text stringlengths 20 553 | entities listlengths 0 5 |
|---|---|
However , she was referred to our institution in July 2016 with progression of ovarian cyst to 6 cm on a pelvic ultrasonogram 2 weeks ago . | [
{
"entity_text": "ovarian cyst",
"type": "CLINENTITY"
}
] |
The patient underwent menopause at age 48 years , with an uneventful past menstrual cycle . | [] |
She had no medical history except the benign thyroid nodule , no relevant surgical history and had not received hormonal therapy . | [
{
"entity_text": "benign thyroid nodule",
"type": "CLINENTITY"
}
] |
Routine blood chemistry and serum tumor marker analysis showed that the levels of carcinoembryonic antigen , CA 19-9 , CA 125 , and human epididymis protein 4 were all within the normal ranges . | [] |
Uterine cervical cytology at the time of admission was normal . | [] |
TVS showed a left ovarian unilocular cyst , size 6 cm × 5 cm × 4 cm , with diffuse low-level internal echoes , thin walled , smooth margined , no septa and no papillary projections . | [
{
"entity_text": "ovarian unilocular cyst",
"type": "CLINENTITY"
}
] |
The uterus size was 6 cm × 4 cm × 3 cm , and a 1 cm uterine myoma was found in the fundus . | [
{
"entity_text": "uterine myoma",
"type": "CLINENTITY"
}
] |
Pelvic contrast-enhanced computed tomography ( ECT ) images revealed a unilocular cystic lesion measuring 6 cm at its widest dimension , without enhancing solid intramural nodules and no evidence of lymphadenopathy or ascites . | [
{
"entity_text": "unilocular cystic lesion",
"type": "CLINENTITY"
},
{
"entity_text": "lymphadenopathy",
"type": "CLINENTITY"
},
{
"entity_text": "ascites",
"type": "CLINENTITY"
}
] |
CT scan indicated benign ovarian cystic tumors . | [
{
"entity_text": "benign ovarian cystic tumors",
"type": "CLINENTITY"
}
] |
The patient underwent laparoendoscopic single-site ( LESS ) surgery . | [] |
On laparoscopic inspection , the cyst was found to be located in the ampullary and fimbrial regions of the left fallopian tube . | [
{
"entity_text": "cyst",
"type": "CLINENTITY"
}
] |
The left fallopian tube was grossly unremarkable and the left ovary was atrophied . | [
{
"entity_text": "left ovary was atrophied",
"type": "CLINENTITY"
}
] |
The left ovary and tube were completely separate from the cyst and the cyst was surrounded by a translucent wall with serous cystic components , but solid components were not seen inside . | [
{
"entity_text": "cyst",
"type": "CLINENTITY"
},
{
"entity_text": "cyst",
"type": "CLINENTITY"
}
] |
Clinical diagnosis was suggestive of left paratubal cyst . | [
{
"entity_text": "paratubal cyst",
"type": "CLINENTITY"
}
] |
The patient underwent hysterectomy and BSO . | [] |
Although tumor markers were normal and there was no presence of papillary projections , the progression in size in the postmenopausal woman indicated a possible malignancy . | [
{
"entity_text": "malignancy",
"type": "CLINENTITY"
}
] |
Frozen sections were prepared from surgery specimens and confirmed a benign cyst . | [
{
"entity_text": "benign cyst",
"type": "CLINENTITY"
}
] |
After surgery , the pelvic cavity was explored and no specific findings were found in the abdominal cavity . | [] |
Histopathological examination of the paratubal cyst revealed the presence of polypoid lesions on the internal surface of the cyst . | [
{
"entity_text": "polypoid lesions",
"type": "CLINENTITY"
},
{
"entity_text": "cyst",
"type": "CLINENTITY"
}
] |
The tumor cells showed nuclear atypism and stratification , which are histological characteristics of borderline tumor . | [
{
"entity_text": "tumor cells",
"type": "CLINENTITY"
}
] |
A final diagnosis of paratubal borderline serous tumor was confirmed . | [
{
"entity_text": "paratubal borderline serous tumor",
"type": "CLINENTITY"
}
] |
The patient was discharged from the hospital on postoperative day 3 . | [] |
CT images were retrospectively evaluated , focusing on the left ovary , fallopian tube , and paratubal cyst after surgery . | [
{
"entity_text": "paratubal cyst",
"type": "CLINENTITY"
}
] |
Multiplanar reconstruction CT imaging revealed linear fat planes between the left ovary and the cyst , indicating that the left ovary , fallopian tube and paratubal cyst were separate structures , similar to those seen during surgery . | [
{
"entity_text": "cyst",
"type": "CLINENTITY"
},
{
"entity_text": "paratubal cyst",
"type": "CLINENTITY"
}
] |
The tumor was not completely staged , and a comprehensive surgical staging operation was recommended ; however , the patient refused adjuvant surgical treatment and opted for close follow-up . | [
{
"entity_text": "tumor",
"type": "CLINENTITY"
}
] |
Pelvic ECT , TVS and tumor markers were checked every three months . | [] |
The patient remains asymptomatic and follow-up at 24 months showed no evidence of recurrence or metastasis . | [
{
"entity_text": "metastasis",
"type": "CLINENTITY"
}
] |
A 61 - year-old man presented with chronic left ear discharge , left-sided headache , diplopia associated with vertigo , tinnitus , and hearing impairment . | [
{
"entity_text": "left ear discharge",
"type": "CLINENTITY"
},
{
"entity_text": "left-sided headache",
"type": "CLINENTITY"
},
{
"entity_text": "hearing impairment",
"type": "CLINENTITY"
}
] |
MRI with contrast showed asymmetrical signal changes in the bilateral petrous bone with reduced enhancement on the left with high suspicion of petrositis ; in the context of chronic tympanomastoiditis , there was a 10 × 4 mm enhancing lesion in the left internal auditory meatus involving the 7 th- 8 th nerve complex . | [
{
"entity_text": "petrositis",
"type": "CLINENTITY"
},
{
"entity_text": "chronic tympanomastoiditis",
"type": "CLINENTITY"
},
{
"entity_text": "lesion",
"type": "CLINENTITY"
}
] |
The patient was treated conservatively with local and systemic antimicrobial agents , he had satisfactory response and improvement regarding symptoms of ear discharge , vertigo , and diplopia , but there is no remarkable response regarding hearing loss and tinnitus . | [
{
"entity_text": "ear discharge",
"type": "CLINENTITY"
},
{
"entity_text": "vertigo",
"type": "CLINENTITY"
},
{
"entity_text": "diplopia",
"type": "CLINENTITY"
},
{
"entity_text": "hearing loss",
"type": "CLINENTITY"
},
{
"entity_text": "tinnitus",
"type": "CL... |
A 27 - year-old pregnant woman presented to our facility at 35 weeks ' gestation with a 3 - months history of right upper abdominal pain associated with generalized itch , tea colored urine , mastic -colored stool , and significant weight loss . | [
{
"entity_text": "right upper abdominal pain",
"type": "CLINENTITY"
},
{
"entity_text": "generalized itch",
"type": "CLINENTITY"
},
{
"entity_text": "tea colored urine",
"type": "CLINENTITY"
},
{
"entity_text": "mastic -colored stool",
"type": "CLINENTITY"
},
{
"e... |
No headache , blurred vision or spontaneous bleeding were mentioned . | [
{
"entity_text": "headache",
"type": "CLINENTITY"
},
{
"entity_text": "blurred vision",
"type": "CLINENTITY"
},
{
"entity_text": "bleeding",
"type": "CLINENTITY"
}
] |
She was not a known diabetic or hypertensive and has no history of blood transfusion . | [
{
"entity_text": "diabetic",
"type": "CLINENTITY"
}
] |
Clinical signs on examination included mild pallor and cholestatic jaundice . | [
{
"entity_text": "pallor",
"type": "CLINENTITY"
},
{
"entity_text": "cholestatic jaundice",
"type": "CLINENTITY"
}
] |
Her blood pressure was 100 / 70 mmHg with a pulse rate of 98 beats / min , respiratory rate about 16 / min and oral temperature of 37 ° C . | [] |
Respiratory , cardiovascular and neurological examinations were unremarkable . | [] |
The abdomen was grossly distended with visible collateral veins . | [] |
Liver was enlarged , hard , nodular with a painful irregular edge . | [
{
"entity_text": "Liver was enlarged",
"type": "CLINENTITY"
}
] |
The spleen was not palpable . | [] |
There was bipedal edema up to the mid shin . | [
{
"entity_text": "bipedal edema",
"type": "CLINENTITY"
}
] |
Fetal heart rate was 140 bpm and regular . | [] |
Laboratory examination showed leukocytosis , anemia and normal platelet counts . | [
{
"entity_text": "leukocytosis",
"type": "CLINENTITY"
},
{
"entity_text": "anemia",
"type": "CLINENTITY"
}
] |
Aspartate aminotransferase ( AST ) were raised ( 4 times upper limit ) , total protein and albumin were low , 43 g / L and 25 g / L respectively , INR 1 . 20 and glycaemia 0 . 70 g / L . | [] |
Her alphafeto-protein ( AFP ) was higher ( 2232 ng / mL ) . | [] |
HBsAg was positive . | [] |
She tested negative to human immunodeficiency viruses ( HIV ) and HCV . | [
{
"entity_text": "human immunodeficiency viruses",
"type": "CLINENTITY"
},
{
"entity_text": "HIV",
"type": "CLINENTITY"
},
{
"entity_text": "HCV",
"type": "CLINENTITY"
}
] |
Abdominal ultrasound showed a heterogeneous coarse liver with multiple hypoechoic lesions . | [] |
Pelvic scan revealed a normal fetus with a gestational age of about 35 weeks . | [] |
The diagnosis of hepatocellular carcinoma on a decompensated cirrhosis was made . | [
{
"entity_text": "hepatocellular carcinoma",
"type": "CLINENTITY"
},
{
"entity_text": "decompensated cirrhosis",
"type": "CLINENTITY"
}
] |
She was managed with analgesia , spironolactone and tenofovir added for prevention of mother-to-child transmission of the hepatitis B infection . | [
{
"entity_text": "hepatitis B infection",
"type": "CLINENTITY"
}
] |
The plan was to have the mother ' s health improved to securely induce the labour . | [] |
Unfortunately , at day two of hospitalization , the patient experienced progressive loss of conscious along with epistaxis and multi-organ failure . | [
{
"entity_text": "loss of conscious",
"type": "CLINENTITY"
},
{
"entity_text": "epistaxis",
"type": "CLINENTITY"
},
{
"entity_text": "multi-organ failure",
"type": "CLINENTITY"
}
] |
Laboratory assessment revealed HB- 8 . 4 g / dL , WBC 37500 cells / dL , Platelets 436000 / ul , INR- 2 . 57 and recurrent hypoglycemia . | [
{
"entity_text": "recurrent hypoglycemia",
"type": "CLINENTITY"
}
] |
Cesarean section was urgently performed and the outcome was a healthy newborn weighted 2 . 9 kg but the mother died soon after . | [] |
Patient information : a 9 - month-old boy presented to the emergency room with a 3 - day history of refusal to bear weight on the right lower extremity and febrile peaks of up to 38 . 5 ° C for 24 hours . | [
{
"entity_text": "febrile peaks",
"type": "CLINENTITY"
}
] |
His parents had noted an ankle trauma in the previous week . | [
{
"entity_text": "ankle trauma",
"type": "CLINENTITY"
}
] |
The primary care physician had initially suspected a talus fracture . | [
{
"entity_text": "talus fracture",
"type": "CLINENTITY"
}
] |
His right ankle was immobilized by a plaster splint and his parents were instructed to apply ice . | [] |
However , the child continued to experience ankle pain and fever . | [
{
"entity_text": "ankle pain",
"type": "CLINENTITY"
},
{
"entity_text": "fever",
"type": "CLINENTITY"
}
] |
He was returned to the emergency room after two days . | [] |
His symptoms were aggravated . | [] |
The ankle was noted to be slightly edematous , but warm to the touch , and diffusely tender to palpation . | [] |
His temperature was 39 ° C . | [] |
Diagnostic assessment : the hemoglobin was 9 . 5 g / dl , the white blood cell count was 18800 / mm 3 , and the C-reactive protein ( CRP ) was 75 mm / h . | [] |
Serum laboratory studies , including CBC count and inflammatory markers , were all elevated . | [] |
An X-ray of the ankle showed a posterior-medial lytic lesion of the talus and soft tissue swelling around the ankle joint . | [
{
"entity_text": "lesion of the talus",
"type": "CLINENTITY"
},
{
"entity_text": "soft tissue swelling around the ankle joint",
"type": "CLINENTITY"
}
] |
However , the computed tomography ( CT ) scan findings revealed a talus fracture . | [
{
"entity_text": "talus fracture",
"type": "CLINENTITY"
}
] |
A magnetic resonance imaging ( MRI ) was not done as it was not available . | [] |
Given the clinical findings a talar osteomyelitis with septic arthritis of the ankle was suspected despite the result of the CT scan . | [
{
"entity_text": "osteomyelitis",
"type": "CLINENTITY"
},
{
"entity_text": "septic arthritis",
"type": "CLINENTITY"
}
] |
The bone scintigraphy demonstrated a septic arthritis and the presence of bone marrow edema in the talus without being able to reach a precise diagnosis of osteomyelitis . | [
{
"entity_text": "septic arthritis",
"type": "CLINENTITY"
},
{
"entity_text": "bone marrow edema",
"type": "CLINENTITY"
},
{
"entity_text": "osteomyelitis",
"type": "CLINENTITY"
}
] |
Therapeutic intervention : the patient was urgently taken to the operating room . | [] |
During the operation , the ankle joint was explored through an anterior approach . | [] |
There were some false membranes , a thin turbid fluid and a pertuit at the junction bone cartilage of the talus . | [] |
The talar cartilage was regular and normal-looking . | [] |
The pertuit , allowing access to a cavity , was cleaned and the yellow organized fibrinous pus was drained . | [] |
The biopsy specimens for the histopathological examination and culture were taken at that site . | [] |
Curettage and irrigation were performed , and the joint was closed over suction drains . | [] |
An empirical antibiotic treatment IV ( cephalosporin + gentamycine ) was initiated . | [] |
Follow-up and outcomes : febrile peaks persisted during the first three days . | [
{
"entity_text": "febrile peaks",
"type": "CLINENTITY"
}
] |
The blood culture and the specimen of the joint isolated Staphylococcus aureus Meti-R . | [] |
The anatomopathological analysis of the ankle specimen showed histological features of an abscess and hyperplastic synovial cells . | [
{
"entity_text": "abscess",
"type": "CLINENTITY"
},
{
"entity_text": "synovial cells",
"type": "CLINENTITY"
}
] |
So , the IV antibiotic treatment was substituted by teicoplanin with a better clinical and biological progression . | [] |
Drainage was maintained for twelve days ( until normalization of CRP ) and intravenous antibiotics for 3 weeks . | [] |
In the third week , the peripheral leukocytes count was 8600 / mL , and the CRP decreased to 2 . 43 mg . | [] |
The patient ' s antibiotic was then substituted by oral pristinamycin for three weeks . | [] |
In the fourth week , the ESR and CRP were 7 mm / hr and 3 mg / L , respectively . | [] |
At that time , the patient did not complain of any pain or limitation of the range of motion of the ankle . | [
{
"entity_text": "pain",
"type": "CLINENTITY"
}
] |
The cast was removed six weeks after surgery . | [] |
At six months , radiographies showed that the lesion healed completely . | [] |
The parents were very satisfied . | [] |
Their child acquired walking at the age of 14 months . | [] |
In the last follow-up visit at 18 months postoperatively , the patient had no pain or limitation in walking and running . | [
{
"entity_text": "pain",
"type": "CLINENTITY"
}
] |
We report a case A 6 day old female neonate was referred to our center on account of bilateral eversion of the upper eyelids since birth . | [
{
"entity_text": "bilateral eversion of the upper eyelids",
"type": "CLINENTITY"
}
] |
The baby was a full term product of an uneventful pregnancy delivered via spontaneous vaginal route . | [] |
There was no use of instrumentation and she cried spontaneously at birth . | [] |
Further information gathered from the referral note revealed that the child has been on gentamycin eye drop and systemic antibiotics but with no apparent improvement 6 days prior to presentation-the reason for referral . | [] |
Examination at presentation revealed an otherwise normal child with bilateral complete eversion of the upper eyelids . | [
{
"entity_text": "bilateral complete eversion of the upper eyelids",
"type": "CLINENTITY"
}
] |
There were marked chemosis bilaterally worst in the right . | [
{
"entity_text": "chemosis bilaterally",
"type": "CLINENTITY"
}
] |
Both eyes were double-everted using lid retractor in order to assess the conditions of the two eyeballs which were both found to be normal . | [] |
Attempt at repositioning the eyelids was unsuccessful because of the marked chemosis . | [
{
"entity_text": "chemosis",
"type": "CLINENTITY"
}
] |
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