text_id
stringclasses 37
values | sentence_id
int64 1
43
| text
stringlengths 20
513
| relations
listlengths 0
13
|
|---|---|---|---|
100682
| 13
|
Late enhancement revealed a patchy subepicardial hyperenhancement of the medio-distal segments of the anterior and anterolateral walls which confirm the diagnosis of myocarditis.
|
[] |
100682
| 14
|
The patient was treated with cefotaxime and doxycycline.
|
[] |
100682
| 15
|
All serological tests (chlamydia, coxiella, mycoplasma, rickettsia, lyme and bartonella) obtained during the hospitalization were negative.
|
[
[
"negative",
"mycoplasma"
],
[
"negative",
"coxiella"
],
[
"negative",
"bartonella"
],
[
"negative",
"rickettsia"
],
[
"negative",
"lyme"
],
[
"negative",
"tests"
],
[
"negative",
"chlamydia"
]
] |
100682
| 16
|
Five days later, the patient was asymptomatic.
|
[] |
100682
| 17
|
The 24 hours ECG monitoring showed a sinus rhythm.
|
[] |
100682
| 18
|
The TTE revealed a normal LVEF and an improvement in the LVGLS with segmental reduced values concordant with the CMR abnormalities.
|
[] |
100682
| 19
|
At one-month follow-up the patient made a full recovery without any recurring cardiovascular symptoms or abnormal electrocardiographic or echocardiographic findings.
|
[] |
100705
| 1
|
We report the case of a male patient, 79 years old, diabetic for 10 years on metformin, hypertensive for 5 years on amilodipine; occasional alcoholic weaned 4 years ago.
|
[] |
100705
| 2
|
He was initially admitted for mental confusion with sudden onset dysarthria dating back 48 hours before.
|
[] |
100705
| 3
|
Initial assessment found Glasgow score (GCS) of 12/15 (eye opening at 5, verbal response at 2, motor response at 5), symmetrical and reactive pupils, without feeling-motor deficit, normal osteotendinous reflexes, slightly polypneic at 24 cycles/min, pulsed oxygen saturation (SpO 2) at 97% in ambient air, he was tachycardic at 115 bpm and hypertensive at 160/95 mmHg, his capillary blood glucose at 2.24 g/L, and glycosuria on the urine dipstick test without ketonuria.
|
[
[
"12/15",
"GCS"
],
[
"12/15",
"Glasgow"
],
[
"5",
"opening"
],
[
"2",
"response"
],
[
"5",
"response"
],
[
"24 cycles/min",
"polypneic"
],
[
"97%",
"SpO"
],
[
"97%",
"saturation"
],
[
"115 bpm",
"tachycardic"
],
[
"160/95 mmHg",
"hypertensive"
],
[
"2.24 g/L",
"glucose"
],
[
"without ketonuria",
"glycosuria"
]
] |
100705
| 4
|
The patient was apyretic.
|
[] |
100705
| 5
|
Arterial gas testing showed normal corrected anion gap metabolic acidosis, with hypokalaemia at 3 mmol/L and normal lactatemia at 0.43 mmol/L.
|
[
[
"normal",
"acidosis"
],
[
"3 mmol/L",
"hypokalaemia"
],
[
"normal",
"lactatemia"
],
[
"0.43 mmol/L",
"lactatemia"
]
] |
100705
| 6
|
Diagnosis of diabetes decompensation was made despite absence of ketone bodies on urine dipstick test.
|
[] |
100705
| 7
|
After conditioning, the patient was put on a hydration regimen with hypokalaemia correction and insulin therapy, and then referred to intensive care for additional management in face of non-improvement in his neurological condition.
|
[] |
100705
| 8
|
A brain scan was performed objectifying multiple parietal ischemic foci, chest scanner showed a thickening of the septal and foci of bronchial dilation without sign of pneumopathy linked to COVID-19 infection; abdominal ultrasound did not show any abnormalities.
|
[] |
100705
| 9
|
An electrocardiogram was performed showing no electrical signs of hypokalaemia or repolarization disturbances, transthoracic echocardiography was normal, as was ultrasound of supraortic trunks.
|
[
[
"normal",
"echocardiography"
],
[
"normal",
"ultrasound"
]
] |
100705
| 10
|
Laboratory workup showed an elevated C-reactive protein (CRP) of 45.5 with negative procalcitonin (0.04 ng/ml), white blood cells at 12,500 (PNN at 9280 and normal lymphocytes at 2140), no thrombocytopenia, normal ferritinemia, fibrinogen levels elevated to 5.37 and negative D-dimers.
|
[
[
"elevated",
"CRP"
],
[
"elevated",
"protein"
],
[
"45.5",
"CRP"
],
[
"45.5",
"protein"
],
[
"negative",
"procalcitonin"
],
[
"0.04 ng/ml",
"procalcitonin"
],
[
"12,500",
"cells"
],
[
"9280",
"PNN"
],
[
"normal",
"lymphocytes"
],
[
"2140",
"lymphocytes"
],
[
"normal",
"ferritinemia"
],
[
"5.37",
"levels"
],
[
"negative",
"D-dimers"
]
] |
100705
| 11
|
Natremia, magnesemia, corrected serum calcium, phosphoremia and thyroid assessment was normal.
|
[
[
"normal",
"assessment"
]
] |
100705
| 12
|
SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) by nasopharyngeal swab was negative, COVID-19 serology (IgM and IgG) was also negative.
|
[
[
"negative",
"reaction"
],
[
"negative",
"RT-PCR"
],
[
"negative",
"serology"
]
] |
100705
| 13
|
Faced with concept of ischemic lesions on a brain scan, anticoagulation at a prophylactic dose, antiplatelet aggregation with aspirin and statins were initiated as well as an antibiotic therapy at a meningeal dose with ceftriaxone pending results of the lumbar puncture which subsequently showed a clear liquid with a high proteinorachia at 0.58g/l (normal between 0.15 and 0.45), a normal glycorachia/blood sugar ratio at 0.58 (normal at 0.5); with a culture showing less than 3 elements, sterile after 24 hours.
|
[
[
"0.58g/l",
"proteinorachia"
],
[
"0.58",
"ratio"
]
] |
100705
| 14
|
Cerebral Magnetic resonance angiography performed on day 2 of admission showed signs in favor of vascular leukopathy, with some calcifications in basal ganglia and cortical atrophy.
|
[] |
100705
| 15
|
Electroencephalogram showed signs of epilepsy, which prompted us to retain the diagnosis of nonketotic hyperglycemia-related epileptic seizures.
|
[] |
100705
| 16
|
Anticonvulsant treatment was started with sodium valproate.
|
[] |
100705
| 17
|
The Patient worsened neurologically despite correction of his metabolic acidosis, he was intubated on day 3 of his admission (day 5 of symptoms onset).
|
[] |
100705
| 18
|
A cerebral computerized tomography (CT) scan was performed without showing any progressive lesions.
|
[] |
100705
| 19
|
Faced with installation of lymphopenia (HIV serologies 1 and 2 negative) with increased CRP, a multiplex RT-PCR in protected distal bronchial sample as well as in Cerebrospinal fluid (CSF) were performed, the first was positive to SARS-CoV-2.
|
[
[
"negative",
"serologies"
],
[
"positive",
"SARS-CoV"
],
[
"positive",
"RT-PCR"
]
] |
100705
| 20
|
Reverse transcription polymerase chain reaction of SARS-CoV-2 in CSF was positive but with a cycle threshold (CT) of 38.6.
|
[
[
"positive",
"reaction"
],
[
"38.6",
"threshold"
],
[
"38.6",
"CT"
]
] |
100705
| 21
|
The diagnosis of SARS-CoV-2 encephalopathy was retained.
|
[] |
100705
| 22
|
The patient is still in intensive care.
|
[] |
102305
| 1
|
A 32-year-old female patient with Kniest syndrome presented at our department with a painful pseudarthrosis after femoral valgisation osteotomy 8 years ago.
|
[] |
102305
| 2
|
A Wagner cone stem and acetabular roof cup with a cemented Ecofit cup 2M (dual-articulation acetabular cup system) were implanted due to a dysplastic femur with a small medullary space.
|
[] |
102305
| 3
|
The Ecofit cup itself is associated with a reduced risk of dislocation.
|
[] |
102305
| 4
|
The patient was satisfied with the range of motion after hip endoprosthesis and reported a significant increase in quality of life.
|
[] |
102305
| 5
|
The patient is still comfortable with the hip prosthesis at the most recent follow-up 4 years after implantation.
|
[] |
102305
| 6
|
Follow-up radiographs over 4 years have not revealed any signs of loosening or migration, and no Trendelenburg sign was reported for the affected side.
|
[] |
103220
| 1
|
Here we report a case of aggressive metastatic cholangiocarcinoma (MCC) in 72-year-old man, sequentially treated with two targeted chemotherapies.
|
[] |
103220
| 2
|
Initially disease quickly progressed during best clinical practice care (gemcitabine in combination with cisplatin or capecitabine), which was accompanied by significant decrease of life quality.
|
[] |
103220
| 3
|
Monotherapy with TKI sorafenib was prescribed to the patient, which resulted in stabilization of tumor growth and elimination of pain.
|
[] |
103220
| 4
|
The choice of the inhibitor was made based on high-throughput screening of gene expression in the patient's tumor biopsy, utilized by Oncobox platform to build a personalized rating of potentially effective target therapies.
|
[] |
103220
| 5
|
However, time to progression after start of sorafenib administration did not exceed 6 months and the regimen was changed to monotherapy with Pazopanib, another TKI predicted to be effective for this patient according to the same molecular test.
|
[] |
103220
| 6
|
It resulted in disease progression according to RECIST with simultaneous elimination of sorafenib side effects such as rash and hand-foot syndrome.
|
[] |
103220
| 7
|
After 2 years from the diagnosis of MCC the patient was alive and physically active, which is substantially longer than median survival for standard therapy.
|
[] |
104179
| 1
|
Forty year old male presented with a huge mass in this left arm.
|
[] |
104179
| 2
|
The same patient apparently was admitted three years back for excision of the arm swelling which was relatively small that time.
|
[] |
104179
| 3
|
However the patient did not undergo surgery and was takin treatment from local bone setters during the last three years and tumor grew to a larger size during this period.
|
[] |
104179
| 4
|
The current dimensions of tumor was 32x28 cms with circumference of 87 cms.
|
[
[
"32x28 cms",
"dimensions"
],
[
"87 cms",
"circumference"
]
] |
104179
| 5
|
X-ray showed complete destruction of the upper humerus with central calcification.
|
[] |
104179
| 6
|
Biopsy releveled a chondrosarcoma.
|
[] |
104179
| 7
|
Skeletal survey and bone scan did not reveal any other lesion in the body.
|
[] |
104179
| 8
|
A forequarter amputation was done and a 16 kg tumor mass was excised.
|
[] |
104179
| 9
|
At three years follow up, the patient has no complains with no recurrence of the tumor.
|
[] |
104263
| 1
|
This case report describes the condition of a 30-year-old man involved in a motor vehicle collision.
|
[] |
104263
| 2
|
Clinical examination, X-rays, and computed tomography scan revealed a posterior hip dislocation with an ipsilateral femoral head and mid-shaft fractures.
|
[] |
104263
| 3
|
The patient was treated by closed reduction of hip dislocation using a temporarily applied external fixator followed by intramedullary nailing of the femoral shaft.
|
[] |
104263
| 4
|
Achieving a closed reduction is a challenge with ipsilateral fractures but it should be favored over open reduction due to a lower risk of complications.
|
[] |
104263
| 5
|
The type of femoral head fracture, in this case, may have aided in an easier reduction.
|
[] |
105094
| 1
|
We present a case of a 77-year-old Caucasian woman with obstructive jaundice.
|
[] |
105094
| 2
|
Laboratory tests revealed that she had elevated bilirubin and liver enzyme levels.
|
[
[
"elevated",
"levels"
]
] |
105094
| 3
|
A computed tomographic scan showed a homogeneous 5 × 3-cm mass obstructing the common bile duct.
|
[] |
105094
| 4
|
The results of brush cytology were consistent with a bile duct villous papilloma.
|
[] |
105094
| 5
|
However, on the basis of the tumor's radiological features, a preliminary diagnosis of extrahepatic bile duct malignant tumor was made.
|
[] |
105094
| 6
|
After discussion among the multidisciplinary team, a surgical resection of the bile duct tumor was performed.
|
[] |
105094
| 7
|
Histopathological examination confirmed a villous adenoma.
|
[] |
105094
| 8
|
The patient's postoperative course was uneventful.
|
[] |
105223
| 1
|
A 49-year-old white Caucasian woman presented with vaginal bleeding.
|
[] |
105223
| 2
|
A pelvic examination revealed a cystic lesion arising from her cervix.
|
[] |
105223
| 3
|
Examination of a biopsy specimen revealed a poorly differentiated neoplasm, with sheets of small hyperchromatic cells, staining weakly for neuroendocrine markers.
|
[] |
105223
| 4
|
She was diagnosed with small cell carcinoma and started on concurrent chemotherapy and radiation.
|
[] |
105223
| 5
|
However, additional positive immunostaining for CD99 was strongly suggestive of Ewing's sarcoma.
|
[] |
105223
| 6
|
Fluorescence in situ hybridization revealed ESWR1 gene rearrangement, confirming Ewing's sarcoma.
|
[] |
105223
| 7
|
Our patient underwent surgery, which confirmed stage IIB Ewing's sarcoma.
|
[] |
105223
| 8
|
She received adjuvant chemotherapy but died from progressive metastatic disease after four cycles.
|
[] |
105832
| 1
|
A 35-year-old Caucasian woman known to suffer from late familial hyperinsulinemic hypoglycemia due to a well-known mutation in the insulin receptor gene has been pregnant 6 times.
|
[] |
105832
| 2
|
The patient was treated with injections of Sandostatin LAR® (octreotide) during the first four pregnancies.
|
[] |
105832
| 3
|
Her first pregnancy in 1999 was unknown until approximately 25th gestational weeks with fatal intrauterine growth retardation.
|
[] |
105832
| 4
|
The following two pregnancies were terminated on parental request after a chorion villus biopsy revealed the mutation causing late familial hyperinsulinemic hypoglycemia.
|
[] |
105832
| 5
|
During the fourth pregnancy, in which the fetus also had the mutation, serial ultrasound examinations showed a small fetus with appropriate growth.
|
[] |
105832
| 6
|
At birth the girl was small for gestational age.
|
[] |
105832
| 7
|
She was admitted to the neonatal special care unit due to low blood glucose and intravenous glucose and early feeding was initiated.
|
[] |
105832
| 8
|
One day old, her condition deteriorated with signs of an abdominal catastrophe indicating necrotizing enterocolitis.
|
[] |
105832
| 9
|
After two laparotomies - both confirming necrotizing enterocolitis - the child died 8 days after birth.
|
[] |
105832
| 10
|
In the following two pregnancies Sandostatin LAR® was stopped before pregnancy and the patient was treated only with diet restriction and intensive glucose monitoring.
|
[] |
105832
| 11
|
Both pregnancies ended successfully.
|
[] |
105832
| 12
|
One child carried the mutation and was small for gestational age at birth while the other child did not carry the mutation and had normal birth weight.
|
[] |
106233
| 1
|
A 70yrs old Female was admitted in our institution diagnosed with severe bilateral Osteoarthritis.
|
[] |
106233
| 2
|
The x-rays showed bone on bone Tricompartment OA Knee with Varus Malalignment.
|
[] |
106233
| 3
|
She was posted for Single Stage Bilateral Total Knee Replacement and as planned the Left Knee Was Operated first.
|
[] |
106233
| 4
|
After exposure, Proximal Tibial, Distal Femoral Cuts and measurement of extension gaps the synovium from the anterior Femur was removed and sizing was done.
|
[] |
106233
| 5
|
The AP cut was then proceeded with.
|
[] |
106233
| 6
|
We spotted a small Osteochondral Cyst in the Anterior Femur which was curretted to remove the cystic material, which is when we realised that the cyst was large and communicating with the medulary canal.
|
[] |
106233
| 7
|
The remaining Femoral preparations was done keeping in mind the risk of iatrogenic fracture and extension Stem was used in the femur.
|
[] |
106233
| 8
|
The defect was then packed cancellous bone graft.
|
[] |
106841
| 1
|
Our patient was an 87-year-old African-American woman who was a nursing home resident, with a history of diabetes mellitus type 2 and subarachnoid hemorrhage leading to aphasia, hemiplegia, seizures and dysphagia requiring percutaneous gastric feeds.
|
[] |
106841
| 2
|
While at the nursing home, she had recurrent aspiration pneumonia and large tube-feed residuals consistent with a diagnosis of underlying gastroparesis.
|
[] |
106841
| 3
|
Her management included metoclopramide and reduced tube-feeding rates, which improved her symptoms.
|
[] |
106841
| 4
|
However, within months the aspiration and increased residuals returned.
|
[] |
106841
| 5
|
After trials of different medication therapies without success, she started mirtazapine and her residual volume and aspirations decreased with a dose of 15mg nightly.
|
[] |
107405
| 1
|
A 37-year-old Arabian woman presented with 12 months of progressive Cushing's syndrome-like symptoms.
|
[] |
107405
| 2
|
Biochemical evaluation confirmed adrenocorticotropic hormone -dependent Cushing's syndrome.
|
[] |
107405
| 3
|
However, the anatomical site of her excess adrenocorticotropic hormone secretion was not clearly delineated by further investigations.
|
[] |
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