaction coefficient = -1.40; 95% CI -3.91 to 1.10) or anxiety symptoms (randomization-by-time interaction coefficient = -0.55; 95% CI -1.59 to 0.49). The intervention did not reduce caregiver burden or their health related quality of life.
Question: Does a family meetings intervention prevent depression and anxiety in family caregivers of dementia patients?
Options:
A. yes
B. no
C. maybe
|
This study did not demonstrate preventive effects of family meetings on the mental health of family caregivers. Further research should determine whether this intervention might be more beneficial if provided in a more concentrated dose, when applied for therapeutic purposes or targeted towards subgroups of caregivers. The answer is: B
|
B
|
Does a family meetings intervention prevent depression and anxiety in family caregivers of dementia patients?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To describe the interstitial fluid (ISF) and plasma pharmacokinetics of meropenem in patients on continuous venovenous haemodiafiltration (CVVHDF).
- This was a prospective observational pharmacokinetic study. Meropenem (500 mg) was administered every 8 h. CVVHDF was targeted as a 2-3 L/h exchange using a polyacrylonitrile filter with a surface area of 1.05 m2 and a blood flow rate of 200 mL/min. Serial blood (pre- and post-filter), filtrate/dialysate and ISF concentrations were measured on 2 days of treatment (Profiles A and B). Subcutaneous tissue ISF concentrations were determined using microdialysis.
- A total of 384 samples were collected. During Profile A, the comparative median (IQR) ISF and plasma peak concentrations were 13.6 (12.0-16.8) and 40.7 (36.6-45.6) mg/L and the trough concentrations were 2.6 (2.4-3.4) and 4.9 (3.5-5.0) mg/L, respectively. During Profile B, the ISF trough concentrations increased by ∼40%. Meropenem ISF penetration was estimated at 63% (60%-69%) and 69% (65%-74%) for Profiles A and B, respectively, using comparative plasma and ISF AUCs. For Profile A, the plasma elimination t1/2 was 3.7 (3.3-4.0) h, the volume of distribution was 0.35 (0.25-0.46) L/kg, the total clearance was 4.1 (4.1-4.8) L/h and the CVVHDF clearance was 2.9 (2.7-3.1) L/h.
Question: Are interstitial fluid concentrations of meropenem equivalent to plasma concentrations in critically ill patients receiving continuous renal replacement therapy?
Options:
A. yes
B. no
C. maybe
|
This is the first known report of concurrent plasma and ISF concentrations of a meropenem antibiotic during CVVHDF. We observed that the ISF concentrations of meropenem were significantly lower than the plasma concentrations, although the present dose was appropriate for infections caused by intermediately susceptible pathogens (MIC≤4 mg/L). The answer is: B
|
B
|
Are interstitial fluid concentrations of meropenem equivalent to plasma concentrations in critically ill patients receiving continuous renal replacement therapy?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- One of the problems with manual resuscitators is the difficulty in achieving accurate volume delivery. The volume delivered to the patient varies by the physical characteristics of the person and method. This study was designed to compare tidal volumes delivered by the squeezing method, physical characteristics and education and practice levels.
- 114 individuals trained in basic life support and bag-valve-mask ventilation participated in this study. Individual characteristics were obtained by the observer and the education and practice level were described by the subjects. Ventilation was delivered with a manual resuscitator connected to a microspirometer and volumes were measured. Subjects completed three procedures: one-handed, two-handed and two-handed half-compression.
- The mean (standard deviation) volumes for the one-handed method were 592.84 ml (SD 117.39), two-handed 644.24 ml (SD 144.7) and two-handed half-compression 458.31 ml (SD 120.91) (p<0.01). Tidal volume delivered by two hands was significantly greater than that delivered by one hand (r = 0.398, p<0.01). The physical aspects including hand size, volume and grip power had no correlation with the volume delivered. There were slight increases in tidal volume with education and practice, but correlation was weak (r = 0.213, r = 0.281, r = 0.131, p<0.01).
Question: Can you deliver accurate tidal volume by manual resuscitator?
Options:
A. yes
B. no
C. maybe
|
The tidal volume delivered by a manual resuscitator shows large variations. There were significant differences in the volume delivered by compression methods, but physical characteristics are not a predictor of tidal volume delivery. The manual resuscitator is not a suitable device for accurate ventilation. The answer is: B
|
B
|
Can you deliver accurate tidal volume by manual resuscitator?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The specific aim of this investigation was to evaluate the proficiency of health care providers and patients in the proper use of metered-dose inhalers.
- Health care providers, which include house staff, nurses, and respiratory care practitioners who provide care to patients with asthma in the primary general medicine clinic or the pulmonary medicine clinic of a university-county hospital in which patients were referred, were surveyed and assigned a performance score regarding the knowledge base of the appropriate use of metered-dose inhalers. Patients who attended the primary care general medicine and pulmonary subspecialty clinic were also assessed as to their proficiency in the use of metered-dose inhalers.
- A significant percentage of patients had a poor understanding of the technique used with the metered-dose inhaler. House staff and nursing staff were also less proficient in the proper use of the metered-dose inhaler. The respiratory care practitioners were the most knowledgeable of the health care providers.
Question: Metered-dose inhalers. Do health care providers know what to teach?
Options:
A. yes
B. no
C. maybe
|
This study confirms that a large percentage of patients use metered-dose inhalers improperly. It also demonstrates a significant lack of understanding by health care providers of the proper use of metered-dose inhalers. Furthermore, this study supports the use of respiratory care practitioners in the outpatient setting, since they were the most proficient among all the health care providers in the proper use of metered-dose inhalers. The answer is: B
|
B
|
Metered-dose inhalers. Do health care providers know what to teach?
|
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}
|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The present analysis compares two palliative treatment concepts for lung cancer in terms of overall survival.
- Survival data from 207 patients were used in a retrospective analysis. All patients received palliative treatment comprising either 25 Gy applied in 5 fractions or 50 Gy in 20 fractions. A subgroup analysis was performed to compare patients with a good-fair vs. poor overall condition.
- Median survival times were 21 weeks (range 6-26 weeks) for patients treated with 25 Gy in 5 fractions and 23 weeks (range 14.5-31.5 weeks) for patients treated with 50 Gy in 20 fractions (95 % confidence interval, CI; p = 0.334). For patients with a good-fair overall condition, median survival times were 30 weeks (21.8-39.2 weeks) for 25 Gy in 5 fractions and 28 weeks (14.2-41.8 weeks) for 50 Gy in 20 fractions (CI 95 %, p = 0.694). In patients with a poor overall condition, these values were 18 weeks (14.5-21.5 weeks) and 21 weeks (13.0-29.0 weeks), respectively (CI 95 %, p = 0.248).
Question: Does high-dose radiotherapy benefit palliative lung cancer patients?
Options:
A. yes
B. no
C. maybe
|
The palliative treatment concept of 25 Gy applied in 5 fractions is sufficient for radiation of lung cancer, given that there was no obvious survival improvement in patients treated with the higher total dose regimen. The answer is: B
|
B
|
Does high-dose radiotherapy benefit palliative lung cancer patients?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The placement of the superficial cervical plexus block has been the subject of controversy. Although the investing cervical fascia has been considered as an impenetrable barrier, clinically, the placement of the block deep or superficial to the fascia provides the same effective anesthesia. The underlying mechanism is unclear. The aim of this study was to investigate the three-dimensional organization of connective tissues in the anterior region of the neck.
- Using a combination of dissection, E12 sheet plastination, and confocal microscopy, fascial structures in the anterior cervical triangle were examined in 10 adult human cadavers.
- In the upper cervical region, the fascia of strap muscles in the middle and the fasciae of the submandibular glands on both sides formed a dumbbell-like fascia sheet that had free lateral margins and did not continue with the sternocleidomastoid fascia. In the lower cervical region, no single connective tissue sheet extended directly between the sternocleidomastoid muscles. The fascial structure deep to platysma in the anterior cervical triangle comprised the strap fascia.
Question: Does the investing layer of the deep cervical fascia exist?
Options:
A. yes
B. no
C. maybe
|
This study provides anatomical evidence to indicate that the so-called investing cervical fascia does not exist in the anterior triangle of the neck. Taking the previous reports together, the authors' findings strongly suggest that deep potential spaces in the neck are directly continuous with the subcutaneous tissue. The answer is: B
|
B
|
Does the investing layer of the deep cervical fascia exist?
|
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}
|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Angiotensin-converting enzyme inhibitors (ACE-I) are considered safe, but they are associated with characteristic side effects, namely cough and angioedema, usually requiring discontinuation. We perceived that referrals for these side effects have become more and more frequent; therefore, we evaluated the degree of knowledge on the safety of ACE-I in different medical categories.
- A questionnaire (13 questions) on side effects of ACE-I was posted to physicians.
- Everyday clinical practice.
- Cardiologists, allergists, and general practitioners (GPs) from the National Healthcare System.
- Three hundred twelve physicians were contacted, and 154 returned questionnaires that could be analyzed. Of the 154 physicians (mean age, 45 years) 48 were cardiologists, 52 were GPs, and 54 were allergists. The percentage of correct answers was low: 31.9% for cardiologists, 40% for GPs, and 33% for allergists. Thus, GPs provided a significantly higher percentage of correct answers with respect to the remaining categories (p = 0.05). The lower rate of correct answers (0 to 15.9%) concerned the time of onset of cough and the action to take. Cardiologists seemed to be less aware of the fact that angiotensin receptor blockers (sartans) can cross-react with ACE-I.
Question: Are physicians aware of the side effects of angiotensin-converting enzyme inhibitors?
Options:
A. yes
B. no
C. maybe
|
Overall, there was a poor knowledge of the side effects of ACE-I. This may account for the increased referrals for chronic cough and angioedema. The answer is: B
|
B
|
Are physicians aware of the side effects of angiotensin-converting enzyme inhibitors?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Several atypical antipsychotics (AAPs) are used as second-line agents for treatment resistant depression. AAPs can be expensive compared to other treatment options and can cause several side effects.
- To estimate healthcare costs and utilization of AAPs compared to other second-line agents.
- Observational study using Medicaid claims data (2006-2011). Subjects were depression-diagnosed adult members with at least two prescriptions of antidepressant medications followed by a second-line agent. Gamma generalized linear models (GLM) produced estimates of the difference in mean expenditures among treatment groups after adjusting for individual baseline characteristics using propensity scores. Negative binomial models produced estimates of the difference in number of hospitalizations and emergency department (ED) visits.
- A total of 3910 members received second-line treatment. Treatment groups were AAPs (n = 2211), augmentation agents other than AAPs (n = 1008), and antidepressant switching (n = 691). AAPs resulted in higher mean adjusted pharmacy costs and higher mean adjusted total mental health-related costs. Mean adjusted total healthcare costs and number of inpatient and ED visits were not different among treatments.
Question: Does the use of atypical antipsychotics as adjunctive therapy in depression result in cost savings?
Options:
A. yes
B. no
C. maybe
|
The results show no evidence that AAPs used as second-line treatment for depression results in overall cost savings or lower inpatient and ED visits compared to other treatment strategies. The answer is: B
|
B
|
Does the use of atypical antipsychotics as adjunctive therapy in depression result in cost savings?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Knowing the collaterals is essential for a spleen-preserving distal pancreatectomy with resection of the splenic vessels.
- To ascertain the sources of the blood supply to the spleen after a spleen-preserving distal pancreatectomy with resection of the splenic vessels.
- Perfusion of the cadaveric left gastric and right gastroepiploic arteries with methylene blue after occlusion of all the arteries except the short gastric arteries (n=10). Intraoperative color Doppler ultrasound was used for the evaluation of the hilar arterial blood flow at distal pancreatectomy (n=23) after 1) clamping of the splenic artery alone, 2) clamping of the splenic and left gastroepiploic arteries and 3) clamping of the splenic and short gastric arteries. CT angiography of the gastric and splenic vessels before and after a spleen-preserving distal pancreatectomy (n=10).
- Perfusion of the cadaveric arteries revealed no effective direct or indirect (through the submucous gastric arterial network) communication between the left gastric and the branches of the short gastric arteries. In no case did intraoperative color Doppler ultrasound detect any hilar arterial blood flow after the clamping of the splenic and left gastroepiploic arteries. The clamping of the short gastric arteries did not change the flow parameters. In none of the cases did a post-spleen-preserving distal pancreatectomy with resection of the splenic vessels CT angiography delineate the short gastric vessels supplying the spleen. In all cases, the gastroepiploic arcade was the main arterial pathway feeding the spleen.
Question: Spleen-preserving distal pancreatectomy with resection of the splenic vessels. Should one rely on the short gastric arteries?
Options:
A. yes
B. no
C. maybe
|
Experimental, intra- and postoperative instrumental investigations did not show the short gastric arteries to be engaged in the blood supply to the spleen after a spleen-preserving distal pancreatectomy with resection of the splenic vessels. In all cases, the left gastroepiploic artery was the main collateral vessel. The answer is: B
|
B
|
Spleen-preserving distal pancreatectomy with resection of the splenic vessels. Should one rely on the short gastric arteries?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To assess the feasibility and safety of diagnostic or therapeutic semirigid ureteroscopy without ureteral meatus dilatation.
- A comparative, retrospective study was conducted of patients undergoing ureteroscopy from January 2000 to May 2008. For data analysis purposes, the population was divided into two groups based on whether ureteroscopy had been performed with (Group 1) or without (Group 2) ureteral meatus dilatation. Variables recorded included age, sex, type of procedure, surgical diagnosis, passive or active dilatation, number of stones, stone location, stone diameter, peroperative and postoperative complications, internal urinary diversion after the procedure, therapeutic success rate, operating time, and hospital stay duration. A 8-9.8 Fr Wolf semirigid ureteroscope was used. Descriptive statistics of the population and cohorts were performed, providing medians, quartiles, and limit values for non-normally distributed interval variables, and absolute and relative frequencies for categorical variables. Shapiro-Wilk's, Mann-Whitney's U, Chi-square, and Fisher's exact tests were used for statistical analysis. A value of p 2 alpha<or = 0.005 was considered statistically significant. Arcus Quickstat Biomedical 1.0 software was used.
- Among the 306 ureteroscopies studied, 286 performed in 256 patients were analyzed. Median age was 50 years (16-83), 59% of patients were male, and elective ureteroscopy was performed in 183 patients (64%). Group 1: 191 ureteroscopies, Group 2: 95 ureteroscopies. Stone location: 149 in distal ureter, 60 in middle ureter, and 35 in proximal ureter. Sixty-nine percent of stones had sizes ranging from 5 and 10 mm. The overall success rate was 86.5%. There were 5 peroperative and 22 postoperative complications, with no statistically significant differences between the groups.
Question: Diagnostic and therapeutic ureteroscopy: is dilatation of ureteral meatus always necessary?
Options:
A. yes
B. no
C. maybe
|
In selected cases, ureteroscopy may be performed without ureteral meatus dilatation with success and morbidity rates similar to when the procedure is performed with meatal dilatation. The answer is: B
|
B
|
Diagnostic and therapeutic ureteroscopy: is dilatation of ureteral meatus always necessary?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- The US Preventive Services Task Force recommends against spirometry in the absence of symptoms. However, as much as 50% of COPD cases in the United States remain undiagnosed.
- Report of symptoms, smoking history, and spirometric data were collected from subjects screened for a work-related medical evaluation (N = 3,955). Prevalence of airflow obstruction and respiratory symptoms were assessed. Sensitivity, specificity, positive and negative predictive values, and relative risks of predicting symptoms and smoking history for COPD were calculated.
- Forty-four percent of smokers in our sample had airways obstruction (AO). Of these, 36% reported a diagnosis of or treatment for COPD. Odds ratio (95% CI) for AO with smoking (>or = 20 pack-years) was 3.73 (3.12- 4.45), 1.98 (1.73-2.27) for cough, 1.79 (1.55-2.08) for dyspnea, 1.95 (1.70-2.34) for sputum, and 2.59 (2.26-2.97) for wheeze. Respiratory symptoms were reported by 92% of smokers with AO, 86% smokers with restriction, 76% smokers with normal spirometry, and 73% of nonsmokers. Sensitivity (92% vs 90%), specificity (19% vs 22%), positive (47% vs 40%) and negative (75% vs 80%) predictive values for the presence of one or more symptoms were similar between smokers and all subjects.
Question: Do symptoms predict COPD in smokers?
Options:
A. yes
B. no
C. maybe
|
COPD is underdiagnosed in the United States. Symptoms are frequent in subjects with AO and increase their risk for COPD, but add little beyond age and smoking history to the predictive value of spirometry. In view of the high prevalence of symptoms and their poor predictive value, a simpler and more effective approach would be to screen older smokers. The answer is: B
|
B
|
Do symptoms predict COPD in smokers?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Urine samples were examined by wet smear microscopy, incubated in 5% CO(2) for 1-2 days, and species-specific real-time polymerase chain reaction (PCR) for A. schaalii was performed.
- In 5 of the 29 screened urines, A. schaalii was found only by real-time PCR in quantities equivalent to ≥ 10(4) -10(5) CFU/mL. In addition, A. schaalii was found in quantities equivalent to ≥ 10(6) CFU/mL by both culture and PCR in two children with a urinary tract infection and large numbers of leucocytes in the urine.
Question: Actinobaculum schaalii, a cause of urinary tract infections in children?
Options:
A. yes
B. no
C. maybe
|
Actinobaculum schaalii is CO(2)-dependent. Therefore, if there are clinical symptoms and/or a negative culture despite the presence of leucocytes in the urine, Gram staining and incubation in 5% CO(2) or species-specific real-time PCR should be performed to identify A. schaalii. The answer is: C
|
C
|
Actinobaculum schaalii, a cause of urinary tract infections in children?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Metabolic syndrome (MetS) is associated with increased risk for cardiovascular events. We evaluated heart dimensions in hypertensive patients with MetS.
- The study included 75 hypertensive patients (34 males, 41 females; mean age 51+/-9 years) without coronary artery disease. Patients were evaluated in two groups depending on the presence or absence of MetS. Age- and gender-matched 20 healthy subjects (9 males, 11 females; mean age 50+/-5 years) comprised the control group. The diagnosis of MetS was based on the presence of at least three of five MetS criteria. Hypertension was defined as arterial blood pressure exceeding 140/85 mmHg on three consecutive measurements or the use of antihypertensive drugs. Echocardiographic measurements included interventricular septal thickness, left ventricular internal diameter, posterior wall thickness, aortic diameter, left atrial diameter, relative wall thickness, and left ventricular mass.
- Metabolic syndrome was present in 32 hypertensive patients (42.7%; 18 males, 14 females). The mean number of MetS criteria was 2.6+/-1.0 in the hypertensive group. Compared to the control group, patients with or without MetS exhibited significantly increased interventricular septum and posterior wall thickness, left atrial diameter, relative wall thickness, and left ventricular mass (p<0.05). The only significant difference between the two patient groups was that MetS was associated with a greater left atrial diameter (p=0.019). Left atrial diameter was correlated with the number of MetS criteria (r=0.51; p<0.001).
Question: Does accompanying metabolic syndrome contribute to heart dimensions in hypertensive patients?
Options:
A. yes
B. no
C. maybe
|
Left ventricular dimensions are not influenced by MetS. Rather than MetS, hypertension is primarily responsible for changes in left ventricular dimensions. However, left atrial enlargement is more prominent in patients with MetS, suggesting that each MetS criterion contributes to left ventricular diastolic dysfunction. The answer is: C
|
C
|
Does accompanying metabolic syndrome contribute to heart dimensions in hypertensive patients?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To determine current practice and to assess the value of routine follow-up procedures for endometrial cancer surveillance. To discuss whether such procedures are feasible and effective to identify asymptomatic recurrences and describe the pattern of relapse detected by procedures.
- The records of 282 consecutive women with recurrent endometrial cancer treated from 1986 to 2005 were retrospectively collected in 8 Italian institutions. Primary disease, clinical history, and recurrence features and data were analyzed.
- Thirty-five (12.4%) of 282 patients had recurrence in vaginal vault, 51 patients (18.0%) had recurrence in central pelvis, 14 patients (4.9%) had recurrence in pelvic wall, and 39 patients (13.8%) had recurrence in lymph nodes. One-hundred twenty-eight patients (45.3%) showed a distant relapse, whereas 15 patients (5.3%) developed both distant relapse and local relapse. The site of relapse influenced survival because the patients with vaginal vault recurrences lived significantly longer than the patients with recurrences in other sites. Eighty (28.4%) of the 282 patients became symptomatic and anticipated the scheduled visit, 37 (13.1 %) of the patients reported their symptoms during the follow-up meeting, and 165 (58.5 %) of the patients were asymptomatic and the diagnostic path was introduced by a planned visit or examination. Among the asymptomatic patients, the first procedure that led to further examinations was clinical visit alone for 60 (36.4%) of 165 patients, imaging for 103 patients (62.4%), and cytologic examination for 2 patients (1.2%). Symptoms at recurrence can predict survival: patients with an asymptomatic recurrence had a median survival time from relapse of 35 months versus 13 months if they had a symptomatic repetition (P = 0.0001).
Question: Could different follow-up modalities play a role in the diagnosis of asymptomatic endometrial cancer relapses?
Options:
A. yes
B. no
C. maybe
|
Follow-up after endometrial cancer treatment varies in Italy. In this retrospective study, women with asymptomatic recurrence have shown a better clinical outcome compared with those with symptomatic relapse. The optimal approach is actually unknown, and guidelines comparing follow-up protocols have not been established. Prospective cost-effectiveness studies are needed. The answer is: C
|
C
|
Could different follow-up modalities play a role in the diagnosis of asymptomatic endometrial cancer relapses?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- In familial adenomatous polyposis (FAP), correlations between site of mutation in the adenomatous polyposis coli (APC) gene and severity of colonic polyposis or extracolonic manifestations are well known. While mutation analysis is important for predictive diagnosis in persons at risk, its relevance for clinical management of individual patients is open to question.
- We examined 680 unrelated FAP families for germline mutations in the APC gene. Clinical information was obtained from 1256 patients.
- APC mutations were detected in 48% (327/680) of families. Age at diagnosis of FAP based on bowel symptoms and age at diagnosis of colorectal cancer in untreated patients were used as indicators of the severity of the natural course of the disease. A germline mutation was detected in 230 of 404 patients who were diagnosed after onset of bowel symptoms (rectal bleeding, abdominal pain, diarrhoea). When these patients were grouped according to the different sites of mutations, mean values for age at onset of disease differed significantly: patients carrying APC mutations at codon 1309 showed a disease onset 10 years earlier (mean age 20 years) compared with patients with mutations between codons 168 and 1580 (except codon 1309) (mean age 30 years), whereas patients with mutations at the 5' end of codon 168 or the 3' end of codon 1580 were diagnosed at a mean age of 52 years. Within each group of patients however large phenotypic variation was observed, even among patients with identical germline mutations. A higher incidence of desmoids was found in patients with mutations between codons 1445 and 1580 compared with mutations at other sites, while no correlation between site of mutation and presence of duodenal adenomas was observed.
Question: Can APC mutation analysis contribute to therapeutic decisions in familial adenomatous polyposis?
Options:
A. yes
B. no
C. maybe
|
As age at manifestation and course of the disease may be rather variable, even in carriers of identical germline mutations, therapeutic decisions should be based on colonoscopic findings in individual patients rather than on the site of mutation. However, in patients with mutations within codons 1445-1580, it may be advisable to postpone elective colectomy because desmoids may arise through surgical intervention. The answer is: C
|
C
|
Can APC mutation analysis contribute to therapeutic decisions in familial adenomatous polyposis?
|
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- Breast cancer is the most common malignancy afflicting women, and the most common cancer overall in Jordan. A woman's decision to go for screening is influenced by her social support network. This study aims to explore Jordanian men's individual and contextual perspectives on women's breast cancer and their own role in the breast health of the females within their families.
- An explorative qualitative design was used to purposively recruit 24 married men aged 27 to 65 years (median 43 years) from four governorates in Jordan. Data in the form of interviews transcriptions was subjected to qualitative content analysis.
- Three themes were identified: a) Supporting one's wife; b) Marital needs and obligations; c) Constrained by a culture of destiny and shame. The first theme was built on men's feelings of responsibility for the family's health and well-being, their experiences of encouraging their wives to seek health care and their providing counselling and instrumental support. The second theme emerged from men's views about other men's rejection of a wife inflicted by breast cancer, their own perceptions of diminished femininity due to mastectomy and their own concerns about protecting the family from the hereditary risk of breast cancer. The third theme was seen in men's perception of breast cancer as an inevitable act of God that is far away from one's own family, in associating breast cancer with improper behaviour and in their readiness to face the culture of Eib (shame).
Question: "Would a man smell a rose then throw it away?
Options:
A. yes
B. no
C. maybe
|
Jordanian men perceive themselves as having a vital role in supporting, guiding and encouraging their wives to follow breast cancer early detection recommendations. Breast health awareness campaigns could involve husbands to capitalize on family support. The answer is: C
|
C
|
"Would a man smell a rose then throw it away?
|
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{
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|
You are a biomedical QA model evaluator. Your task is to read the context carefully, answer the given question with one of the provided options (A, B, C).
Based on this comparison, indicate whether your prediction is correct or incorrect.
Context:
- To assess Internet use amongst young people to determine whether it would be a practical way to provide sex education and information.
- Year 10 students (aged 14-15 years) from North Nottinghamshire schools were asked to participate in focus groups to discuss the Internet. A series of predefined questions were directed to the whole group to generate debate. Areas explored included: Internet access and site; frequency and purpose of Internet use; websites visited; ideas for a genitourinary medicine (GUM) website. Responses were recorded by a hand count or as individual verbal responses.
- Thirteen focus groups were held involving 287 students of approximately equal sex distribution. All had access to Internet facilities at school and 224 (78.0%) had access elsewhere. Access was at least once a week by 178 (62.0%) mostly for e-mail, games, chatlines and homework. No one accessed for health information. One hundred and seventy-nine (62.4%) participants said they would use a GUM website. A 'question line' where they could e-mail questions to a health care professional was of interest to 202 (70.4%) participants.
Question: Can the Internet be used to improve sexual health awareness in web-wise young people?
Options:
A. yes
B. no
C. maybe
|
The Internet would be a practical and accessible way of delivering sexual health education to young people, particularly if it is incorporated into activities and websites they enjoy. The answer is: C
|
C
|
Can the Internet be used to improve sexual health awareness in web-wise young people?
|
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|
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