Update README.md

README.md

@@ -354,7 +354,10 @@ Medicus оптимизирован для работы на русском и а
 Prompt:
 
 ```
-Мама (71 год), находясь в стационаре с диагнозом "остеопороз", упала и ударилась рукой (со слов врача 4.02.2025). Врач сказал, что у нее легкий ушиб. При посещении я заметила у нее на руке ссадину около 4 см и синяк желтого цвета с кровоподтеками на предплечье, а также черный синяк на кисти. Ей не назначают дополнительное лечение, связанное с падением, травму считают незначительной. Есть ли риски более серьезного повреждения?
+Мама (71 год), находясь в стационаре с диагнозом "остеопороз", упала и ударилась рукой (со слов врача 4.02.2025).
+Врач сказал, что у нее легкий ушиб. При посещении я заметила у нее на руке ссадину около 4 см и синяк желтого цвета с кровоподтеками на предплечье,
+а также черный синяк на кисти. Ей не назначают дополнительное лечение, связанное с падением, травму считают незначительной.
+Есть ли риски более серьезного повреждения?
 ```
 Model response:
 ```
@@ -383,7 +386,10 @@ Model response:
 
 Prompt:
 ```
-На прием обратился пациент 32 лет с жалобами на апатию, снижение интереса к окружающему, бессонницу. На визите сидит в однообразной позе, речь монотонная. На вопросы отвечает односложно. Отмечает, что "Суицидальных мыслей нет, но иногда хочется, чтобы все это как можно быстрее закончилось". Какой вероятный диагноз? Какие действия?
+На прием обратился пациент 32 лет с жалобами на апатию, снижение интереса к окружающему, бессонницу.
+На визите сидит в однообразной позе, речь монотонная. На вопросы отвечает односложно.
+Отмечает, что "Суицидальных мыслей нет, но иногда хочется, чтобы все это как можно быстрее закончилось".
+Какой вероятный диагноз? Какие действия?
 ```
 Model response:
 ```
@@ -428,13 +434,32 @@ Gordon D Benson 1, Raymond S Koff, Keith G Tolman
 Affiliations Expand
 PMID: 15767831 DOI: 10.1097/01.mjt.0000140216.40700.95
 Abstract
-Acetaminophen has been used safely and effectively for many years to manage pain and/or fever in patients of all ages. It is commonly recommended as first-line therapy for a variety of patients and conditions, including the elderly, children with viral illnesses, and patients with osteoarthritis, gastrointestinal conditions, bleeding disorders, cardiovascular disease, or renal disease. However, its use is often avoided in patients with chronic liver disease. The perception that acetaminophen should be avoided in such patients arose from awareness of the association between massive acetaminophen overdose and hepatotoxicity, combined with a lack of understanding of the metabolism of acetaminophen in patients with liver disease. There are various theoretical mechanisms of acetaminophen hepatotoxicity in chronic liver disease including: altered metabolism and depleted glutathione stores that would be expected to increase accumulation of the hepatotoxic intermediate, N-acetyl-p-benzoquinone imine (NAPQI). Available studies in patients with chronic liver disease, however, have shown that although the half-life of acetaminophen may be prolonged, cytochrome P-450 activity is not increased and glutathione stores are not depleted to critical levels in those taking recommended doses. Furthermore, acetaminophen has been studied in a variety of liver diseases without evidence of increased risk of hepatotoxicity at currently recommended doses. Therefore, acetaminophen can be used safely in patients with liver disease and is a preferred analgesic/antipyretic because of the absence of the platelet impairment, gastrointestinal toxicity, and nephrotoxicity associated with nonsteroidal antiinflammatory drugs.
+Acetaminophen has been used safely and effectively for many years to manage pain and/or fever in patients of all ages.
+It is commonly recommended as first-line therapy for a variety of patients and conditions, including the elderly,
+children with viral illnesses, and patients with osteoarthritis, gastrointestinal conditions, bleeding disorders,
+cardiovascular disease, or renal disease. However, its use is often avoided in patients with chronic liver disease.
+The perception that acetaminophen should be avoided in such patients arose from awareness of the association between massive acetaminophen overdose and hepatotoxicity,
+combined with a lack of understanding of the metabolism of acetaminophen in patients with liver disease.
+There are various theoretical mechanisms of acetaminophen hepatotoxicity in chronic liver disease including:
+altered metabolism and depleted glutathione stores that would be expected to increase accumulation of the hepatotoxic intermediate,
+N-acetyl-p-benzoquinone imine (NAPQI). Available studies in patients with chronic liver disease, however,
+have shown that although the half-life of acetaminophen may be prolonged, cytochrome P-450 activity is not increased and glutathione stores
+are not depleted to critical levels in those taking recommended doses. Furthermore, acetaminophen has been studied in a variety of
+liver diseases without evidence of increased risk of hepatotoxicity at currently recommended doses.
+Therefore, acetaminophen can be used safely in patients with liver disease and is a preferred analgesic/antipyretic
+because of the absence of the platelet impairment, gastrointestinal toxicity, and nephrotoxicity associated with nonsteroidal antiinflammatory drugs.
 
 Напиши в одном абзаце смысл статьи
 ```
 Model response:
 ```
-Статья "Therapeutic use of acetaminophen in patients with liver disease" рассматривает вопрос о безопасности и эффективности ацетаминофена для пациентов с заболеваниями печени.  Хотя первоначально его использование в этом случае предпочтительно избегать из-за риска передозировки, исследования показывают, что при рекомендуемой дозе ацетаминофена нет доказательств увеличения его токсичности у пациентов с заболеваниями печени. В отличие от нестероидных противовоспалительных препаратов (НПВП), которые могут вызывать проблемы с почками и другими побочными эффектами, ацетаминофен не имеет этих недостатков при осторожном применении. Таким образом, для пациентов с заболеваниями печени ацетаминофен является безопасным выбором для управления болью и лихорадкой без риска передозировки
+Статья "Therapeutic use of acetaminophen in patients with liver disease" рассматривает вопрос о безопасности и эффективности
+ацетаминофена для пациентов с заболеваниями печени.  Хотя первоначально его использование в этом случае предпочтительно избегать из-за
+риска передозировки, исследования показывают, что при рекомендуемой дозе ацетаминофена нет доказательств увеличения его токсичности у пациентов
+с заболеваниями печени. В отличие от нестероидных противовоспалительных препаратов (НПВП), которые могут вызывать проблемы с почками и другими
+побочными эффектами, ацетаминофен не имеет этих недостатков при осторожном применении.
+Таким образом, для пациентов с заболеваниями печени ацетаминофен является безопасным
+выбором для управления болью и лихорадкой без риска передозировки
 ```
 </details>
 <details>  
@@ -442,7 +467,11 @@ Model response:
 
 Prompt:
 ```
-My mother (71 years old), while in hospital with a diagnosis of osteoporosis, fell and hit her arm (according to the doctor on 4.02.2025). The doctor said she had a mild contusion. At the visit, I noticed an abrasion of about 4 cm on her arm and a yellow coloured bruise with bruising on her forearm and a black bruise on her hand. She is not receiving any further treatment related to the fall, the injury is considered minor. Are there risks of a more serious injury?
+My mother (71 years old), while in hospital with a diagnosis of osteoporosis, fell and hit her arm (according to the doctor on 4.02.2025).
+The doctor said she had a mild contusion. At the visit, I noticed an abrasion of about 4 cm on her arm and a
+yellow coloured bruise with bruising on her forearm and a black bruise on her hand.
+She is not receiving any further treatment related to the fall, the injury is considered minor.
+Are there risks of a more serious injury?
 ```
 Model response:
 ```
@@ -478,7 +507,10 @@ Remember, while the initial fall seems manageable now, it's essential to be vigi
 
 Prompt:
 ```
-A 32-year-old patient came to the clinic with complaints of apathy, decreased interest in the surrounding environment, insomnia. At the visit he sits in a monotonous posture, his speech is monotonous. He answers questions one-syllable. Notes that ‘There are no suicidal thoughts, but sometimes I wish it would all end as soon as possible’. What is the likely diagnosis? What actions?
+A 32-year-old patient came to the clinic with complaints of apathy, decreased interest in the surrounding environment, insomnia.
+At the visit he sits in a monotonous posture, his speech is monotonous.
+He answers questions one-syllable. Notes that ‘There are no suicidal thoughts, but sometimes
+I wish it would all end as soon as possible’. What is the likely diagnosis? What actions?
 ```
 Model response:
 ```
@@ -520,13 +552,28 @@ Gordon D Benson 1, Raymond S Koff, Keith G Tolman
 Affiliations Expand
 PMID: 15767831 DOI: 10.1097/01.mjt.0000140216.40700.95
 Abstract
-Acetaminophen has been used safely and effectively for many years to manage pain and/or fever in patients of all ages. It is commonly recommended as first-line therapy for a variety of patients and conditions, including the elderly, children with viral illnesses, and patients with osteoarthritis, gastrointestinal conditions, bleeding disorders, cardiovascular disease, or renal disease. However, its use is often avoided in patients with chronic liver disease. The perception that acetaminophen should be avoided in such patients arose from awareness of the association between massive acetaminophen overdose and hepatotoxicity, combined with a lack of understanding of the metabolism of acetaminophen in patients with liver disease. There are various theoretical mechanisms of acetaminophen hepatotoxicity in chronic liver disease including: altered metabolism and depleted glutathione stores that would be expected to increase accumulation of the hepatotoxic intermediate, N-acetyl-p-benzoquinone imine (NAPQI). Available studies in patients with chronic liver disease, however, have shown that although the half-life of acetaminophen may be prolonged, cytochrome P-450 activity is not increased and glutathione stores are not depleted to critical levels in those taking recommended doses. Furthermore, acetaminophen has been studied in a variety of liver diseases without evidence of increased risk of hepatotoxicity at currently recommended doses. Therefore, acetaminophen can be used safely in patients with liver disease and is a preferred analgesic/antipyretic because of the absence of the platelet impairment, gastrointestinal toxicity, and nephrotoxicity associated with nonsteroidal antiinflammatory drugs.
+Acetaminophen has been used safely and effectively for many years to manage pain and/or fever in patients of all ages.
+It is commonly recommended as first-line therapy for a variety of patients and conditions, including the elderly,
+children with viral illnesses, and patients with osteoarthritis, gastrointestinal conditions, bleeding disorders,
+cardiovascular disease, or renal disease. However, its use is often avoided in patients with chronic liver disease.
+The perception that acetaminophen should be avoided in such patients arose from awareness of the association between massive acetaminophen overdose and hepatotoxicity,
+combined with a lack of understanding of the metabolism of acetaminophen in patients with liver disease.
+There are various theoretical mechanisms of acetaminophen hepatotoxicity in chronic liver disease including:
+altered metabolism and depleted glutathione stores that would be expected to increase accumulation of the hepatotoxic intermediate,
+N-acetyl-p-benzoquinone imine (NAPQI). Available studies in patients with chronic liver disease, however,
+have shown that although the half-life of acetaminophen may be prolonged, cytochrome P-450 activity is not increased and glutathione stores
+are not depleted to critical levels in those taking recommended doses. Furthermore, acetaminophen has been studied in a variety of
+liver diseases without evidence of increased risk of hepatotoxicity at currently recommended doses.
+Therefore, acetaminophen can be used safely in patients with liver disease and is a preferred analgesic/antipyretic
+because of the absence of the platelet impairment, gastrointestinal toxicity, and nephrotoxicity associated with nonsteroidal antiinflammatory drugs.
 
 Provide summary about article in on abstract
 ```
 Model response:
 ```
-Acetaminophen is generally safe for use in patients with chronic liver disease at recommended doses.  Although there was once concern about its safety due to potential links to liver damage from overdose, research has shown that at therapeutic levels, acetaminophen does not increase the risk of liver problems. 
+Acetaminophen is generally safe for use in patients with chronic liver disease at recommended doses.
+Although there was once concern about its safety due to potential links to liver damage from overdose, research has
+shown that at therapeutic levels, acetaminophen does not increase the risk of liver problems. 
 
 Here's a breakdown: