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The aortic arch is left-sided and patent with normal descending aorta pulsatility. | [
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] | Argilla | null | null | null | {
"medical_specialty": " Cardiovascular / Pulmonary"
} | Default | 2022-12-07T10:14:26.966656 | null |
PREOPERATIVE DIAGNOSIS: , Lipodystrophy of the abdomen and thighs. | [
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,POSTOPERATIVE DIAGNOSIS:, Lipodystrophy of the abdomen and thighs. | [
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,OPERATION: , Suction-assisted lipectomy. | [
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} | Default | 2022-12-07T10:14:26.969405 | null |
,FINDINGS AND PROCEDURE:, With the patient under satisfactory general endotracheal anesthesia, the entire abdomen, flanks, perineum, and thighs to the knees were prepped and draped circumferentially in sterile fashion. | [
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} | Default | 2022-12-07T10:14:26.969797 | null |
After this had been completed, a #15 blade was used to make small stab wounds in the lateral hips, the pubic area, and upper edge of the umbilicus. | [
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} | Default | 2022-12-07T10:14:26.970111 | null |
Through these small incisions, a cannula was used to infiltrate lactated Ringers with 1000 cc was infiltrated initially into the abdomen. | [
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A 3 and 4-mm cannulas were then used to carry out the liposuction of the abdomen removing a total of 1100 cc of aspirate, which was mostly fat, little fluid, and blood. | [
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Attention was then directed to the thighs both inner and outer. | [
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A total of 1000 cc was infiltrated in both lateral thighs only about 50 cc in the medial thighs. | [
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After this had been completed, 3 and 4-mm cannulas were used to suction 650 cc from each side, approximately 50 cc in the inner thigh and 600 on each lateral thigh. | [
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All of this aspirate was mostly fat with little fluid and very little blood. | [
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Wounds were cleaned and steri-stripped and dressing of ABD pads and ***** was then applied. | [
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The patient tolerated the procedure very well and was sent to the recovery room in good condition. | [
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Normal cardiac chambers size. | [
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} | Default | 2022-12-07T10:14:26.973392 | null |
Normal left ventricular size. | [
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Normal LV systolic function. | [
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Ejection fraction estimated around 60%.,4. | [
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Aortic valve seen with good motion. | [
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Mitral valve seen with good motion. | [
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Tricuspid valve seen with good motion. | [
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No pericardial effusion or intracardiac masses. | [
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} | Default | 2022-12-07T10:14:26.974512 | null |
Trace mitral regurgitation. | [
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Trace tricuspid regurgitation. | [
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Normal LV systolic function. | [
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Ejection fraction estimated around 60%., | [
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PREOPERATIVE DIAGNOSIS: , Morbid obesity. , | [
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POSTOPERATIVE DIAGNOSIS: , Morbid obesity. , | [
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PROCEDURE:, Laparoscopic Roux-en-Y gastric bypass, antecolic, antegastric with 25-mm EEA anastamosis, esophagogastroduodenoscopy. , | [
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ANESTHESIA: , General with endotracheal intubation. , | [
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INDICATIONS FOR PROCEDURE: , This is a 50-year-old male who has been overweight for many years and has tried multiple different weight loss diets and programs. | [
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The patient has now begun to have comorbidities related to the obesity. | [
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The patient has attended our bariatric seminar and met with our dietician and psychologist. | [
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The patient has read through our comprehensive handout and understands the risks and benefits of bypass surgery as evidenced by the signing of our consent form. | [
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"evidenced",
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"."
] | [
{
"end": 112,
"label": "KEYPHRASE",
"score": 0,
"start": 98
}
] | Argilla | null | null | null | {
"medical_specialty": " Bariatrics"
} | Default | 2022-12-07T10:14:26.978734 | null |
The patient was taken to the operating room and placed supine on the operating room table. | [
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{
"end": 39,
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},
{
"end": 79,
"label": "KEYPHRASE",
"score": 0,
"start": 70
}
] | Argilla | null | null | null | {
"medical_specialty": " Bariatrics"
} | Default | 2022-12-07T10:14:26.979304 | null |
General anesthesia was administered with endotracheal intubation. | [
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] | [
{
"end": 19,
"label": "KEYPHRASE",
"score": 0,
"start": 9
},
{
"end": 65,
"label": "KEYPHRASE",
"score": 0,
"start": 42
}
] | Argilla | null | null | null | {
"medical_specialty": " Bariatrics"
} | Default | 2022-12-07T10:14:26.979497 | null |
A Foley catheter was placed for bladder decompression. | [
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"decompression",
"."
] | [
{
"end": 17,
"label": "KEYPHRASE",
"score": 0,
"start": 9
},
{
"end": 40,
"label": "KEYPHRASE",
"score": 0,
"start": 33
},
{
"end": 54,
"label": "KEYPHRASE",
"score": 0,
"start": 41
}
] | Argilla | null | null | null | {
"medical_specialty": " Bariatrics"
} | Default | 2022-12-07T10:14:26.979677 | null |
All pressure points were carefully padded, and sequential compression devices were placed on the legs. | [
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] | [
{
"end": 13,
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"start": 5
},
{
"end": 70,
"label": "KEYPHRASE",
"score": 0,
"start": 59
}
] | Argilla | null | null | null | {
"medical_specialty": " Bariatrics"
} | Default | 2022-12-07T10:14:26.979874 | null |
The abdomen was prepped and draped in standard, sterile, surgical fashion. | [
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{
"end": 12,
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{
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{
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},
{
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"score": 0,
"start": 58
},
{
"end": 74,
"label": "KEYPHRASE",
"score": 0,
"start": 67
}
] | Argilla | null | null | null | {
"medical_specialty": " Bariatrics"
} | Default | 2022-12-07T10:14:26.980071 | null |
Marcaine was injected into the umbilicus. | [
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"."
] | [
{
"end": 41,
"label": "KEYPHRASE",
"score": 0,
"start": 32
}
] | Argilla | null | null | null | {
"medical_specialty": " Bariatrics"
} | Default | 2022-12-07T10:14:26.980230 | null |
Mild aortic stenosis, widely calcified, minimally restricted. | [
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"stenosis",
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"widely",
"calcified",
",",
"minimally",
"restricted",
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] | [
{
"end": 20,
"label": "KEYPHRASE",
"score": 0,
"start": 5
},
{
"end": 38,
"label": "KEYPHRASE",
"score": 0,
"start": 29
}
] | Argilla | null | null | null | {
"medical_specialty": " Cardiovascular / Pulmonary"
} | Default | 2022-12-07T10:14:26.981682 | null |
Mild left ventricular hypertrophy but normal systolic function. | [
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"ventricular",
"hypertrophy",
"but",
"normal",
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"function",
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] | [
{
"end": 33,
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"score": 0,
"start": 10
},
{
"end": 44,
"label": "KEYPHRASE",
"score": 0,
"start": 38
},
{
"end": 62,
"label": "KEYPHRASE",
"score": 0,
"start": 45
}
] | Argilla | null | null | null | {
"medical_specialty": " Cardiovascular / Pulmonary"
} | Default | 2022-12-07T10:14:26.981928 | null |
Normal right ventricle. | [
"Normal",
"right",
"ventricle",
"."
] | [
{
"end": 22,
"label": "KEYPHRASE",
"score": 0,
"start": 13
}
] | Argilla | null | null | null | {
"medical_specialty": " Cardiovascular / Pulmonary"
} | Default | 2022-12-07T10:14:26.982241 | null |
Normal appearance of the tricuspid and mitral valves. | [
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"and",
"mitral",
"valves",
"."
] | [
{
"end": 34,
"label": "KEYPHRASE",
"score": 0,
"start": 25
},
{
"end": 45,
"label": "KEYPHRASE",
"score": 0,
"start": 39
},
{
"end": 52,
"label": "KEYPHRASE",
"score": 0,
"start": 46
}
] | Argilla | null | null | null | {
"medical_specialty": " Cardiovascular / Pulmonary"
} | Default | 2022-12-07T10:14:26.982445 | null |
Normal left ventricle and left ventricular systolic function. | [
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"ventricular",
"systolic",
"function",
"."
] | [
{
"end": 21,
"label": "KEYPHRASE",
"score": 0,
"start": 12
},
{
"end": 60,
"label": "KEYPHRASE",
"score": 0,
"start": 31
}
] | Argilla | null | null | null | {
"medical_specialty": " Cardiovascular / Pulmonary"
} | Default | 2022-12-07T10:14:26.982646 | null |
There is 1 to 2+ aortic regurgitation easily seen, but no aortic stenosis. | [
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{
"end": 23,
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"start": 24
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{
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"label": "KEYPHRASE",
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"start": 58
}
] | Argilla | null | null | null | {
"medical_specialty": " Cardiovascular / Pulmonary"
} | Default | 2022-12-07T10:14:26.982882 | null |
Mild tricuspid regurgitation with only mild increase in right heart pressures, 30-35 mmHg maximum. | [
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{
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"start": 62
}
] | Argilla | null | null | null | {
"medical_specialty": " Cardiovascular / Pulmonary"
} | Default | 2022-12-07T10:14:26.983132 | null |
Normal left ventricle. | [
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] | [
{
"end": 21,
"label": "KEYPHRASE",
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"start": 12
}
] | Argilla | null | null | null | {
"medical_specialty": " Cardiovascular / Pulmonary"
} | Default | 2022-12-07T10:14:26.983322 | null |
Mild tricuspid regurgitation, but only mild increase in right heart pressures. | [
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{
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"start": 62
}
] | Argilla | null | null | null | {
"medical_specialty": " Cardiovascular / Pulmonary"
} | Default | 2022-12-07T10:14:26.983660 | null |
CC:, Confusion and slurred speech. | [
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"."
] | [
{
"end": 33,
"label": "KEYPHRASE",
"score": 0,
"start": 19
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.990454 | null |
,HX , (primarily obtained from boyfriend): This 31 y/o RHF experienced a "flu-like illness 6-8 weeks prior to presentation. | [
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{
"end": 122,
"label": "KEYPHRASE",
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}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.990799 | null |
3-4 weeks prior to presentation, she was found "passed out" in bed, and when awoken appeared confused, and lethargic. | [
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] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.991114 | null |
For two weeks prior to presentation she demonstrated emotional lability, uncharacteristic of her ( outbursts of anger and inappropriate laughter). | [
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{
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"start": 112
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] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.991581 | null |
,She began slurring her speech 2 days prior to admission. | [
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{
"end": 56,
"label": "KEYPHRASE",
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"start": 47
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.991993 | null |
On the day of presentation she developed right facial weakness and began stumbling to the right. | [
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{
"end": 62,
"label": "KEYPHRASE",
"score": 0,
"start": 54
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.992254 | null |
She denied any associated headache, nausea, vomiting, fever, chills, neck stiffness or visual change. | [
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{
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"label": "KEYPHRASE",
"score": 0,
"start": 87
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.992547 | null |
There was no history of illicit drug/ETOH use or head trauma. | [
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] | [
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{
"end": 60,
"label": "KEYPHRASE",
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"start": 49
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.992817 | null |
3 children alive and well. | [
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"."
] | [
{
"end": 10,
"label": "KEYPHRASE",
"score": 0,
"start": 2
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.993656 | null |
Denied tobacco/illicit drug use. | [
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"illicit",
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] | [
{
"end": 14,
"label": "KEYPHRASE",
"score": 0,
"start": 7
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.993858 | null |
T36.8C.,MS: Alert and oriented to name only. | [
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"name",
"only",
"."
] | [
{
"end": 30,
"label": "KEYPHRASE",
"score": 0,
"start": 22
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.994708 | null |
,CN: Flattened right nasolabial fold only. | [
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"nasolabial",
"fold",
"only",
"."
] | [
{
"end": 36,
"label": "KEYPHRASE",
"score": 0,
"start": 21
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.995742 | null |
,Motor: Mild weakness in RUE manifested by pronator drift. | [
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] | [
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"end": 21,
"label": "KEYPHRASE",
"score": 0,
"start": 13
},
{
"end": 57,
"label": "KEYPHRASE",
"score": 0,
"start": 43
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.996002 | null |
Other extremities were full strength. | [
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] | [
{
"end": 17,
"label": "KEYPHRASE",
"score": 0,
"start": 6
},
{
"end": 36,
"label": "KEYPHRASE",
"score": 0,
"start": 28
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.996229 | null |
,Sensory: withdrew to noxious stimulation in all 4 extremities. | [
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] | [
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"end": 41,
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"score": 0,
"start": 30
},
{
"end": 62,
"label": "KEYPHRASE",
"score": 0,
"start": 51
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.996465 | null |
,Station: Right pronator drift. | [
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"drift",
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] | [
{
"end": 30,
"label": "KEYPHRASE",
"score": 0,
"start": 16
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.996849 | null |
,Reflexes: 2/2BUE, 3/3BLE, Plantars were flexor bilaterally. | [
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] | [
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"end": 47,
"label": "KEYPHRASE",
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"start": 41
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.997366 | null |
Outside HCT showed hypodensities in the right putamen, left caudate, and at several subcortical locations (not specified).,COURSE: ,MRI Brian Scan, 2/11/92 revealed an old lacunar infarct in the right basal ganglia, edema within the head of the left caudate nucleus suggesting an acute ischemic event, and arterial enhancement of the left MCA distribution suggesting slow flow. | [
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"start": 315
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{
"end": 376,
"label": "KEYPHRASE",
"score": 0,
"start": 372
}
] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.998439 | null |
The latter suggested a vasculopathy such as Moya Moya, or fibromuscular dysplasia. | [
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] | [
{
"end": 81,
"label": "KEYPHRASE",
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] | Argilla | null | null | null | {
"medical_specialty": " Neurology"
} | Default | 2022-12-07T10:14:26.998794 | null |
HIV, ANA, Anti-cardiolipin Antibody titer, Cardiac enzymes, TFTs, B12, and cholesterol studies were unremarkable. | [
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,She underwent a cerebral angiogram on 2/12/92. | [
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This revealed an occlusion of the left MCA just distal to its origin. | [
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The distal distribution of the left MCA filled on later films through collaterals from the left ACA. | [
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There was also an occlusion of the right MCA just distal to the temporal branch. | [
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Distal branches of the right MCA filled through collaterals from the right ACA. | [
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No other vascular abnormalities were noted. | [
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These findings were felt to be atypical but nevertheless suspicious of a large caliber vasculitis such as Moya Moya disease. | [
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Neuropsychologic testing revealed widespread cognitive dysfunction with particular impairment of language function. | [
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} | Default | 2022-12-07T10:14:27.001345 | null |
She was subsequently discharged home on no medications. | [
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,In 9/92 she was admitted for sudden onset right hemiparesis and mental status change. | [
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Exam revealed the hemiparesis and in addition she was found to have significant neck lymphadenopathy. | [
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} | Default | 2022-12-07T10:14:27.002497 | null |
OB/GYN exam including cervical biopsy, and abdominal/pelvic CT scanning revealed stage IV squamous cell cancer of the cervix. | [
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She died 9/24/92 of cervical cancer. | [
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PAST MEDICAL HISTORY:, Significant for hypertension. | [
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The patient takes hydrochlorothiazide for this. | [
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She also suffers from high cholesterol and takes Crestor. | [
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She also has dry eyes and uses Restasis for this. | [
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She denies liver disease, kidney disease, cirrhosis, hepatitis, diabetes mellitus, thyroid disease, bleeding disorders, prior DVT, HIV and gout. | [
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She also denies cardiac disease and prior history of cancer. | [
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} | Default | 2022-12-07T10:14:27.010148 | null |
,PAST SURGICAL HISTORY: , Significant for tubal ligation in 1993. | [
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She had a hysterectomy done in 2000 and a gallbladder resection done in 2002.,MEDICATIONS: , Crestor 20 mg p.o. | [
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daily, hydrochlorothiazide 20 mg p.o. | [
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,ALLERGIES TO MEDICATIONS: , Bactrim which causes a rash. | [
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The patient denies latex allergy. | [
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She is employed as a manager at the New York department of taxation. | [
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She is married with four children. | [
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,FAMILY HISTORY: , Significant for type II diabetes on her mother's side as well as liver and heart failure. | [
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She has one sibling that suffers from high cholesterol and high triglycerides. | [
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She also complains about snoring and occasional slight asthma. | [
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She does complain about peripheral ankle swelling and heartburn. | [
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She also gives a history of hemorrhoids and bladder infections in the past. | [
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