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Monitoring is an umlsterm, pressure is an umlsterm | DerRadiologe.80380624.eng.abstr_task1 | Sentence: Purpose : Monitoring of intraluminal pressure in standardized enteroclysis .
Instructions: please typing these entity words according to sentence: Monitoring, pressure
Options: umlsterm
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Monitoring, pressure | DerRadiologe.80380624.eng.abstr_task2 | Sentence: Purpose : Monitoring of intraluminal pressure in standardized enteroclysis .
Instructions: please extract entity words from the input sentence
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creatinina is a NORMALIZABLES, penicilina sódica is a NORMALIZABLES, aztreonam is a NORMALIZABLES, vancomicina is a NORMALIZABLES, solución salina is a NORMALIZABLES, hemoglobina is a PROTEINAS, creatinina is a NORMALIZABLES | 338_task0 | Sentence: Se trata de un paciente masculino de 52 años de edad con antecedente médico de hipertensión arterial controlada y enfermedad renal crónica de estadio V de 6 años de evolución en hemodiálisis 3 veces por semana que inicia enfermedad cuando presenta odontalgia de incisivos inferiores, disfagia, odinofagia, aumento del volumen en la región submandibular dolorosa e hipertermia local, motivo por el cual el paciente acude a la Unidad de Cirugía Bucal y Maxilofacial del Hospital General del Oeste "Dr. José Gregorio Hernández" (CBMF-HGO); 24 h después, dadas las condiciones clínicas sistémicas del paciente y presentando leucocitosis de 27.800 U/mm3, con neutrofilia de 82,4% y creatinina en 7,5 mg/dl, se decide su ingreso.
En el examen físico se observan escleras ictéricas, un aumento del volumen severo con predominio de la región submentoniana y submandibular bilateral y apertura bucal limitada a 15 mm aproximadamente. En el examen intrabucal se evidencia edentulismo parcial maxilomandibular, enfermedad periodontal crónica generalizada con movilidad de grado IV de 3,1 y 4,1, presencia de irritantes locales, halitosis, aumento del volumen severo del piso de la boca y espacio sublingual bilateral con glosoptosis.
En conjunto con los servicios de Infectología y Medicina Interna se inicia un tratamiento empírico con penicilina sódica cristalina de 4.000.000 UI cada 6 h por vía intravenosa y aztreonam de 1 g por vía intravenosa con orden diaria.
Se indica tomografía computarizada en la que se evidencia una imagen isodensa en el espacio parafaríngeo compatible con un aumento del volumen, mostrando una disminución de la luz de las vías aéreas de la región cervical y corroborando el diagnóstico de angina de Ludwig.
En 10 d de tratamiento la evolución fue tórpida. Se realiza una reevaluación por infectología que indica vancomicina de 1 g por vía intravenosa, fármaco que causa mejoría clínica importante al paciente. Tras una estabilización sistémica del paciente se realiza una exodoncia de 3,1 y 4,1 y un drenaje quirúrgico de los espacios sublinguales, submandibulares y submentoniano que se logra a través de una incisión submentoniana y submandibular bilateral inferior al basal mandibular que permite el acceso, la comunicación y el establecimiento de 3 drenajes pasivos con sonda Nellaton para realizar 3 lavados diarios de solución salina durante 3 semanas.
El paciente en las evoluciones posteriores al drenaje quirúrgico y al recambio de la terapia antibiótica presentó una disminución en el aumento del volumen y una estabilización de la frecuencia respiratoria. La última hematología registrada revela una serie blanca de 8.600 U/mm3, a expensas de neutrófilos (78%), hemoglobina de 9,5 g/dl, hematocrito en 32,7% y creatinina en 6,8 mg/dl. Todas estas condiciones llevaron al alta médica.
Instructions: please extract entities and their types from the input sentence, all entity types are in options
Options: NORMALIZABLES, PROTEINAS
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] | Se trata de un paciente masculino de 52 años de edad con antecedente médico de hipertensión arterial controlada y enfermedad renal crónica de estadio V de 6 años de evolución en hemodiálisis 3 veces por semana que inicia enfermedad cuando presenta odontalgia de incisivos inferiores, disfagia, odinofagia, aumento del volumen en la región submandibular dolorosa e hipertermia local, motivo por el cual el paciente acude a la Unidad de Cirugía Bucal y Maxilofacial del Hospital General del Oeste "Dr. José Gregorio Hernández" (CBMF-HGO); 24 h después, dadas las condiciones clínicas sistémicas del paciente y presentando leucocitosis de 27.800 U/mm3, con neutrofilia de 82,4% y creatinina en 7,5 mg/dl, se decide su ingreso.
En el examen físico se observan escleras ictéricas, un aumento del volumen severo con predominio de la región submentoniana y submandibular bilateral y apertura bucal limitada a 15 mm aproximadamente. En el examen intrabucal se evidencia edentulismo parcial maxilomandibular, enfermedad periodontal crónica generalizada con movilidad de grado IV de 3,1 y 4,1, presencia de irritantes locales, halitosis, aumento del volumen severo del piso de la boca y espacio sublingual bilateral con glosoptosis.
En conjunto con los servicios de Infectología y Medicina Interna se inicia un tratamiento empírico con penicilina sódica cristalina de 4.000.000 UI cada 6 h por vía intravenosa y aztreonam de 1 g por vía intravenosa con orden diaria.
Se indica tomografía computarizada en la que se evidencia una imagen isodensa en el espacio parafaríngeo compatible con un aumento del volumen, mostrando una disminución de la luz de las vías aéreas de la región cervical y corroborando el diagnóstico de angina de Ludwig.
En 10 d de tratamiento la evolución fue tórpida. Se realiza una reevaluación por infectología que indica vancomicina de 1 g por vía intravenosa, fármaco que causa mejoría clínica importante al paciente. Tras una estabilización sistémica del paciente se realiza una exodoncia de 3,1 y 4,1 y un drenaje quirúrgico de los espacios sublinguales, submandibulares y submentoniano que se logra a través de una incisión submentoniana y submandibular bilateral inferior al basal mandibular que permite el acceso, la comunicación y el establecimiento de 3 drenajes pasivos con sonda Nellaton para realizar 3 lavados diarios de solución salina durante 3 semanas.
El paciente en las evoluciones posteriores al drenaje quirúrgico y al recambio de la terapia antibiótica presentó una disminución en el aumento del volumen y una estabilización de la frecuencia respiratoria. La última hematología registrada revela una serie blanca de 8.600 U/mm3, a expensas de neutrófilos (78%), hemoglobina de 9,5 g/dl, hematocrito en 32,7% y creatinina en 6,8 mg/dl. Todas estas condiciones llevaron al alta médica.
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] | [
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"PROTEINAS"
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creatinina is a NORMALIZABLES, penicilina sódica is a NORMALIZABLES, aztreonam is a NORMALIZABLES, vancomicina is a NORMALIZABLES, solución salina is a NORMALIZABLES, hemoglobina is a PROTEINAS, creatinina is a NORMALIZABLES | 338_task1 | Sentence: Se trata de un paciente masculino de 52 años de edad con antecedente médico de hipertensión arterial controlada y enfermedad renal crónica de estadio V de 6 años de evolución en hemodiálisis 3 veces por semana que inicia enfermedad cuando presenta odontalgia de incisivos inferiores, disfagia, odinofagia, aumento del volumen en la región submandibular dolorosa e hipertermia local, motivo por el cual el paciente acude a la Unidad de Cirugía Bucal y Maxilofacial del Hospital General del Oeste "Dr. José Gregorio Hernández" (CBMF-HGO); 24 h después, dadas las condiciones clínicas sistémicas del paciente y presentando leucocitosis de 27.800 U/mm3, con neutrofilia de 82,4% y creatinina en 7,5 mg/dl, se decide su ingreso.
En el examen físico se observan escleras ictéricas, un aumento del volumen severo con predominio de la región submentoniana y submandibular bilateral y apertura bucal limitada a 15 mm aproximadamente. En el examen intrabucal se evidencia edentulismo parcial maxilomandibular, enfermedad periodontal crónica generalizada con movilidad de grado IV de 3,1 y 4,1, presencia de irritantes locales, halitosis, aumento del volumen severo del piso de la boca y espacio sublingual bilateral con glosoptosis.
En conjunto con los servicios de Infectología y Medicina Interna se inicia un tratamiento empírico con penicilina sódica cristalina de 4.000.000 UI cada 6 h por vía intravenosa y aztreonam de 1 g por vía intravenosa con orden diaria.
Se indica tomografía computarizada en la que se evidencia una imagen isodensa en el espacio parafaríngeo compatible con un aumento del volumen, mostrando una disminución de la luz de las vías aéreas de la región cervical y corroborando el diagnóstico de angina de Ludwig.
En 10 d de tratamiento la evolución fue tórpida. Se realiza una reevaluación por infectología que indica vancomicina de 1 g por vía intravenosa, fármaco que causa mejoría clínica importante al paciente. Tras una estabilización sistémica del paciente se realiza una exodoncia de 3,1 y 4,1 y un drenaje quirúrgico de los espacios sublinguales, submandibulares y submentoniano que se logra a través de una incisión submentoniana y submandibular bilateral inferior al basal mandibular que permite el acceso, la comunicación y el establecimiento de 3 drenajes pasivos con sonda Nellaton para realizar 3 lavados diarios de solución salina durante 3 semanas.
El paciente en las evoluciones posteriores al drenaje quirúrgico y al recambio de la terapia antibiótica presentó una disminución en el aumento del volumen y una estabilización de la frecuencia respiratoria. La última hematología registrada revela una serie blanca de 8.600 U/mm3, a expensas de neutrófilos (78%), hemoglobina de 9,5 g/dl, hematocrito en 32,7% y creatinina en 6,8 mg/dl. Todas estas condiciones llevaron al alta médica.
Instructions: please typing these entity words according to sentence: creatinina, penicilina sódica, aztreonam, vancomicina, solución salina, hemoglobina, creatinina
Options: NORMALIZABLES, PROTEINAS
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] | Se trata de un paciente masculino de 52 años de edad con antecedente médico de hipertensión arterial controlada y enfermedad renal crónica de estadio V de 6 años de evolución en hemodiálisis 3 veces por semana que inicia enfermedad cuando presenta odontalgia de incisivos inferiores, disfagia, odinofagia, aumento del volumen en la región submandibular dolorosa e hipertermia local, motivo por el cual el paciente acude a la Unidad de Cirugía Bucal y Maxilofacial del Hospital General del Oeste "Dr. José Gregorio Hernández" (CBMF-HGO); 24 h después, dadas las condiciones clínicas sistémicas del paciente y presentando leucocitosis de 27.800 U/mm3, con neutrofilia de 82,4% y creatinina en 7,5 mg/dl, se decide su ingreso.
En el examen físico se observan escleras ictéricas, un aumento del volumen severo con predominio de la región submentoniana y submandibular bilateral y apertura bucal limitada a 15 mm aproximadamente. En el examen intrabucal se evidencia edentulismo parcial maxilomandibular, enfermedad periodontal crónica generalizada con movilidad de grado IV de 3,1 y 4,1, presencia de irritantes locales, halitosis, aumento del volumen severo del piso de la boca y espacio sublingual bilateral con glosoptosis.
En conjunto con los servicios de Infectología y Medicina Interna se inicia un tratamiento empírico con penicilina sódica cristalina de 4.000.000 UI cada 6 h por vía intravenosa y aztreonam de 1 g por vía intravenosa con orden diaria.
Se indica tomografía computarizada en la que se evidencia una imagen isodensa en el espacio parafaríngeo compatible con un aumento del volumen, mostrando una disminución de la luz de las vías aéreas de la región cervical y corroborando el diagnóstico de angina de Ludwig.
En 10 d de tratamiento la evolución fue tórpida. Se realiza una reevaluación por infectología que indica vancomicina de 1 g por vía intravenosa, fármaco que causa mejoría clínica importante al paciente. Tras una estabilización sistémica del paciente se realiza una exodoncia de 3,1 y 4,1 y un drenaje quirúrgico de los espacios sublinguales, submandibulares y submentoniano que se logra a través de una incisión submentoniana y submandibular bilateral inferior al basal mandibular que permite el acceso, la comunicación y el establecimiento de 3 drenajes pasivos con sonda Nellaton para realizar 3 lavados diarios de solución salina durante 3 semanas.
El paciente en las evoluciones posteriores al drenaje quirúrgico y al recambio de la terapia antibiótica presentó una disminución en el aumento del volumen y una estabilización de la frecuencia respiratoria. La última hematología registrada revela una serie blanca de 8.600 U/mm3, a expensas de neutrófilos (78%), hemoglobina de 9,5 g/dl, hematocrito en 32,7% y creatinina en 6,8 mg/dl. Todas estas condiciones llevaron al alta médica.
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creatinina, penicilina sódica, aztreonam, vancomicina, solución salina, hemoglobina, creatinina | 338_task2 | Sentence: Se trata de un paciente masculino de 52 años de edad con antecedente médico de hipertensión arterial controlada y enfermedad renal crónica de estadio V de 6 años de evolución en hemodiálisis 3 veces por semana que inicia enfermedad cuando presenta odontalgia de incisivos inferiores, disfagia, odinofagia, aumento del volumen en la región submandibular dolorosa e hipertermia local, motivo por el cual el paciente acude a la Unidad de Cirugía Bucal y Maxilofacial del Hospital General del Oeste "Dr. José Gregorio Hernández" (CBMF-HGO); 24 h después, dadas las condiciones clínicas sistémicas del paciente y presentando leucocitosis de 27.800 U/mm3, con neutrofilia de 82,4% y creatinina en 7,5 mg/dl, se decide su ingreso.
En el examen físico se observan escleras ictéricas, un aumento del volumen severo con predominio de la región submentoniana y submandibular bilateral y apertura bucal limitada a 15 mm aproximadamente. En el examen intrabucal se evidencia edentulismo parcial maxilomandibular, enfermedad periodontal crónica generalizada con movilidad de grado IV de 3,1 y 4,1, presencia de irritantes locales, halitosis, aumento del volumen severo del piso de la boca y espacio sublingual bilateral con glosoptosis.
En conjunto con los servicios de Infectología y Medicina Interna se inicia un tratamiento empírico con penicilina sódica cristalina de 4.000.000 UI cada 6 h por vía intravenosa y aztreonam de 1 g por vía intravenosa con orden diaria.
Se indica tomografía computarizada en la que se evidencia una imagen isodensa en el espacio parafaríngeo compatible con un aumento del volumen, mostrando una disminución de la luz de las vías aéreas de la región cervical y corroborando el diagnóstico de angina de Ludwig.
En 10 d de tratamiento la evolución fue tórpida. Se realiza una reevaluación por infectología que indica vancomicina de 1 g por vía intravenosa, fármaco que causa mejoría clínica importante al paciente. Tras una estabilización sistémica del paciente se realiza una exodoncia de 3,1 y 4,1 y un drenaje quirúrgico de los espacios sublinguales, submandibulares y submentoniano que se logra a través de una incisión submentoniana y submandibular bilateral inferior al basal mandibular que permite el acceso, la comunicación y el establecimiento de 3 drenajes pasivos con sonda Nellaton para realizar 3 lavados diarios de solución salina durante 3 semanas.
El paciente en las evoluciones posteriores al drenaje quirúrgico y al recambio de la terapia antibiótica presentó una disminución en el aumento del volumen y una estabilización de la frecuencia respiratoria. La última hematología registrada revela una serie blanca de 8.600 U/mm3, a expensas de neutrófilos (78%), hemoglobina de 9,5 g/dl, hematocrito en 32,7% y creatinina en 6,8 mg/dl. Todas estas condiciones llevaron al alta médica.
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En el examen físico se observan escleras ictéricas, un aumento del volumen severo con predominio de la región submentoniana y submandibular bilateral y apertura bucal limitada a 15 mm aproximadamente. En el examen intrabucal se evidencia edentulismo parcial maxilomandibular, enfermedad periodontal crónica generalizada con movilidad de grado IV de 3,1 y 4,1, presencia de irritantes locales, halitosis, aumento del volumen severo del piso de la boca y espacio sublingual bilateral con glosoptosis.
En conjunto con los servicios de Infectología y Medicina Interna se inicia un tratamiento empírico con penicilina sódica cristalina de 4.000.000 UI cada 6 h por vía intravenosa y aztreonam de 1 g por vía intravenosa con orden diaria.
Se indica tomografía computarizada en la que se evidencia una imagen isodensa en el espacio parafaríngeo compatible con un aumento del volumen, mostrando una disminución de la luz de las vías aéreas de la región cervical y corroborando el diagnóstico de angina de Ludwig.
En 10 d de tratamiento la evolución fue tórpida. Se realiza una reevaluación por infectología que indica vancomicina de 1 g por vía intravenosa, fármaco que causa mejoría clínica importante al paciente. Tras una estabilización sistémica del paciente se realiza una exodoncia de 3,1 y 4,1 y un drenaje quirúrgico de los espacios sublinguales, submandibulares y submentoniano que se logra a través de una incisión submentoniana y submandibular bilateral inferior al basal mandibular que permite el acceso, la comunicación y el establecimiento de 3 drenajes pasivos con sonda Nellaton para realizar 3 lavados diarios de solución salina durante 3 semanas.
El paciente en las evoluciones posteriores al drenaje quirúrgico y al recambio de la terapia antibiótica presentó una disminución en el aumento del volumen y una estabilización de la frecuencia respiratoria. La última hematología registrada revela una serie blanca de 8.600 U/mm3, a expensas de neutrófilos (78%), hemoglobina de 9,5 g/dl, hematocrito en 32,7% y creatinina en 6,8 mg/dl. Todas estas condiciones llevaron al alta médica.
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retinoic acid is a compound, staurosporine is a compound, MMP-21 is a protein, dexamethasone is a compound | DS.d543_task0 | Sentence: Of various agents tested in HaCaT cell cultures, only retinoic acid (10(-6) M) and staurosporine (2.5 x 10(-8) M) upregulated MMP-21 mRNA and protein expression, whereas tumor promoters, hormones, or dexamethasone were without effect.
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retinoic acid is a compound, staurosporine is a compound, MMP-21 is a protein, dexamethasone is a compound | DS.d543_task1 | Sentence: Of various agents tested in HaCaT cell cultures, only retinoic acid (10(-6) M) and staurosporine (2.5 x 10(-8) M) upregulated MMP-21 mRNA and protein expression, whereas tumor promoters, hormones, or dexamethasone were without effect.
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Esomeprazole is a Intervention_Pharmacological, chronic heartburn is a Outcome_Physical, without erosive oesophagitis is a Participant_Condition, relieve symptoms is a Outcome_Physical, efficacy and safety is a Outcome_Other, esomeprazole is a Intervention_Pharmacological, frequent heartburn for > or = 6 months is a Participant_Condition, 241 is a Participant_Sample-size, 234 is a Participant_Sample-size, placebo is a Intervention_Control, 242 is a Participant_Sample-size, complete resolution of heartburn is a Outcome_Physical, percentage of heartburn - free days is a Outcome_Physical, time to first and sustained resolution of heartburn is a Outcome_Physical, spectrum and frequency of adverse events is a Outcome_Adverse-effects, effective and safe is a Outcome_Other | 15182_task0 | Sentence: Esomeprazole resolves chronic heartburn in patients without erosive oesophagitis . BACKGROUND Patients with chronic heartburn but with no endoscopic evidence of erosive oesophagitis require gastric acid suppression to relieve symptoms . AIM To assess the efficacy and safety of esomeprazole in patients with frequent heartburn for > or = 6 months and no evidence of erosive oesophagitis on endoscopy . METHODS Two randomized , double-blind , 4-week , multi-centre trials with identical methodology compared once-daily esomeprazole , 40 mg ( n = 241 ) or 20 mg ( n = 234 ) , with placebo ( n = 242 ) for the rigorous end-point of complete resolution of heartburn . Secondary end-points included the percentage of heartburn-free days and the time to first and sustained resolution of heartburn . RESULTS Patients treated with either dose of esomeprazole were two to three times more likely to achieve complete resolution of heartburn than patients treated with placebo ( P < 0.001 ) . The percentage of heartburn-free days was significantly higher with esomeprazole 40 mg ( 63 % , 66 % ) or 20 mg ( 63 % , 68 % ) than with placebo ( 46 % , 36 % ; P < or = 0.001 ) in each of the two studies . Esomeprazole was associated with a significantly shorter mean time to first ( 6-7 days ) and sustained ( 12-17 days ) resolution of heartburn compared with placebo ( first , 10-12 days ; sustained , 21-22 days ; P < or = 0.008 ) . The spectrum and frequency of adverse events with esomeprazole were similar to those with placebo . CONCLUSIONS Esomeprazole , at daily doses of 40 mg or 20 mg , is effective and safe for the treatment of chronic heartburn in patients without erosive oesophagitis .
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Esomeprazole is a Intervention_Pharmacological, chronic heartburn is a Outcome_Physical, without erosive oesophagitis is a Participant_Condition, relieve symptoms is a Outcome_Physical, efficacy and safety is a Outcome_Other, esomeprazole is a Intervention_Pharmacological, frequent heartburn for > or = 6 months is a Participant_Condition, 241 is a Participant_Sample-size, 234 is a Participant_Sample-size, placebo is a Intervention_Control, 242 is a Participant_Sample-size, complete resolution of heartburn is a Outcome_Physical, percentage of heartburn - free days is a Outcome_Physical, time to first and sustained resolution of heartburn is a Outcome_Physical, spectrum and frequency of adverse events is a Outcome_Adverse-effects, effective and safe is a Outcome_Other | 15182_task1 | Sentence: Esomeprazole resolves chronic heartburn in patients without erosive oesophagitis . BACKGROUND Patients with chronic heartburn but with no endoscopic evidence of erosive oesophagitis require gastric acid suppression to relieve symptoms . AIM To assess the efficacy and safety of esomeprazole in patients with frequent heartburn for > or = 6 months and no evidence of erosive oesophagitis on endoscopy . METHODS Two randomized , double-blind , 4-week , multi-centre trials with identical methodology compared once-daily esomeprazole , 40 mg ( n = 241 ) or 20 mg ( n = 234 ) , with placebo ( n = 242 ) for the rigorous end-point of complete resolution of heartburn . Secondary end-points included the percentage of heartburn-free days and the time to first and sustained resolution of heartburn . RESULTS Patients treated with either dose of esomeprazole were two to three times more likely to achieve complete resolution of heartburn than patients treated with placebo ( P < 0.001 ) . The percentage of heartburn-free days was significantly higher with esomeprazole 40 mg ( 63 % , 66 % ) or 20 mg ( 63 % , 68 % ) than with placebo ( 46 % , 36 % ; P < or = 0.001 ) in each of the two studies . Esomeprazole was associated with a significantly shorter mean time to first ( 6-7 days ) and sustained ( 12-17 days ) resolution of heartburn compared with placebo ( first , 10-12 days ; sustained , 21-22 days ; P < or = 0.008 ) . The spectrum and frequency of adverse events with esomeprazole were similar to those with placebo . CONCLUSIONS Esomeprazole , at daily doses of 40 mg or 20 mg , is effective and safe for the treatment of chronic heartburn in patients without erosive oesophagitis .
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] | Esomeprazole resolves chronic heartburn in patients without erosive oesophagitis . BACKGROUND Patients with chronic heartburn but with no endoscopic evidence of erosive oesophagitis require gastric acid suppression to relieve symptoms . AIM To assess the efficacy and safety of esomeprazole in patients with frequent heartburn for > or = 6 months and no evidence of erosive oesophagitis on endoscopy . METHODS Two randomized , double-blind , 4-week , multi-centre trials with identical methodology compared once-daily esomeprazole , 40 mg ( n = 241 ) or 20 mg ( n = 234 ) , with placebo ( n = 242 ) for the rigorous end-point of complete resolution of heartburn . Secondary end-points included the percentage of heartburn-free days and the time to first and sustained resolution of heartburn . RESULTS Patients treated with either dose of esomeprazole were two to three times more likely to achieve complete resolution of heartburn than patients treated with placebo ( P < 0.001 ) . The percentage of heartburn-free days was significantly higher with esomeprazole 40 mg ( 63 % , 66 % ) or 20 mg ( 63 % , 68 % ) than with placebo ( 46 % , 36 % ; P < or = 0.001 ) in each of the two studies . Esomeprazole was associated with a significantly shorter mean time to first ( 6-7 days ) and sustained ( 12-17 days ) resolution of heartburn compared with placebo ( first , 10-12 days ; sustained , 21-22 days ; P < or = 0.008 ) . The spectrum and frequency of adverse events with esomeprazole were similar to those with placebo . CONCLUSIONS Esomeprazole , at daily doses of 40 mg or 20 mg , is effective and safe for the treatment of chronic heartburn in patients without erosive oesophagitis . | [
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Esomeprazole, chronic heartburn, without erosive oesophagitis, relieve symptoms, efficacy and safety, esomeprazole, frequent heartburn for > or = 6 months, 241, 234, placebo, 242, complete resolution of heartburn, percentage of heartburn - free days, time to first and sustained resolution of heartburn, spectrum and frequency of adverse events, effective and safe | 15182_task2 | Sentence: Esomeprazole resolves chronic heartburn in patients without erosive oesophagitis . BACKGROUND Patients with chronic heartburn but with no endoscopic evidence of erosive oesophagitis require gastric acid suppression to relieve symptoms . AIM To assess the efficacy and safety of esomeprazole in patients with frequent heartburn for > or = 6 months and no evidence of erosive oesophagitis on endoscopy . METHODS Two randomized , double-blind , 4-week , multi-centre trials with identical methodology compared once-daily esomeprazole , 40 mg ( n = 241 ) or 20 mg ( n = 234 ) , with placebo ( n = 242 ) for the rigorous end-point of complete resolution of heartburn . Secondary end-points included the percentage of heartburn-free days and the time to first and sustained resolution of heartburn . RESULTS Patients treated with either dose of esomeprazole were two to three times more likely to achieve complete resolution of heartburn than patients treated with placebo ( P < 0.001 ) . The percentage of heartburn-free days was significantly higher with esomeprazole 40 mg ( 63 % , 66 % ) or 20 mg ( 63 % , 68 % ) than with placebo ( 46 % , 36 % ; P < or = 0.001 ) in each of the two studies . Esomeprazole was associated with a significantly shorter mean time to first ( 6-7 days ) and sustained ( 12-17 days ) resolution of heartburn compared with placebo ( first , 10-12 days ; sustained , 21-22 days ; P < or = 0.008 ) . The spectrum and frequency of adverse events with esomeprazole were similar to those with placebo . CONCLUSIONS Esomeprazole , at daily doses of 40 mg or 20 mg , is effective and safe for the treatment of chronic heartburn in patients without erosive oesophagitis .
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] | Esomeprazole resolves chronic heartburn in patients without erosive oesophagitis . BACKGROUND Patients with chronic heartburn but with no endoscopic evidence of erosive oesophagitis require gastric acid suppression to relieve symptoms . AIM To assess the efficacy and safety of esomeprazole in patients with frequent heartburn for > or = 6 months and no evidence of erosive oesophagitis on endoscopy . METHODS Two randomized , double-blind , 4-week , multi-centre trials with identical methodology compared once-daily esomeprazole , 40 mg ( n = 241 ) or 20 mg ( n = 234 ) , with placebo ( n = 242 ) for the rigorous end-point of complete resolution of heartburn . Secondary end-points included the percentage of heartburn-free days and the time to first and sustained resolution of heartburn . RESULTS Patients treated with either dose of esomeprazole were two to three times more likely to achieve complete resolution of heartburn than patients treated with placebo ( P < 0.001 ) . The percentage of heartburn-free days was significantly higher with esomeprazole 40 mg ( 63 % , 66 % ) or 20 mg ( 63 % , 68 % ) than with placebo ( 46 % , 36 % ; P < or = 0.001 ) in each of the two studies . Esomeprazole was associated with a significantly shorter mean time to first ( 6-7 days ) and sustained ( 12-17 days ) resolution of heartburn compared with placebo ( first , 10-12 days ; sustained , 21-22 days ; P < or = 0.008 ) . The spectrum and frequency of adverse events with esomeprazole were similar to those with placebo . CONCLUSIONS Esomeprazole , at daily doses of 40 mg or 20 mg , is effective and safe for the treatment of chronic heartburn in patients without erosive oesophagitis . | [
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α1,3-fucosyltransferases is a GENE-N, FUT9 is a GENE-Y, E - selectin is a GENE-Y, carbohydrates is a CHEMICAL, E / P - selectin is a GENE-N, glycosyltransferases is a GENE-N, glycoTs is a GENE-N, selectin is a GENE-N, glycoTs is a GENE-N, α1,3-fucosyltransferases is a GENE-N, FUT4 is a GENE-Y, FUT7 is a GENE-Y, FUT9 is a GENE-Y, selectin is a GENE-N, L- , E- , and P - selectin is a GENE-N, FUT7 is a GENE-Y, FUT4 is a GENE-Y, selectin is a GENE-N, N is a CHEMICAL, P - selectin glycoprotein ligand-1 is a GENE-N, PSGL-1 is a GENE-N, P / L - selectin is a GENE-N, FUT4 is a GENE-Y, FUT7 is a GENE-Y, E - selectin is a GENE-Y, α1,3-fucosyltransferase is a GENE-N, FUT9 is a GENE-Y, fucosyltransferases is a GENE-N, E - selectin is a GENE-Y, human glycoT is a GENE-N, FUT9 is a GENE-Y, human E - selectin is a GENE-Y | 23260_task0 | Sentence: Silencing α1,3-fucosyltransferases in human leukocytes reveals a role for FUT9 enzyme during E-selectin-mediated cell adhesion.
Leukocyte adhesion during inflammation is initiated by the binding of sialofucosylated carbohydrates expressed on leukocytes to endothelial E/P-selectin. Although the glycosyltransferases (glycoTs) constructing selectin-ligands have largely been identified using knock-out mice, important differences may exist between humans and mice. To address this, we developed a systematic lentivirus-based shRNA delivery workflow to create human leukocytic HL-60 cell lines that lack up to three glycoTs. Using this, the contributions of all three myeloid α1,3-fucosyltransferases (FUT4, FUT7, and FUT9) to selectin-ligand biosynthesis were evaluated. The cell adhesion properties of these modified cells to L-, E-, and P-selectin under hydrodynamic shear were compared with bone marrow-derived neutrophils from Fut4(-/-)Fut7(-/-) dual knock-out mice. Results demonstrate that predominantly FUT7, and to a lesser extent FUT4, forms the selectin-ligand at the N terminus of leukocyte P-selectin glycoprotein ligand-1 (PSGL-1) in humans and mice. Here, 85% reduction in leukocyte interaction was observed in human FUT4(-)7(-) dual knockdowns on P/L-selectin substrates. Unlike Fut4(-/-)Fut7(-/-) mouse neutrophils, however, human knockdowns lacking FUT4 and FUT7 only exhibited partial reduction in rolling interaction on E-selectin. In this case, the third α1,3-fucosyltransferase FUT9 played an important role because leukocyte adhesion was reduced by 50-60% in FUT9-HL-60, 70-80% in dual knockdown FUT7(-)9(-) cells, and ∼85% in FUT4(-)7(-)9(-) triple knockdowns. Gene silencing results are in agreement with gain-of-function experiments where all three fucosyltransferases conferred E-selectin-mediated rolling in HEK293T cells. This study advances new tools to study human glycoT function. It suggests a species-specific role for FUT9 during the biosynthesis of human E-selectin ligands.
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Leukocyte adhesion during inflammation is initiated by the binding of sialofucosylated carbohydrates expressed on leukocytes to endothelial E/P-selectin. Although the glycosyltransferases (glycoTs) constructing selectin-ligands have largely been identified using knock-out mice, important differences may exist between humans and mice. To address this, we developed a systematic lentivirus-based shRNA delivery workflow to create human leukocytic HL-60 cell lines that lack up to three glycoTs. Using this, the contributions of all three myeloid α1,3-fucosyltransferases (FUT4, FUT7, and FUT9) to selectin-ligand biosynthesis were evaluated. The cell adhesion properties of these modified cells to L-, E-, and P-selectin under hydrodynamic shear were compared with bone marrow-derived neutrophils from Fut4(-/-)Fut7(-/-) dual knock-out mice. Results demonstrate that predominantly FUT7, and to a lesser extent FUT4, forms the selectin-ligand at the N terminus of leukocyte P-selectin glycoprotein ligand-1 (PSGL-1) in humans and mice. Here, 85% reduction in leukocyte interaction was observed in human FUT4(-)7(-) dual knockdowns on P/L-selectin substrates. Unlike Fut4(-/-)Fut7(-/-) mouse neutrophils, however, human knockdowns lacking FUT4 and FUT7 only exhibited partial reduction in rolling interaction on E-selectin. In this case, the third α1,3-fucosyltransferase FUT9 played an important role because leukocyte adhesion was reduced by 50-60% in FUT9-HL-60, 70-80% in dual knockdown FUT7(-)9(-) cells, and ∼85% in FUT4(-)7(-)9(-) triple knockdowns. Gene silencing results are in agreement with gain-of-function experiments where all three fucosyltransferases conferred E-selectin-mediated rolling in HEK293T cells. This study advances new tools to study human glycoT function. It suggests a species-specific role for FUT9 during the biosynthesis of human E-selectin ligands. | [
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α1,3-fucosyltransferases is a GENE-N, FUT9 is a GENE-Y, E - selectin is a GENE-Y, carbohydrates is a CHEMICAL, E / P - selectin is a GENE-N, glycosyltransferases is a GENE-N, glycoTs is a GENE-N, selectin is a GENE-N, glycoTs is a GENE-N, α1,3-fucosyltransferases is a GENE-N, FUT4 is a GENE-Y, FUT7 is a GENE-Y, FUT9 is a GENE-Y, selectin is a GENE-N, L- , E- , and P - selectin is a GENE-N, FUT7 is a GENE-Y, FUT4 is a GENE-Y, selectin is a GENE-N, N is a CHEMICAL, P - selectin glycoprotein ligand-1 is a GENE-N, PSGL-1 is a GENE-N, P / L - selectin is a GENE-N, FUT4 is a GENE-Y, FUT7 is a GENE-Y, E - selectin is a GENE-Y, α1,3-fucosyltransferase is a GENE-N, FUT9 is a GENE-Y, fucosyltransferases is a GENE-N, E - selectin is a GENE-Y, human glycoT is a GENE-N, FUT9 is a GENE-Y, human E - selectin is a GENE-Y | 23260_task1 | Sentence: Silencing α1,3-fucosyltransferases in human leukocytes reveals a role for FUT9 enzyme during E-selectin-mediated cell adhesion.
Leukocyte adhesion during inflammation is initiated by the binding of sialofucosylated carbohydrates expressed on leukocytes to endothelial E/P-selectin. Although the glycosyltransferases (glycoTs) constructing selectin-ligands have largely been identified using knock-out mice, important differences may exist between humans and mice. To address this, we developed a systematic lentivirus-based shRNA delivery workflow to create human leukocytic HL-60 cell lines that lack up to three glycoTs. Using this, the contributions of all three myeloid α1,3-fucosyltransferases (FUT4, FUT7, and FUT9) to selectin-ligand biosynthesis were evaluated. The cell adhesion properties of these modified cells to L-, E-, and P-selectin under hydrodynamic shear were compared with bone marrow-derived neutrophils from Fut4(-/-)Fut7(-/-) dual knock-out mice. Results demonstrate that predominantly FUT7, and to a lesser extent FUT4, forms the selectin-ligand at the N terminus of leukocyte P-selectin glycoprotein ligand-1 (PSGL-1) in humans and mice. Here, 85% reduction in leukocyte interaction was observed in human FUT4(-)7(-) dual knockdowns on P/L-selectin substrates. Unlike Fut4(-/-)Fut7(-/-) mouse neutrophils, however, human knockdowns lacking FUT4 and FUT7 only exhibited partial reduction in rolling interaction on E-selectin. In this case, the third α1,3-fucosyltransferase FUT9 played an important role because leukocyte adhesion was reduced by 50-60% in FUT9-HL-60, 70-80% in dual knockdown FUT7(-)9(-) cells, and ∼85% in FUT4(-)7(-)9(-) triple knockdowns. Gene silencing results are in agreement with gain-of-function experiments where all three fucosyltransferases conferred E-selectin-mediated rolling in HEK293T cells. This study advances new tools to study human glycoT function. It suggests a species-specific role for FUT9 during the biosynthesis of human E-selectin ligands.
Instructions: please typing these entity words according to sentence: α1,3-fucosyltransferases, FUT9, E - selectin, carbohydrates, E / P - selectin, glycosyltransferases, glycoTs, selectin, glycoTs, α1,3-fucosyltransferases, FUT4, FUT7, FUT9, selectin, L- , E- , and P - selectin, FUT7, FUT4, selectin, N, P - selectin glycoprotein ligand-1, PSGL-1, P / L - selectin, FUT4, FUT7, E - selectin, α1,3-fucosyltransferase, FUT9, fucosyltransferases, E - selectin, human glycoT, FUT9, human E - selectin
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Leukocyte adhesion during inflammation is initiated by the binding of sialofucosylated carbohydrates expressed on leukocytes to endothelial E/P-selectin. Although the glycosyltransferases (glycoTs) constructing selectin-ligands have largely been identified using knock-out mice, important differences may exist between humans and mice. To address this, we developed a systematic lentivirus-based shRNA delivery workflow to create human leukocytic HL-60 cell lines that lack up to three glycoTs. Using this, the contributions of all three myeloid α1,3-fucosyltransferases (FUT4, FUT7, and FUT9) to selectin-ligand biosynthesis were evaluated. The cell adhesion properties of these modified cells to L-, E-, and P-selectin under hydrodynamic shear were compared with bone marrow-derived neutrophils from Fut4(-/-)Fut7(-/-) dual knock-out mice. Results demonstrate that predominantly FUT7, and to a lesser extent FUT4, forms the selectin-ligand at the N terminus of leukocyte P-selectin glycoprotein ligand-1 (PSGL-1) in humans and mice. Here, 85% reduction in leukocyte interaction was observed in human FUT4(-)7(-) dual knockdowns on P/L-selectin substrates. Unlike Fut4(-/-)Fut7(-/-) mouse neutrophils, however, human knockdowns lacking FUT4 and FUT7 only exhibited partial reduction in rolling interaction on E-selectin. In this case, the third α1,3-fucosyltransferase FUT9 played an important role because leukocyte adhesion was reduced by 50-60% in FUT9-HL-60, 70-80% in dual knockdown FUT7(-)9(-) cells, and ∼85% in FUT4(-)7(-)9(-) triple knockdowns. Gene silencing results are in agreement with gain-of-function experiments where all three fucosyltransferases conferred E-selectin-mediated rolling in HEK293T cells. This study advances new tools to study human glycoT function. It suggests a species-specific role for FUT9 during the biosynthesis of human E-selectin ligands. | [
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α1,3-fucosyltransferases, FUT9, E - selectin, carbohydrates, E / P - selectin, glycosyltransferases, glycoTs, selectin, glycoTs, α1,3-fucosyltransferases, FUT4, FUT7, FUT9, selectin, L- , E- , and P - selectin, FUT7, FUT4, selectin, N, P - selectin glycoprotein ligand-1, PSGL-1, P / L - selectin, FUT4, FUT7, E - selectin, α1,3-fucosyltransferase, FUT9, fucosyltransferases, E - selectin, human glycoT, FUT9, human E - selectin | 23260_task2 | Sentence: Silencing α1,3-fucosyltransferases in human leukocytes reveals a role for FUT9 enzyme during E-selectin-mediated cell adhesion.
Leukocyte adhesion during inflammation is initiated by the binding of sialofucosylated carbohydrates expressed on leukocytes to endothelial E/P-selectin. Although the glycosyltransferases (glycoTs) constructing selectin-ligands have largely been identified using knock-out mice, important differences may exist between humans and mice. To address this, we developed a systematic lentivirus-based shRNA delivery workflow to create human leukocytic HL-60 cell lines that lack up to three glycoTs. Using this, the contributions of all three myeloid α1,3-fucosyltransferases (FUT4, FUT7, and FUT9) to selectin-ligand biosynthesis were evaluated. The cell adhesion properties of these modified cells to L-, E-, and P-selectin under hydrodynamic shear were compared with bone marrow-derived neutrophils from Fut4(-/-)Fut7(-/-) dual knock-out mice. Results demonstrate that predominantly FUT7, and to a lesser extent FUT4, forms the selectin-ligand at the N terminus of leukocyte P-selectin glycoprotein ligand-1 (PSGL-1) in humans and mice. Here, 85% reduction in leukocyte interaction was observed in human FUT4(-)7(-) dual knockdowns on P/L-selectin substrates. Unlike Fut4(-/-)Fut7(-/-) mouse neutrophils, however, human knockdowns lacking FUT4 and FUT7 only exhibited partial reduction in rolling interaction on E-selectin. In this case, the third α1,3-fucosyltransferase FUT9 played an important role because leukocyte adhesion was reduced by 50-60% in FUT9-HL-60, 70-80% in dual knockdown FUT7(-)9(-) cells, and ∼85% in FUT4(-)7(-)9(-) triple knockdowns. Gene silencing results are in agreement with gain-of-function experiments where all three fucosyltransferases conferred E-selectin-mediated rolling in HEK293T cells. This study advances new tools to study human glycoT function. It suggests a species-specific role for FUT9 during the biosynthesis of human E-selectin ligands.
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Leukocyte adhesion during inflammation is initiated by the binding of sialofucosylated carbohydrates expressed on leukocytes to endothelial E/P-selectin. Although the glycosyltransferases (glycoTs) constructing selectin-ligands have largely been identified using knock-out mice, important differences may exist between humans and mice. To address this, we developed a systematic lentivirus-based shRNA delivery workflow to create human leukocytic HL-60 cell lines that lack up to three glycoTs. Using this, the contributions of all three myeloid α1,3-fucosyltransferases (FUT4, FUT7, and FUT9) to selectin-ligand biosynthesis were evaluated. The cell adhesion properties of these modified cells to L-, E-, and P-selectin under hydrodynamic shear were compared with bone marrow-derived neutrophils from Fut4(-/-)Fut7(-/-) dual knock-out mice. Results demonstrate that predominantly FUT7, and to a lesser extent FUT4, forms the selectin-ligand at the N terminus of leukocyte P-selectin glycoprotein ligand-1 (PSGL-1) in humans and mice. Here, 85% reduction in leukocyte interaction was observed in human FUT4(-)7(-) dual knockdowns on P/L-selectin substrates. Unlike Fut4(-/-)Fut7(-/-) mouse neutrophils, however, human knockdowns lacking FUT4 and FUT7 only exhibited partial reduction in rolling interaction on E-selectin. In this case, the third α1,3-fucosyltransferase FUT9 played an important role because leukocyte adhesion was reduced by 50-60% in FUT9-HL-60, 70-80% in dual knockdown FUT7(-)9(-) cells, and ∼85% in FUT4(-)7(-)9(-) triple knockdowns. Gene silencing results are in agreement with gain-of-function experiments where all three fucosyltransferases conferred E-selectin-mediated rolling in HEK293T cells. This study advances new tools to study human glycoT function. It suggests a species-specific role for FUT9 during the biosynthesis of human E-selectin ligands. | [
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Radiologischen is an umlsterm, Informationssystemen is an umlsterm, Informationssysteme is an umlsterm | DerRadiologe.90390286.ger.abstr_task0 | Sentence: Hintergrund : Die zunehmende Verbreitung von Radiologischen Informationssystemen ( RIS ) und Picture Archiving and Communication Systems ( PACS ) in den letzten Jahren stellt neue Anforderungen an die Integration der einzelnen , ehemals voneinander unabhaengigen Informationssysteme ( RIS Modalitaeten , PACS ) . , Im Folgenden werden die Moeglichkeiten zur Integration der einzelnen Systeme dargestellt .
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Radiologischen is an umlsterm, Informationssystemen is an umlsterm, Informationssysteme is an umlsterm | DerRadiologe.90390286.ger.abstr_task1 | Sentence: Hintergrund : Die zunehmende Verbreitung von Radiologischen Informationssystemen ( RIS ) und Picture Archiving and Communication Systems ( PACS ) in den letzten Jahren stellt neue Anforderungen an die Integration der einzelnen , ehemals voneinander unabhaengigen Informationssysteme ( RIS Modalitaeten , PACS ) . , Im Folgenden werden die Moeglichkeiten zur Integration der einzelnen Systeme dargestellt .
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linitis plástica is a MORFOLOGIA_NEOPLASIA, adenocarcinoma is a MORFOLOGIA_NEOPLASIA, afectación a distancia is a MORFOLOGIA_NEOPLASIA, adenocarcinoma gástrico con células en anillo de sello , grado 3 is a MORFOLOGIA_NEOPLASIA, neoplásica is a MORFOLOGIA_NEOPLASIA, pT2bN0/15M0 is a MORFOLOGIA_NEOPLASIA, afectación peritoneal is a MORFOLOGIA_NEOPLASIA, implantes peritoneales is a MORFOLOGIA_NEOPLASIA, malignos is a MORFOLOGIA_NEOPLASIA, Adenocarcinoma gástrico reintervenido estadio IV ( metástasis is a MORFOLOGIA_NEOPLASIA, neoplásica is a MORFOLOGIA_NEOPLASIA | 413_task0 | Sentence: Anamnesis
Mujer de 53 años. Sin alergias conocidas, hábitos tóxicos ni patología previa de interés salvo la oncológica. Intervenida de cesárea, hemorroides y apendicectomía.
Situación sociofamiliar: vive con su esposo (que es el cuidador principal y trabaja de celador en un hospital) y tienen dos hijos de 24 y 28 años. Es ama de casa y su situación basal previa a su ingreso es de dependiencia (índice de Barthel 40). Tienen un buen nivel de información sobre el diagnóstico y pronóstico de la enfermedad.
Historia oncológica: desde julio de 2010 comienza con náuseas y vómitos postprandiales, y tras consultar en tres ocasiones al Servicio de Urgencias se realiza ecografía abdominal, objetivando engrosamiento de la pared antral, por lo que ingresa para estudio.
Tras objetivar en al endoscopia hallazgos de linitis plástica y biopsia compatible con adenocarcinoma gástrico, se descarta afectación a distancia, y se programa para laparoscopia exploradora en septiembre de 2010, realizándose gastrectomía subtotal y reconstrucción Billroth II y se diagnostica de adenocarcinoma gástrico con células en anillo de sello, grado 3, pobremente diferenciado con abundante invasión perineural, márgenes quirúrgicos libres de infiltración neoplásica, pT2bN0/15M0 (estadio IB) con factores de mal pronóstico.
Se decide tratamiento adyuvante según esquema Mac Donalds, finalizando tratamiento RT el 3/3/2011 (dosis total de 50,4 Gy: 28 sesiones, 1,8 Gy/sesión).
Se mantiene estable, hasta que en julio de 2013 comienza con pérdida de peso severa y anorexia, realizándose el estudio de extensión que objetiva recidiva local con dudosa afectación peritoneal, por lo que, tras la realización de la PET negativa, es derivada para valoración de cirugía de rescate, que se desestima, por lo que se decide inicio de tratamiento con ECF (tras dos ciclos muestra mala tolerancia por mucositis y diarrea G2-3), por lo que se modifica por Folfox-6 (disminución de dosis tras el tercer ciclo por toxicidad hematológica), retirando el oxaliplatino tras el sexto ciclo por reacción alérgica grave, manteniendo 5-FU + leuco hasta completar siete ciclos más, finalizando en mayo de 2014.
Tras respuesta parcial en las pruebas de imagen, se decide realizar una intervención sobre recidiva a nivel de la anastomosis (14/10/2014), con postoperatorio tórpido por aparición de fístula enteropancreática. AP: pT4bN0 (por infiltración de asa intestinal), estadio IIIb.
Mantuvo revisiones sin evidencia de enfermedad hasta principios de marzo de 2015, cuando ingresa para estudio por un cuadro de varios meses de pérdida de peso cuantificada en 20 kg, con importante afectación del estado general, astenia intensa y náuseas pese al tratamiento con progestágenos, corticoides orales, suplementos proteicos y seguimiento en consultas de Nutrición. Portadora de port-a-cath® desde 2010.
Exploración física
A su llegada a planta, paciente estable hemodinámicamente. Afebril. Eupneica en reposo. Consciente, orientada y con sensorio plenamente conservado. Caquexia extrema y sarcopenia generalizada. Peso 32 kg. Talla 158 cm. A nivel infraclavicular derecho, reservorio subcutáneo sin datos de infección local. Resto de la exploración anodina.
Pruebas complementarias
» Analítica a su llegada (13-3-2015). Hemograma: anemia leve normocítica y normocroma. Serie blanca y plaquetaria normal. Bioquímica completa, incluyendo función hepática, CPK, troponinas, amilasa normal, salvo proteínas totales 4,79 mg/dl.
» TC de tórax y abdomen sin contraste (16-3-2015): sin alteraciones significativas.
» Estudio gastroduodenal (20-3-2015): sin alteraciones (tránsito rápido por yeyuno).
» Ecocardiograma transtorácico (30-3-2015): masa móvil de unos 5 cm2 de superficie en la aurícula derecha, probablemente procedente de la vena cava superior que protruye durante la diástole hacia el ventrículo derecho. Derrame pericárdico leve posterior con fracción de eyección conservada y válvulas sin alteraciones.
» Radiografía de tórax urgente (30-3-2015): aumento de densidad en la parte medial y posterior del lóbulo inferior derecho de nueva aparición.
» RM craneal con contraste (1-4-2015): imágenes sugerentes de posibles embolismos milimétricos distribuidos por ambos hemisferios.
» TC de tórax y abdomen con contraste (4-4-2015): tromboembolismo pulmonar con afectación de la arteria del lóbulo inferior derecho y múltiples ramas segmentarias. Condensación pulmonar en el lóbulo inferior derecho con derrame pleural paraneumónico y derrame pleural loculado izquierdo. Pequeñas opacidades pulmonares parenquimatosas periféricas y pequeños infiltrados pulmonares en el hemitórax izquierdo, uno de ellos con cavitación compatible con embolismos sépticos. Derrame pericárdico.
Hígado de estasis. Ascitis e implantes peritoneales malignos.
» Radiografía de tórax (7-5-2015): importante derrame pleural derecho con atelectasia compresiva del lóbulo inferior. Discreto derrame pleural izquierdo.
» Ecocardiograma transtorácico (16-5-2015): masa móvil en el techo de la aurícula derecha de tamaño mucho más reducido que en estudios previos, limitada a la vena cava superior y sin protrusión hacia el ventrículo.
Diagnóstico
» Tromboembolismos sépticos pulmonares diseminados, secundarios a endocarditis aguda y bacteriemia por Staphylococcus capitis/ureoliticus
» Adenocarcinoma gástrico reintervenido estadio IV (metástasis peritoneales).
» Derrame pleural derecho paraneumónico recurrente evacuado mediante toracocentesis.
» Desnutrición calórico-proteica severa que precisa nutrición parenteral.
» Delirium hipoactivo en el contexto de sepsis y neoplasia.
Tratamiento
A su llegada iniciamos nutrición parenteral, aumentamos la dosis de corticoide y se pauta cinitaprida como procinético, mejorando la tolerancia a la dieta. Tras descartar datos de progresión de la enfermedad en las pruebas previamente referidas, se inician preparativos para el alta hospitalaria, pero el día previo a la misma la paciente presenta un cuadro séptico con hipotensión, fiebre con tiritona y deterioro del estado general, con agudización de las náuseas y los vómitos.
Se solicitan hemocultivos de sangre periférica, urocultivo, orina, análisis y radiografía de tórax, detectando un cuadro compatible con cuadro séptico grave de origen pulmonar. Se pauta sueroterapia intensa, antieméticos y antibioterapia de amplio espectro por neumonía nosocomial en paciente inmunodeprimida.
Evolución
A las 48 horas nos informan de crecimiento en hemocultivos de sangre periférica Staphylococcus coagulasa negativo capitis/ureoliticus meticilín sensible, por lo que tras consultar con el Servicio de Infecciones se decide ampliar el espectro antibiótico y añadir linezolid, al tener mayor impregnación a nivel pulmonar. Pese a dichas medidas y los antitérmicos pautados, la paciente persiste con fiebre mantenida de 38 ºC y muy mal estado general (secreciones en la boca de coloración clara, espumosas; la paciente está nauseosa, muy decaída, con cuadro de delirium y disartria asociado). Ante la evolución tórpida se añade tratamiento antifúngico i.v. y se solicita una TC de tórax-abdomen urgente, un ecocardiograma y una RM craneal, que objetivan imagen de una gran masa de 5 cm2 a nivel de la aurícula derecha sugerente de endocarditis aguda con tromboembolismos sépticos pulmonares bilaterales diseminados con derrame pleural derecho en moderada cuantía asociado (probablemente paraneumónico), hígado de estasis y ascitis leve-moderada.
La paciente presentó disnea progresiva en el contexto de derrame pleural y sobrecarga hídrica para tratamiento del shock séptico que precisó de toracocentesis evacuadora en tres ocasiones (débito > 2.750 cc en total), objetivando líquido inflamatorio sin afectación neoplásica.
En reunión multidisciplinar (Cardiología, Infecciones, Radiología, UCI y Oncología) se descarta la opción de cirugía cardíaca dados el mal estado general y la progresión de la enfermedad de base, por lo que se decide tratamiento médico conservador (antibiótico dirigido frente al estafilococo aislado, con cloxacilina y amikacina, manteniendo linezolid); se inicia anticoagulación; se retira el foco de infección (aislándose estafilococo en punta del catéter similar al extraído en los hemocultivos de sangre periférica) y se canaliza una nueva vía central a nivel yugular izquierdo para nutrición parenteral y administración de medicación.
Con dichas medidas, se consigue la desaparición de la fiebre y a las 3 semanas presenta mejoría radiológica, analítica (normalización de leucocitos, plaquetas y coagulación), ecocardiográfica (práctica desaparición de la masa auricular) y mejoría de reactantes inflamatorios (PCR pasa de 30 mg/dl a 4 mg/dl), por lo que se reduce el espectro antibiótico.
Durante la evolución del cuadro se trabaja de forma continua el aspecto psicológico con la paciente y au familia junto a una psicóloga, enfermería y el equipo médico, entendiendo la gravedad del cuadro y aceptando el deterioro progresivo pese a todas las medidas tomadas.
A pesar de ello, la paciente mantiene un deterioro clínico progresivo con persistencia de náuseas y vómitos en relación con secreciones bronquiales paraneumónicas de muy difícil control pese a la asociación de múltiples antieméticos. La paciente presenta un nuevo deterioro clínico, con disminución marcada del nivel de consciencia, agitación y fracaso multiorgánico que no responde a ltratamiento y fallece en paz, sin signos de sufrimiento a las 24 horas del deterioro tras 70 días de ingreso.
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] | Anamnesis
Mujer de 53 años. Sin alergias conocidas, hábitos tóxicos ni patología previa de interés salvo la oncológica. Intervenida de cesárea, hemorroides y apendicectomía.
Situación sociofamiliar: vive con su esposo (que es el cuidador principal y trabaja de celador en un hospital) y tienen dos hijos de 24 y 28 años. Es ama de casa y su situación basal previa a su ingreso es de dependiencia (índice de Barthel 40). Tienen un buen nivel de información sobre el diagnóstico y pronóstico de la enfermedad.
Historia oncológica: desde julio de 2010 comienza con náuseas y vómitos postprandiales, y tras consultar en tres ocasiones al Servicio de Urgencias se realiza ecografía abdominal, objetivando engrosamiento de la pared antral, por lo que ingresa para estudio.
Tras objetivar en al endoscopia hallazgos de linitis plástica y biopsia compatible con adenocarcinoma gástrico, se descarta afectación a distancia, y se programa para laparoscopia exploradora en septiembre de 2010, realizándose gastrectomía subtotal y reconstrucción Billroth II y se diagnostica de adenocarcinoma gástrico con células en anillo de sello, grado 3, pobremente diferenciado con abundante invasión perineural, márgenes quirúrgicos libres de infiltración neoplásica, pT2bN0/15M0 (estadio IB) con factores de mal pronóstico.
Se decide tratamiento adyuvante según esquema Mac Donalds, finalizando tratamiento RT el 3/3/2011 (dosis total de 50,4 Gy: 28 sesiones, 1,8 Gy/sesión).
Se mantiene estable, hasta que en julio de 2013 comienza con pérdida de peso severa y anorexia, realizándose el estudio de extensión que objetiva recidiva local con dudosa afectación peritoneal, por lo que, tras la realización de la PET negativa, es derivada para valoración de cirugía de rescate, que se desestima, por lo que se decide inicio de tratamiento con ECF (tras dos ciclos muestra mala tolerancia por mucositis y diarrea G2-3), por lo que se modifica por Folfox-6 (disminución de dosis tras el tercer ciclo por toxicidad hematológica), retirando el oxaliplatino tras el sexto ciclo por reacción alérgica grave, manteniendo 5-FU + leuco hasta completar siete ciclos más, finalizando en mayo de 2014.
Tras respuesta parcial en las pruebas de imagen, se decide realizar una intervención sobre recidiva a nivel de la anastomosis (14/10/2014), con postoperatorio tórpido por aparición de fístula enteropancreática. AP: pT4bN0 (por infiltración de asa intestinal), estadio IIIb.
Mantuvo revisiones sin evidencia de enfermedad hasta principios de marzo de 2015, cuando ingresa para estudio por un cuadro de varios meses de pérdida de peso cuantificada en 20 kg, con importante afectación del estado general, astenia intensa y náuseas pese al tratamiento con progestágenos, corticoides orales, suplementos proteicos y seguimiento en consultas de Nutrición. Portadora de port-a-cath® desde 2010.
Exploración física
A su llegada a planta, paciente estable hemodinámicamente. Afebril. Eupneica en reposo. Consciente, orientada y con sensorio plenamente conservado. Caquexia extrema y sarcopenia generalizada. Peso 32 kg. Talla 158 cm. A nivel infraclavicular derecho, reservorio subcutáneo sin datos de infección local. Resto de la exploración anodina.
Pruebas complementarias
» Analítica a su llegada (13-3-2015). Hemograma: anemia leve normocítica y normocroma. Serie blanca y plaquetaria normal. Bioquímica completa, incluyendo función hepática, CPK, troponinas, amilasa normal, salvo proteínas totales 4,79 mg/dl.
» TC de tórax y abdomen sin contraste (16-3-2015): sin alteraciones significativas.
» Estudio gastroduodenal (20-3-2015): sin alteraciones (tránsito rápido por yeyuno).
» Ecocardiograma transtorácico (30-3-2015): masa móvil de unos 5 cm2 de superficie en la aurícula derecha, probablemente procedente de la vena cava superior que protruye durante la diástole hacia el ventrículo derecho. Derrame pericárdico leve posterior con fracción de eyección conservada y válvulas sin alteraciones.
» Radiografía de tórax urgente (30-3-2015): aumento de densidad en la parte medial y posterior del lóbulo inferior derecho de nueva aparición.
» RM craneal con contraste (1-4-2015): imágenes sugerentes de posibles embolismos milimétricos distribuidos por ambos hemisferios.
» TC de tórax y abdomen con contraste (4-4-2015): tromboembolismo pulmonar con afectación de la arteria del lóbulo inferior derecho y múltiples ramas segmentarias. Condensación pulmonar en el lóbulo inferior derecho con derrame pleural paraneumónico y derrame pleural loculado izquierdo. Pequeñas opacidades pulmonares parenquimatosas periféricas y pequeños infiltrados pulmonares en el hemitórax izquierdo, uno de ellos con cavitación compatible con embolismos sépticos. Derrame pericárdico.
Hígado de estasis. Ascitis e implantes peritoneales malignos.
» Radiografía de tórax (7-5-2015): importante derrame pleural derecho con atelectasia compresiva del lóbulo inferior. Discreto derrame pleural izquierdo.
» Ecocardiograma transtorácico (16-5-2015): masa móvil en el techo de la aurícula derecha de tamaño mucho más reducido que en estudios previos, limitada a la vena cava superior y sin protrusión hacia el ventrículo.
Diagnóstico
» Tromboembolismos sépticos pulmonares diseminados, secundarios a endocarditis aguda y bacteriemia por Staphylococcus capitis/ureoliticus
» Adenocarcinoma gástrico reintervenido estadio IV (metástasis peritoneales).
» Derrame pleural derecho paraneumónico recurrente evacuado mediante toracocentesis.
» Desnutrición calórico-proteica severa que precisa nutrición parenteral.
» Delirium hipoactivo en el contexto de sepsis y neoplasia.
Tratamiento
A su llegada iniciamos nutrición parenteral, aumentamos la dosis de corticoide y se pauta cinitaprida como procinético, mejorando la tolerancia a la dieta. Tras descartar datos de progresión de la enfermedad en las pruebas previamente referidas, se inician preparativos para el alta hospitalaria, pero el día previo a la misma la paciente presenta un cuadro séptico con hipotensión, fiebre con tiritona y deterioro del estado general, con agudización de las náuseas y los vómitos.
Se solicitan hemocultivos de sangre periférica, urocultivo, orina, análisis y radiografía de tórax, detectando un cuadro compatible con cuadro séptico grave de origen pulmonar. Se pauta sueroterapia intensa, antieméticos y antibioterapia de amplio espectro por neumonía nosocomial en paciente inmunodeprimida.
Evolución
A las 48 horas nos informan de crecimiento en hemocultivos de sangre periférica Staphylococcus coagulasa negativo capitis/ureoliticus meticilín sensible, por lo que tras consultar con el Servicio de Infecciones se decide ampliar el espectro antibiótico y añadir linezolid, al tener mayor impregnación a nivel pulmonar. Pese a dichas medidas y los antitérmicos pautados, la paciente persiste con fiebre mantenida de 38 ºC y muy mal estado general (secreciones en la boca de coloración clara, espumosas; la paciente está nauseosa, muy decaída, con cuadro de delirium y disartria asociado). Ante la evolución tórpida se añade tratamiento antifúngico i.v. y se solicita una TC de tórax-abdomen urgente, un ecocardiograma y una RM craneal, que objetivan imagen de una gran masa de 5 cm2 a nivel de la aurícula derecha sugerente de endocarditis aguda con tromboembolismos sépticos pulmonares bilaterales diseminados con derrame pleural derecho en moderada cuantía asociado (probablemente paraneumónico), hígado de estasis y ascitis leve-moderada.
La paciente presentó disnea progresiva en el contexto de derrame pleural y sobrecarga hídrica para tratamiento del shock séptico que precisó de toracocentesis evacuadora en tres ocasiones (débito > 2.750 cc en total), objetivando líquido inflamatorio sin afectación neoplásica.
En reunión multidisciplinar (Cardiología, Infecciones, Radiología, UCI y Oncología) se descarta la opción de cirugía cardíaca dados el mal estado general y la progresión de la enfermedad de base, por lo que se decide tratamiento médico conservador (antibiótico dirigido frente al estafilococo aislado, con cloxacilina y amikacina, manteniendo linezolid); se inicia anticoagulación; se retira el foco de infección (aislándose estafilococo en punta del catéter similar al extraído en los hemocultivos de sangre periférica) y se canaliza una nueva vía central a nivel yugular izquierdo para nutrición parenteral y administración de medicación.
Con dichas medidas, se consigue la desaparición de la fiebre y a las 3 semanas presenta mejoría radiológica, analítica (normalización de leucocitos, plaquetas y coagulación), ecocardiográfica (práctica desaparición de la masa auricular) y mejoría de reactantes inflamatorios (PCR pasa de 30 mg/dl a 4 mg/dl), por lo que se reduce el espectro antibiótico.
Durante la evolución del cuadro se trabaja de forma continua el aspecto psicológico con la paciente y au familia junto a una psicóloga, enfermería y el equipo médico, entendiendo la gravedad del cuadro y aceptando el deterioro progresivo pese a todas las medidas tomadas.
A pesar de ello, la paciente mantiene un deterioro clínico progresivo con persistencia de náuseas y vómitos en relación con secreciones bronquiales paraneumónicas de muy difícil control pese a la asociación de múltiples antieméticos. La paciente presenta un nuevo deterioro clínico, con disminución marcada del nivel de consciencia, agitación y fracaso multiorgánico que no responde a ltratamiento y fallece en paz, sin signos de sufrimiento a las 24 horas del deterioro tras 70 días de ingreso.
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"1",
"-",
"4",
"-",
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"milimétricos",
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"»",
"TC",
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"y",
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"(",
"4",
"-",
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"-",
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",",
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"y",
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"\n",
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"gástrico",
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"(",
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"Derrame",
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"Desnutrición",
"calórico",
"-",
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"precisa",
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"parenteral",
".",
"\n",
"»",
"Delirium",
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"MORFOLOGIA_NEOPLASIA"
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linitis plástica is a MORFOLOGIA_NEOPLASIA, adenocarcinoma is a MORFOLOGIA_NEOPLASIA, afectación a distancia is a MORFOLOGIA_NEOPLASIA, adenocarcinoma gástrico con células en anillo de sello , grado 3 is a MORFOLOGIA_NEOPLASIA, neoplásica is a MORFOLOGIA_NEOPLASIA, pT2bN0/15M0 is a MORFOLOGIA_NEOPLASIA, afectación peritoneal is a MORFOLOGIA_NEOPLASIA, implantes peritoneales is a MORFOLOGIA_NEOPLASIA, malignos is a MORFOLOGIA_NEOPLASIA, Adenocarcinoma gástrico reintervenido estadio IV ( metástasis is a MORFOLOGIA_NEOPLASIA, neoplásica is a MORFOLOGIA_NEOPLASIA | 413_task1 | Sentence: Anamnesis
Mujer de 53 años. Sin alergias conocidas, hábitos tóxicos ni patología previa de interés salvo la oncológica. Intervenida de cesárea, hemorroides y apendicectomía.
Situación sociofamiliar: vive con su esposo (que es el cuidador principal y trabaja de celador en un hospital) y tienen dos hijos de 24 y 28 años. Es ama de casa y su situación basal previa a su ingreso es de dependiencia (índice de Barthel 40). Tienen un buen nivel de información sobre el diagnóstico y pronóstico de la enfermedad.
Historia oncológica: desde julio de 2010 comienza con náuseas y vómitos postprandiales, y tras consultar en tres ocasiones al Servicio de Urgencias se realiza ecografía abdominal, objetivando engrosamiento de la pared antral, por lo que ingresa para estudio.
Tras objetivar en al endoscopia hallazgos de linitis plástica y biopsia compatible con adenocarcinoma gástrico, se descarta afectación a distancia, y se programa para laparoscopia exploradora en septiembre de 2010, realizándose gastrectomía subtotal y reconstrucción Billroth II y se diagnostica de adenocarcinoma gástrico con células en anillo de sello, grado 3, pobremente diferenciado con abundante invasión perineural, márgenes quirúrgicos libres de infiltración neoplásica, pT2bN0/15M0 (estadio IB) con factores de mal pronóstico.
Se decide tratamiento adyuvante según esquema Mac Donalds, finalizando tratamiento RT el 3/3/2011 (dosis total de 50,4 Gy: 28 sesiones, 1,8 Gy/sesión).
Se mantiene estable, hasta que en julio de 2013 comienza con pérdida de peso severa y anorexia, realizándose el estudio de extensión que objetiva recidiva local con dudosa afectación peritoneal, por lo que, tras la realización de la PET negativa, es derivada para valoración de cirugía de rescate, que se desestima, por lo que se decide inicio de tratamiento con ECF (tras dos ciclos muestra mala tolerancia por mucositis y diarrea G2-3), por lo que se modifica por Folfox-6 (disminución de dosis tras el tercer ciclo por toxicidad hematológica), retirando el oxaliplatino tras el sexto ciclo por reacción alérgica grave, manteniendo 5-FU + leuco hasta completar siete ciclos más, finalizando en mayo de 2014.
Tras respuesta parcial en las pruebas de imagen, se decide realizar una intervención sobre recidiva a nivel de la anastomosis (14/10/2014), con postoperatorio tórpido por aparición de fístula enteropancreática. AP: pT4bN0 (por infiltración de asa intestinal), estadio IIIb.
Mantuvo revisiones sin evidencia de enfermedad hasta principios de marzo de 2015, cuando ingresa para estudio por un cuadro de varios meses de pérdida de peso cuantificada en 20 kg, con importante afectación del estado general, astenia intensa y náuseas pese al tratamiento con progestágenos, corticoides orales, suplementos proteicos y seguimiento en consultas de Nutrición. Portadora de port-a-cath® desde 2010.
Exploración física
A su llegada a planta, paciente estable hemodinámicamente. Afebril. Eupneica en reposo. Consciente, orientada y con sensorio plenamente conservado. Caquexia extrema y sarcopenia generalizada. Peso 32 kg. Talla 158 cm. A nivel infraclavicular derecho, reservorio subcutáneo sin datos de infección local. Resto de la exploración anodina.
Pruebas complementarias
» Analítica a su llegada (13-3-2015). Hemograma: anemia leve normocítica y normocroma. Serie blanca y plaquetaria normal. Bioquímica completa, incluyendo función hepática, CPK, troponinas, amilasa normal, salvo proteínas totales 4,79 mg/dl.
» TC de tórax y abdomen sin contraste (16-3-2015): sin alteraciones significativas.
» Estudio gastroduodenal (20-3-2015): sin alteraciones (tránsito rápido por yeyuno).
» Ecocardiograma transtorácico (30-3-2015): masa móvil de unos 5 cm2 de superficie en la aurícula derecha, probablemente procedente de la vena cava superior que protruye durante la diástole hacia el ventrículo derecho. Derrame pericárdico leve posterior con fracción de eyección conservada y válvulas sin alteraciones.
» Radiografía de tórax urgente (30-3-2015): aumento de densidad en la parte medial y posterior del lóbulo inferior derecho de nueva aparición.
» RM craneal con contraste (1-4-2015): imágenes sugerentes de posibles embolismos milimétricos distribuidos por ambos hemisferios.
» TC de tórax y abdomen con contraste (4-4-2015): tromboembolismo pulmonar con afectación de la arteria del lóbulo inferior derecho y múltiples ramas segmentarias. Condensación pulmonar en el lóbulo inferior derecho con derrame pleural paraneumónico y derrame pleural loculado izquierdo. Pequeñas opacidades pulmonares parenquimatosas periféricas y pequeños infiltrados pulmonares en el hemitórax izquierdo, uno de ellos con cavitación compatible con embolismos sépticos. Derrame pericárdico.
Hígado de estasis. Ascitis e implantes peritoneales malignos.
» Radiografía de tórax (7-5-2015): importante derrame pleural derecho con atelectasia compresiva del lóbulo inferior. Discreto derrame pleural izquierdo.
» Ecocardiograma transtorácico (16-5-2015): masa móvil en el techo de la aurícula derecha de tamaño mucho más reducido que en estudios previos, limitada a la vena cava superior y sin protrusión hacia el ventrículo.
Diagnóstico
» Tromboembolismos sépticos pulmonares diseminados, secundarios a endocarditis aguda y bacteriemia por Staphylococcus capitis/ureoliticus
» Adenocarcinoma gástrico reintervenido estadio IV (metástasis peritoneales).
» Derrame pleural derecho paraneumónico recurrente evacuado mediante toracocentesis.
» Desnutrición calórico-proteica severa que precisa nutrición parenteral.
» Delirium hipoactivo en el contexto de sepsis y neoplasia.
Tratamiento
A su llegada iniciamos nutrición parenteral, aumentamos la dosis de corticoide y se pauta cinitaprida como procinético, mejorando la tolerancia a la dieta. Tras descartar datos de progresión de la enfermedad en las pruebas previamente referidas, se inician preparativos para el alta hospitalaria, pero el día previo a la misma la paciente presenta un cuadro séptico con hipotensión, fiebre con tiritona y deterioro del estado general, con agudización de las náuseas y los vómitos.
Se solicitan hemocultivos de sangre periférica, urocultivo, orina, análisis y radiografía de tórax, detectando un cuadro compatible con cuadro séptico grave de origen pulmonar. Se pauta sueroterapia intensa, antieméticos y antibioterapia de amplio espectro por neumonía nosocomial en paciente inmunodeprimida.
Evolución
A las 48 horas nos informan de crecimiento en hemocultivos de sangre periférica Staphylococcus coagulasa negativo capitis/ureoliticus meticilín sensible, por lo que tras consultar con el Servicio de Infecciones se decide ampliar el espectro antibiótico y añadir linezolid, al tener mayor impregnación a nivel pulmonar. Pese a dichas medidas y los antitérmicos pautados, la paciente persiste con fiebre mantenida de 38 ºC y muy mal estado general (secreciones en la boca de coloración clara, espumosas; la paciente está nauseosa, muy decaída, con cuadro de delirium y disartria asociado). Ante la evolución tórpida se añade tratamiento antifúngico i.v. y se solicita una TC de tórax-abdomen urgente, un ecocardiograma y una RM craneal, que objetivan imagen de una gran masa de 5 cm2 a nivel de la aurícula derecha sugerente de endocarditis aguda con tromboembolismos sépticos pulmonares bilaterales diseminados con derrame pleural derecho en moderada cuantía asociado (probablemente paraneumónico), hígado de estasis y ascitis leve-moderada.
La paciente presentó disnea progresiva en el contexto de derrame pleural y sobrecarga hídrica para tratamiento del shock séptico que precisó de toracocentesis evacuadora en tres ocasiones (débito > 2.750 cc en total), objetivando líquido inflamatorio sin afectación neoplásica.
En reunión multidisciplinar (Cardiología, Infecciones, Radiología, UCI y Oncología) se descarta la opción de cirugía cardíaca dados el mal estado general y la progresión de la enfermedad de base, por lo que se decide tratamiento médico conservador (antibiótico dirigido frente al estafilococo aislado, con cloxacilina y amikacina, manteniendo linezolid); se inicia anticoagulación; se retira el foco de infección (aislándose estafilococo en punta del catéter similar al extraído en los hemocultivos de sangre periférica) y se canaliza una nueva vía central a nivel yugular izquierdo para nutrición parenteral y administración de medicación.
Con dichas medidas, se consigue la desaparición de la fiebre y a las 3 semanas presenta mejoría radiológica, analítica (normalización de leucocitos, plaquetas y coagulación), ecocardiográfica (práctica desaparición de la masa auricular) y mejoría de reactantes inflamatorios (PCR pasa de 30 mg/dl a 4 mg/dl), por lo que se reduce el espectro antibiótico.
Durante la evolución del cuadro se trabaja de forma continua el aspecto psicológico con la paciente y au familia junto a una psicóloga, enfermería y el equipo médico, entendiendo la gravedad del cuadro y aceptando el deterioro progresivo pese a todas las medidas tomadas.
A pesar de ello, la paciente mantiene un deterioro clínico progresivo con persistencia de náuseas y vómitos en relación con secreciones bronquiales paraneumónicas de muy difícil control pese a la asociación de múltiples antieméticos. La paciente presenta un nuevo deterioro clínico, con disminución marcada del nivel de consciencia, agitación y fracaso multiorgánico que no responde a ltratamiento y fallece en paz, sin signos de sufrimiento a las 24 horas del deterioro tras 70 días de ingreso.
Instructions: please typing these entity words according to sentence: linitis plástica, adenocarcinoma, afectación a distancia, adenocarcinoma gástrico con células en anillo de sello , grado 3, neoplásica, pT2bN0/15M0, afectación peritoneal, implantes peritoneales, malignos, Adenocarcinoma gástrico reintervenido estadio IV ( metástasis, neoplásica
Options: MORFOLOGIA_NEOPLASIA
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] | Anamnesis
Mujer de 53 años. Sin alergias conocidas, hábitos tóxicos ni patología previa de interés salvo la oncológica. Intervenida de cesárea, hemorroides y apendicectomía.
Situación sociofamiliar: vive con su esposo (que es el cuidador principal y trabaja de celador en un hospital) y tienen dos hijos de 24 y 28 años. Es ama de casa y su situación basal previa a su ingreso es de dependiencia (índice de Barthel 40). Tienen un buen nivel de información sobre el diagnóstico y pronóstico de la enfermedad.
Historia oncológica: desde julio de 2010 comienza con náuseas y vómitos postprandiales, y tras consultar en tres ocasiones al Servicio de Urgencias se realiza ecografía abdominal, objetivando engrosamiento de la pared antral, por lo que ingresa para estudio.
Tras objetivar en al endoscopia hallazgos de linitis plástica y biopsia compatible con adenocarcinoma gástrico, se descarta afectación a distancia, y se programa para laparoscopia exploradora en septiembre de 2010, realizándose gastrectomía subtotal y reconstrucción Billroth II y se diagnostica de adenocarcinoma gástrico con células en anillo de sello, grado 3, pobremente diferenciado con abundante invasión perineural, márgenes quirúrgicos libres de infiltración neoplásica, pT2bN0/15M0 (estadio IB) con factores de mal pronóstico.
Se decide tratamiento adyuvante según esquema Mac Donalds, finalizando tratamiento RT el 3/3/2011 (dosis total de 50,4 Gy: 28 sesiones, 1,8 Gy/sesión).
Se mantiene estable, hasta que en julio de 2013 comienza con pérdida de peso severa y anorexia, realizándose el estudio de extensión que objetiva recidiva local con dudosa afectación peritoneal, por lo que, tras la realización de la PET negativa, es derivada para valoración de cirugía de rescate, que se desestima, por lo que se decide inicio de tratamiento con ECF (tras dos ciclos muestra mala tolerancia por mucositis y diarrea G2-3), por lo que se modifica por Folfox-6 (disminución de dosis tras el tercer ciclo por toxicidad hematológica), retirando el oxaliplatino tras el sexto ciclo por reacción alérgica grave, manteniendo 5-FU + leuco hasta completar siete ciclos más, finalizando en mayo de 2014.
Tras respuesta parcial en las pruebas de imagen, se decide realizar una intervención sobre recidiva a nivel de la anastomosis (14/10/2014), con postoperatorio tórpido por aparición de fístula enteropancreática. AP: pT4bN0 (por infiltración de asa intestinal), estadio IIIb.
Mantuvo revisiones sin evidencia de enfermedad hasta principios de marzo de 2015, cuando ingresa para estudio por un cuadro de varios meses de pérdida de peso cuantificada en 20 kg, con importante afectación del estado general, astenia intensa y náuseas pese al tratamiento con progestágenos, corticoides orales, suplementos proteicos y seguimiento en consultas de Nutrición. Portadora de port-a-cath® desde 2010.
Exploración física
A su llegada a planta, paciente estable hemodinámicamente. Afebril. Eupneica en reposo. Consciente, orientada y con sensorio plenamente conservado. Caquexia extrema y sarcopenia generalizada. Peso 32 kg. Talla 158 cm. A nivel infraclavicular derecho, reservorio subcutáneo sin datos de infección local. Resto de la exploración anodina.
Pruebas complementarias
» Analítica a su llegada (13-3-2015). Hemograma: anemia leve normocítica y normocroma. Serie blanca y plaquetaria normal. Bioquímica completa, incluyendo función hepática, CPK, troponinas, amilasa normal, salvo proteínas totales 4,79 mg/dl.
» TC de tórax y abdomen sin contraste (16-3-2015): sin alteraciones significativas.
» Estudio gastroduodenal (20-3-2015): sin alteraciones (tránsito rápido por yeyuno).
» Ecocardiograma transtorácico (30-3-2015): masa móvil de unos 5 cm2 de superficie en la aurícula derecha, probablemente procedente de la vena cava superior que protruye durante la diástole hacia el ventrículo derecho. Derrame pericárdico leve posterior con fracción de eyección conservada y válvulas sin alteraciones.
» Radiografía de tórax urgente (30-3-2015): aumento de densidad en la parte medial y posterior del lóbulo inferior derecho de nueva aparición.
» RM craneal con contraste (1-4-2015): imágenes sugerentes de posibles embolismos milimétricos distribuidos por ambos hemisferios.
» TC de tórax y abdomen con contraste (4-4-2015): tromboembolismo pulmonar con afectación de la arteria del lóbulo inferior derecho y múltiples ramas segmentarias. Condensación pulmonar en el lóbulo inferior derecho con derrame pleural paraneumónico y derrame pleural loculado izquierdo. Pequeñas opacidades pulmonares parenquimatosas periféricas y pequeños infiltrados pulmonares en el hemitórax izquierdo, uno de ellos con cavitación compatible con embolismos sépticos. Derrame pericárdico.
Hígado de estasis. Ascitis e implantes peritoneales malignos.
» Radiografía de tórax (7-5-2015): importante derrame pleural derecho con atelectasia compresiva del lóbulo inferior. Discreto derrame pleural izquierdo.
» Ecocardiograma transtorácico (16-5-2015): masa móvil en el techo de la aurícula derecha de tamaño mucho más reducido que en estudios previos, limitada a la vena cava superior y sin protrusión hacia el ventrículo.
Diagnóstico
» Tromboembolismos sépticos pulmonares diseminados, secundarios a endocarditis aguda y bacteriemia por Staphylococcus capitis/ureoliticus
» Adenocarcinoma gástrico reintervenido estadio IV (metástasis peritoneales).
» Derrame pleural derecho paraneumónico recurrente evacuado mediante toracocentesis.
» Desnutrición calórico-proteica severa que precisa nutrición parenteral.
» Delirium hipoactivo en el contexto de sepsis y neoplasia.
Tratamiento
A su llegada iniciamos nutrición parenteral, aumentamos la dosis de corticoide y se pauta cinitaprida como procinético, mejorando la tolerancia a la dieta. Tras descartar datos de progresión de la enfermedad en las pruebas previamente referidas, se inician preparativos para el alta hospitalaria, pero el día previo a la misma la paciente presenta un cuadro séptico con hipotensión, fiebre con tiritona y deterioro del estado general, con agudización de las náuseas y los vómitos.
Se solicitan hemocultivos de sangre periférica, urocultivo, orina, análisis y radiografía de tórax, detectando un cuadro compatible con cuadro séptico grave de origen pulmonar. Se pauta sueroterapia intensa, antieméticos y antibioterapia de amplio espectro por neumonía nosocomial en paciente inmunodeprimida.
Evolución
A las 48 horas nos informan de crecimiento en hemocultivos de sangre periférica Staphylococcus coagulasa negativo capitis/ureoliticus meticilín sensible, por lo que tras consultar con el Servicio de Infecciones se decide ampliar el espectro antibiótico y añadir linezolid, al tener mayor impregnación a nivel pulmonar. Pese a dichas medidas y los antitérmicos pautados, la paciente persiste con fiebre mantenida de 38 ºC y muy mal estado general (secreciones en la boca de coloración clara, espumosas; la paciente está nauseosa, muy decaída, con cuadro de delirium y disartria asociado). Ante la evolución tórpida se añade tratamiento antifúngico i.v. y se solicita una TC de tórax-abdomen urgente, un ecocardiograma y una RM craneal, que objetivan imagen de una gran masa de 5 cm2 a nivel de la aurícula derecha sugerente de endocarditis aguda con tromboembolismos sépticos pulmonares bilaterales diseminados con derrame pleural derecho en moderada cuantía asociado (probablemente paraneumónico), hígado de estasis y ascitis leve-moderada.
La paciente presentó disnea progresiva en el contexto de derrame pleural y sobrecarga hídrica para tratamiento del shock séptico que precisó de toracocentesis evacuadora en tres ocasiones (débito > 2.750 cc en total), objetivando líquido inflamatorio sin afectación neoplásica.
En reunión multidisciplinar (Cardiología, Infecciones, Radiología, UCI y Oncología) se descarta la opción de cirugía cardíaca dados el mal estado general y la progresión de la enfermedad de base, por lo que se decide tratamiento médico conservador (antibiótico dirigido frente al estafilococo aislado, con cloxacilina y amikacina, manteniendo linezolid); se inicia anticoagulación; se retira el foco de infección (aislándose estafilococo en punta del catéter similar al extraído en los hemocultivos de sangre periférica) y se canaliza una nueva vía central a nivel yugular izquierdo para nutrición parenteral y administración de medicación.
Con dichas medidas, se consigue la desaparición de la fiebre y a las 3 semanas presenta mejoría radiológica, analítica (normalización de leucocitos, plaquetas y coagulación), ecocardiográfica (práctica desaparición de la masa auricular) y mejoría de reactantes inflamatorios (PCR pasa de 30 mg/dl a 4 mg/dl), por lo que se reduce el espectro antibiótico.
Durante la evolución del cuadro se trabaja de forma continua el aspecto psicológico con la paciente y au familia junto a una psicóloga, enfermería y el equipo médico, entendiendo la gravedad del cuadro y aceptando el deterioro progresivo pese a todas las medidas tomadas.
A pesar de ello, la paciente mantiene un deterioro clínico progresivo con persistencia de náuseas y vómitos en relación con secreciones bronquiales paraneumónicas de muy difícil control pese a la asociación de múltiples antieméticos. La paciente presenta un nuevo deterioro clínico, con disminución marcada del nivel de consciencia, agitación y fracaso multiorgánico que no responde a ltratamiento y fallece en paz, sin signos de sufrimiento a las 24 horas del deterioro tras 70 días de ingreso.
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linitis plástica, adenocarcinoma, afectación a distancia, adenocarcinoma gástrico con células en anillo de sello , grado 3, neoplásica, pT2bN0/15M0, afectación peritoneal, implantes peritoneales, malignos, Adenocarcinoma gástrico reintervenido estadio IV ( metástasis, neoplásica | 413_task2 | Sentence: Anamnesis
Mujer de 53 años. Sin alergias conocidas, hábitos tóxicos ni patología previa de interés salvo la oncológica. Intervenida de cesárea, hemorroides y apendicectomía.
Situación sociofamiliar: vive con su esposo (que es el cuidador principal y trabaja de celador en un hospital) y tienen dos hijos de 24 y 28 años. Es ama de casa y su situación basal previa a su ingreso es de dependiencia (índice de Barthel 40). Tienen un buen nivel de información sobre el diagnóstico y pronóstico de la enfermedad.
Historia oncológica: desde julio de 2010 comienza con náuseas y vómitos postprandiales, y tras consultar en tres ocasiones al Servicio de Urgencias se realiza ecografía abdominal, objetivando engrosamiento de la pared antral, por lo que ingresa para estudio.
Tras objetivar en al endoscopia hallazgos de linitis plástica y biopsia compatible con adenocarcinoma gástrico, se descarta afectación a distancia, y se programa para laparoscopia exploradora en septiembre de 2010, realizándose gastrectomía subtotal y reconstrucción Billroth II y se diagnostica de adenocarcinoma gástrico con células en anillo de sello, grado 3, pobremente diferenciado con abundante invasión perineural, márgenes quirúrgicos libres de infiltración neoplásica, pT2bN0/15M0 (estadio IB) con factores de mal pronóstico.
Se decide tratamiento adyuvante según esquema Mac Donalds, finalizando tratamiento RT el 3/3/2011 (dosis total de 50,4 Gy: 28 sesiones, 1,8 Gy/sesión).
Se mantiene estable, hasta que en julio de 2013 comienza con pérdida de peso severa y anorexia, realizándose el estudio de extensión que objetiva recidiva local con dudosa afectación peritoneal, por lo que, tras la realización de la PET negativa, es derivada para valoración de cirugía de rescate, que se desestima, por lo que se decide inicio de tratamiento con ECF (tras dos ciclos muestra mala tolerancia por mucositis y diarrea G2-3), por lo que se modifica por Folfox-6 (disminución de dosis tras el tercer ciclo por toxicidad hematológica), retirando el oxaliplatino tras el sexto ciclo por reacción alérgica grave, manteniendo 5-FU + leuco hasta completar siete ciclos más, finalizando en mayo de 2014.
Tras respuesta parcial en las pruebas de imagen, se decide realizar una intervención sobre recidiva a nivel de la anastomosis (14/10/2014), con postoperatorio tórpido por aparición de fístula enteropancreática. AP: pT4bN0 (por infiltración de asa intestinal), estadio IIIb.
Mantuvo revisiones sin evidencia de enfermedad hasta principios de marzo de 2015, cuando ingresa para estudio por un cuadro de varios meses de pérdida de peso cuantificada en 20 kg, con importante afectación del estado general, astenia intensa y náuseas pese al tratamiento con progestágenos, corticoides orales, suplementos proteicos y seguimiento en consultas de Nutrición. Portadora de port-a-cath® desde 2010.
Exploración física
A su llegada a planta, paciente estable hemodinámicamente. Afebril. Eupneica en reposo. Consciente, orientada y con sensorio plenamente conservado. Caquexia extrema y sarcopenia generalizada. Peso 32 kg. Talla 158 cm. A nivel infraclavicular derecho, reservorio subcutáneo sin datos de infección local. Resto de la exploración anodina.
Pruebas complementarias
» Analítica a su llegada (13-3-2015). Hemograma: anemia leve normocítica y normocroma. Serie blanca y plaquetaria normal. Bioquímica completa, incluyendo función hepática, CPK, troponinas, amilasa normal, salvo proteínas totales 4,79 mg/dl.
» TC de tórax y abdomen sin contraste (16-3-2015): sin alteraciones significativas.
» Estudio gastroduodenal (20-3-2015): sin alteraciones (tránsito rápido por yeyuno).
» Ecocardiograma transtorácico (30-3-2015): masa móvil de unos 5 cm2 de superficie en la aurícula derecha, probablemente procedente de la vena cava superior que protruye durante la diástole hacia el ventrículo derecho. Derrame pericárdico leve posterior con fracción de eyección conservada y válvulas sin alteraciones.
» Radiografía de tórax urgente (30-3-2015): aumento de densidad en la parte medial y posterior del lóbulo inferior derecho de nueva aparición.
» RM craneal con contraste (1-4-2015): imágenes sugerentes de posibles embolismos milimétricos distribuidos por ambos hemisferios.
» TC de tórax y abdomen con contraste (4-4-2015): tromboembolismo pulmonar con afectación de la arteria del lóbulo inferior derecho y múltiples ramas segmentarias. Condensación pulmonar en el lóbulo inferior derecho con derrame pleural paraneumónico y derrame pleural loculado izquierdo. Pequeñas opacidades pulmonares parenquimatosas periféricas y pequeños infiltrados pulmonares en el hemitórax izquierdo, uno de ellos con cavitación compatible con embolismos sépticos. Derrame pericárdico.
Hígado de estasis. Ascitis e implantes peritoneales malignos.
» Radiografía de tórax (7-5-2015): importante derrame pleural derecho con atelectasia compresiva del lóbulo inferior. Discreto derrame pleural izquierdo.
» Ecocardiograma transtorácico (16-5-2015): masa móvil en el techo de la aurícula derecha de tamaño mucho más reducido que en estudios previos, limitada a la vena cava superior y sin protrusión hacia el ventrículo.
Diagnóstico
» Tromboembolismos sépticos pulmonares diseminados, secundarios a endocarditis aguda y bacteriemia por Staphylococcus capitis/ureoliticus
» Adenocarcinoma gástrico reintervenido estadio IV (metástasis peritoneales).
» Derrame pleural derecho paraneumónico recurrente evacuado mediante toracocentesis.
» Desnutrición calórico-proteica severa que precisa nutrición parenteral.
» Delirium hipoactivo en el contexto de sepsis y neoplasia.
Tratamiento
A su llegada iniciamos nutrición parenteral, aumentamos la dosis de corticoide y se pauta cinitaprida como procinético, mejorando la tolerancia a la dieta. Tras descartar datos de progresión de la enfermedad en las pruebas previamente referidas, se inician preparativos para el alta hospitalaria, pero el día previo a la misma la paciente presenta un cuadro séptico con hipotensión, fiebre con tiritona y deterioro del estado general, con agudización de las náuseas y los vómitos.
Se solicitan hemocultivos de sangre periférica, urocultivo, orina, análisis y radiografía de tórax, detectando un cuadro compatible con cuadro séptico grave de origen pulmonar. Se pauta sueroterapia intensa, antieméticos y antibioterapia de amplio espectro por neumonía nosocomial en paciente inmunodeprimida.
Evolución
A las 48 horas nos informan de crecimiento en hemocultivos de sangre periférica Staphylococcus coagulasa negativo capitis/ureoliticus meticilín sensible, por lo que tras consultar con el Servicio de Infecciones se decide ampliar el espectro antibiótico y añadir linezolid, al tener mayor impregnación a nivel pulmonar. Pese a dichas medidas y los antitérmicos pautados, la paciente persiste con fiebre mantenida de 38 ºC y muy mal estado general (secreciones en la boca de coloración clara, espumosas; la paciente está nauseosa, muy decaída, con cuadro de delirium y disartria asociado). Ante la evolución tórpida se añade tratamiento antifúngico i.v. y se solicita una TC de tórax-abdomen urgente, un ecocardiograma y una RM craneal, que objetivan imagen de una gran masa de 5 cm2 a nivel de la aurícula derecha sugerente de endocarditis aguda con tromboembolismos sépticos pulmonares bilaterales diseminados con derrame pleural derecho en moderada cuantía asociado (probablemente paraneumónico), hígado de estasis y ascitis leve-moderada.
La paciente presentó disnea progresiva en el contexto de derrame pleural y sobrecarga hídrica para tratamiento del shock séptico que precisó de toracocentesis evacuadora en tres ocasiones (débito > 2.750 cc en total), objetivando líquido inflamatorio sin afectación neoplásica.
En reunión multidisciplinar (Cardiología, Infecciones, Radiología, UCI y Oncología) se descarta la opción de cirugía cardíaca dados el mal estado general y la progresión de la enfermedad de base, por lo que se decide tratamiento médico conservador (antibiótico dirigido frente al estafilococo aislado, con cloxacilina y amikacina, manteniendo linezolid); se inicia anticoagulación; se retira el foco de infección (aislándose estafilococo en punta del catéter similar al extraído en los hemocultivos de sangre periférica) y se canaliza una nueva vía central a nivel yugular izquierdo para nutrición parenteral y administración de medicación.
Con dichas medidas, se consigue la desaparición de la fiebre y a las 3 semanas presenta mejoría radiológica, analítica (normalización de leucocitos, plaquetas y coagulación), ecocardiográfica (práctica desaparición de la masa auricular) y mejoría de reactantes inflamatorios (PCR pasa de 30 mg/dl a 4 mg/dl), por lo que se reduce el espectro antibiótico.
Durante la evolución del cuadro se trabaja de forma continua el aspecto psicológico con la paciente y au familia junto a una psicóloga, enfermería y el equipo médico, entendiendo la gravedad del cuadro y aceptando el deterioro progresivo pese a todas las medidas tomadas.
A pesar de ello, la paciente mantiene un deterioro clínico progresivo con persistencia de náuseas y vómitos en relación con secreciones bronquiales paraneumónicas de muy difícil control pese a la asociación de múltiples antieméticos. La paciente presenta un nuevo deterioro clínico, con disminución marcada del nivel de consciencia, agitación y fracaso multiorgánico que no responde a ltratamiento y fallece en paz, sin signos de sufrimiento a las 24 horas del deterioro tras 70 días de ingreso.
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] | Anamnesis
Mujer de 53 años. Sin alergias conocidas, hábitos tóxicos ni patología previa de interés salvo la oncológica. Intervenida de cesárea, hemorroides y apendicectomía.
Situación sociofamiliar: vive con su esposo (que es el cuidador principal y trabaja de celador en un hospital) y tienen dos hijos de 24 y 28 años. Es ama de casa y su situación basal previa a su ingreso es de dependiencia (índice de Barthel 40). Tienen un buen nivel de información sobre el diagnóstico y pronóstico de la enfermedad.
Historia oncológica: desde julio de 2010 comienza con náuseas y vómitos postprandiales, y tras consultar en tres ocasiones al Servicio de Urgencias se realiza ecografía abdominal, objetivando engrosamiento de la pared antral, por lo que ingresa para estudio.
Tras objetivar en al endoscopia hallazgos de linitis plástica y biopsia compatible con adenocarcinoma gástrico, se descarta afectación a distancia, y se programa para laparoscopia exploradora en septiembre de 2010, realizándose gastrectomía subtotal y reconstrucción Billroth II y se diagnostica de adenocarcinoma gástrico con células en anillo de sello, grado 3, pobremente diferenciado con abundante invasión perineural, márgenes quirúrgicos libres de infiltración neoplásica, pT2bN0/15M0 (estadio IB) con factores de mal pronóstico.
Se decide tratamiento adyuvante según esquema Mac Donalds, finalizando tratamiento RT el 3/3/2011 (dosis total de 50,4 Gy: 28 sesiones, 1,8 Gy/sesión).
Se mantiene estable, hasta que en julio de 2013 comienza con pérdida de peso severa y anorexia, realizándose el estudio de extensión que objetiva recidiva local con dudosa afectación peritoneal, por lo que, tras la realización de la PET negativa, es derivada para valoración de cirugía de rescate, que se desestima, por lo que se decide inicio de tratamiento con ECF (tras dos ciclos muestra mala tolerancia por mucositis y diarrea G2-3), por lo que se modifica por Folfox-6 (disminución de dosis tras el tercer ciclo por toxicidad hematológica), retirando el oxaliplatino tras el sexto ciclo por reacción alérgica grave, manteniendo 5-FU + leuco hasta completar siete ciclos más, finalizando en mayo de 2014.
Tras respuesta parcial en las pruebas de imagen, se decide realizar una intervención sobre recidiva a nivel de la anastomosis (14/10/2014), con postoperatorio tórpido por aparición de fístula enteropancreática. AP: pT4bN0 (por infiltración de asa intestinal), estadio IIIb.
Mantuvo revisiones sin evidencia de enfermedad hasta principios de marzo de 2015, cuando ingresa para estudio por un cuadro de varios meses de pérdida de peso cuantificada en 20 kg, con importante afectación del estado general, astenia intensa y náuseas pese al tratamiento con progestágenos, corticoides orales, suplementos proteicos y seguimiento en consultas de Nutrición. Portadora de port-a-cath® desde 2010.
Exploración física
A su llegada a planta, paciente estable hemodinámicamente. Afebril. Eupneica en reposo. Consciente, orientada y con sensorio plenamente conservado. Caquexia extrema y sarcopenia generalizada. Peso 32 kg. Talla 158 cm. A nivel infraclavicular derecho, reservorio subcutáneo sin datos de infección local. Resto de la exploración anodina.
Pruebas complementarias
» Analítica a su llegada (13-3-2015). Hemograma: anemia leve normocítica y normocroma. Serie blanca y plaquetaria normal. Bioquímica completa, incluyendo función hepática, CPK, troponinas, amilasa normal, salvo proteínas totales 4,79 mg/dl.
» TC de tórax y abdomen sin contraste (16-3-2015): sin alteraciones significativas.
» Estudio gastroduodenal (20-3-2015): sin alteraciones (tránsito rápido por yeyuno).
» Ecocardiograma transtorácico (30-3-2015): masa móvil de unos 5 cm2 de superficie en la aurícula derecha, probablemente procedente de la vena cava superior que protruye durante la diástole hacia el ventrículo derecho. Derrame pericárdico leve posterior con fracción de eyección conservada y válvulas sin alteraciones.
» Radiografía de tórax urgente (30-3-2015): aumento de densidad en la parte medial y posterior del lóbulo inferior derecho de nueva aparición.
» RM craneal con contraste (1-4-2015): imágenes sugerentes de posibles embolismos milimétricos distribuidos por ambos hemisferios.
» TC de tórax y abdomen con contraste (4-4-2015): tromboembolismo pulmonar con afectación de la arteria del lóbulo inferior derecho y múltiples ramas segmentarias. Condensación pulmonar en el lóbulo inferior derecho con derrame pleural paraneumónico y derrame pleural loculado izquierdo. Pequeñas opacidades pulmonares parenquimatosas periféricas y pequeños infiltrados pulmonares en el hemitórax izquierdo, uno de ellos con cavitación compatible con embolismos sépticos. Derrame pericárdico.
Hígado de estasis. Ascitis e implantes peritoneales malignos.
» Radiografía de tórax (7-5-2015): importante derrame pleural derecho con atelectasia compresiva del lóbulo inferior. Discreto derrame pleural izquierdo.
» Ecocardiograma transtorácico (16-5-2015): masa móvil en el techo de la aurícula derecha de tamaño mucho más reducido que en estudios previos, limitada a la vena cava superior y sin protrusión hacia el ventrículo.
Diagnóstico
» Tromboembolismos sépticos pulmonares diseminados, secundarios a endocarditis aguda y bacteriemia por Staphylococcus capitis/ureoliticus
» Adenocarcinoma gástrico reintervenido estadio IV (metástasis peritoneales).
» Derrame pleural derecho paraneumónico recurrente evacuado mediante toracocentesis.
» Desnutrición calórico-proteica severa que precisa nutrición parenteral.
» Delirium hipoactivo en el contexto de sepsis y neoplasia.
Tratamiento
A su llegada iniciamos nutrición parenteral, aumentamos la dosis de corticoide y se pauta cinitaprida como procinético, mejorando la tolerancia a la dieta. Tras descartar datos de progresión de la enfermedad en las pruebas previamente referidas, se inician preparativos para el alta hospitalaria, pero el día previo a la misma la paciente presenta un cuadro séptico con hipotensión, fiebre con tiritona y deterioro del estado general, con agudización de las náuseas y los vómitos.
Se solicitan hemocultivos de sangre periférica, urocultivo, orina, análisis y radiografía de tórax, detectando un cuadro compatible con cuadro séptico grave de origen pulmonar. Se pauta sueroterapia intensa, antieméticos y antibioterapia de amplio espectro por neumonía nosocomial en paciente inmunodeprimida.
Evolución
A las 48 horas nos informan de crecimiento en hemocultivos de sangre periférica Staphylococcus coagulasa negativo capitis/ureoliticus meticilín sensible, por lo que tras consultar con el Servicio de Infecciones se decide ampliar el espectro antibiótico y añadir linezolid, al tener mayor impregnación a nivel pulmonar. Pese a dichas medidas y los antitérmicos pautados, la paciente persiste con fiebre mantenida de 38 ºC y muy mal estado general (secreciones en la boca de coloración clara, espumosas; la paciente está nauseosa, muy decaída, con cuadro de delirium y disartria asociado). Ante la evolución tórpida se añade tratamiento antifúngico i.v. y se solicita una TC de tórax-abdomen urgente, un ecocardiograma y una RM craneal, que objetivan imagen de una gran masa de 5 cm2 a nivel de la aurícula derecha sugerente de endocarditis aguda con tromboembolismos sépticos pulmonares bilaterales diseminados con derrame pleural derecho en moderada cuantía asociado (probablemente paraneumónico), hígado de estasis y ascitis leve-moderada.
La paciente presentó disnea progresiva en el contexto de derrame pleural y sobrecarga hídrica para tratamiento del shock séptico que precisó de toracocentesis evacuadora en tres ocasiones (débito > 2.750 cc en total), objetivando líquido inflamatorio sin afectación neoplásica.
En reunión multidisciplinar (Cardiología, Infecciones, Radiología, UCI y Oncología) se descarta la opción de cirugía cardíaca dados el mal estado general y la progresión de la enfermedad de base, por lo que se decide tratamiento médico conservador (antibiótico dirigido frente al estafilococo aislado, con cloxacilina y amikacina, manteniendo linezolid); se inicia anticoagulación; se retira el foco de infección (aislándose estafilococo en punta del catéter similar al extraído en los hemocultivos de sangre periférica) y se canaliza una nueva vía central a nivel yugular izquierdo para nutrición parenteral y administración de medicación.
Con dichas medidas, se consigue la desaparición de la fiebre y a las 3 semanas presenta mejoría radiológica, analítica (normalización de leucocitos, plaquetas y coagulación), ecocardiográfica (práctica desaparición de la masa auricular) y mejoría de reactantes inflamatorios (PCR pasa de 30 mg/dl a 4 mg/dl), por lo que se reduce el espectro antibiótico.
Durante la evolución del cuadro se trabaja de forma continua el aspecto psicológico con la paciente y au familia junto a una psicóloga, enfermería y el equipo médico, entendiendo la gravedad del cuadro y aceptando el deterioro progresivo pese a todas las medidas tomadas.
A pesar de ello, la paciente mantiene un deterioro clínico progresivo con persistencia de náuseas y vómitos en relación con secreciones bronquiales paraneumónicas de muy difícil control pese a la asociación de múltiples antieméticos. La paciente presenta un nuevo deterioro clínico, con disminución marcada del nivel de consciencia, agitación y fracaso multiorgánico que no responde a ltratamiento y fallece en paz, sin signos de sufrimiento a las 24 horas del deterioro tras 70 días de ingreso.
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RB1 is a Gene, RB1 is a Gene, RB1 is a Gene, E1A is a Gene, RB1 is a Gene | 226_task0 | Sentence: Detection of mutations of the RB1 gene in retinoblastoma patients by using exon-by-exon PCR-SSCP analysis. Most sporadic cases of retinoblastoma, malignant eye tumor of children, may require the identification of a mutation of the retinoblastoma gene (RB1 gene) for precise genetic counseling. We established a mutation detection system of and screened for the RB1 gene mutation in 24 patients with retinoblastoma--12 bilateral patients and 12 unilateral patients. Mutation analysis was performed by PCR-mediated SSCP analysis in the entire coding region and promoter region, as an initial screening method, followed by direct genomic sequencing. Possible oncogenic mutations were identified in 14 (58%) of 24 tumors, of which 6 were single base substitutions, 4 were small deletions, 3 were small insertions, and 1 was a complex alteration due to deletion-insertion. A constitutional somatic mosaicism was suggested in one bilateral patient. A majority (57%) of mutations were found in E1A binding domains, and all were presumed to truncate the normal gene products. The mutation analysis presented here may provide a basis for the screening system of RB1 gene mutations in retinoblastoma patients.
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RB1 is a Gene, RB1 is a Gene, RB1 is a Gene, E1A is a Gene, RB1 is a Gene | 226_task1 | Sentence: Detection of mutations of the RB1 gene in retinoblastoma patients by using exon-by-exon PCR-SSCP analysis. Most sporadic cases of retinoblastoma, malignant eye tumor of children, may require the identification of a mutation of the retinoblastoma gene (RB1 gene) for precise genetic counseling. We established a mutation detection system of and screened for the RB1 gene mutation in 24 patients with retinoblastoma--12 bilateral patients and 12 unilateral patients. Mutation analysis was performed by PCR-mediated SSCP analysis in the entire coding region and promoter region, as an initial screening method, followed by direct genomic sequencing. Possible oncogenic mutations were identified in 14 (58%) of 24 tumors, of which 6 were single base substitutions, 4 were small deletions, 3 were small insertions, and 1 was a complex alteration due to deletion-insertion. A constitutional somatic mosaicism was suggested in one bilateral patient. A majority (57%) of mutations were found in E1A binding domains, and all were presumed to truncate the normal gene products. The mutation analysis presented here may provide a basis for the screening system of RB1 gene mutations in retinoblastoma patients.
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RB1, RB1, RB1, E1A, RB1 | 226_task2 | Sentence: Detection of mutations of the RB1 gene in retinoblastoma patients by using exon-by-exon PCR-SSCP analysis. Most sporadic cases of retinoblastoma, malignant eye tumor of children, may require the identification of a mutation of the retinoblastoma gene (RB1 gene) for precise genetic counseling. We established a mutation detection system of and screened for the RB1 gene mutation in 24 patients with retinoblastoma--12 bilateral patients and 12 unilateral patients. Mutation analysis was performed by PCR-mediated SSCP analysis in the entire coding region and promoter region, as an initial screening method, followed by direct genomic sequencing. Possible oncogenic mutations were identified in 14 (58%) of 24 tumors, of which 6 were single base substitutions, 4 were small deletions, 3 were small insertions, and 1 was a complex alteration due to deletion-insertion. A constitutional somatic mosaicism was suggested in one bilateral patient. A majority (57%) of mutations were found in E1A binding domains, and all were presumed to truncate the normal gene products. The mutation analysis presented here may provide a basis for the screening system of RB1 gene mutations in retinoblastoma patients.
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Children is a Person, undergoing is a Temporal, ENT surgery is a Procedure, general anaesthesia is a Procedure | NCT02455921_inc_task0 | Sentence: Children undergoing ENT surgery under general anaesthesia.
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Children is a Person, undergoing is a Temporal, ENT surgery is a Procedure, general anaesthesia is a Procedure | NCT02455921_inc_task1 | Sentence: Children undergoing ENT surgery under general anaesthesia.
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Children, undergoing, ENT surgery, general anaesthesia | NCT02455921_inc_task2 | Sentence: Children undergoing ENT surgery under general anaesthesia.
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magnesium sulphate infusion is a Intervention_Pharmacological, Magnesium sulphate is a Intervention_Pharmacological, anaesthetic consumption is a Outcome_Physical, analgesic requirements . is a Outcome_Physical, duration of block , sedation and analgesic consumption is a Outcome_Physical, after spinal anaesthesia is a Participant_Condition, Fifty is a Participant_Sample-size, ASA I - II patients is a Participant_Condition, Spinal anaesthesia was performed at L3 - 4 or L4 - 5 interspace with 12.5 mg 0.5 % heavy bupivacaine , using a 25 G Quincke needle is a Intervention_Surgical, 5 mg kg ( -1 ) bolus of magnesium sulphate followed by a 500 mg h ( -1 ) infusion or saline is a Intervention_Pharmacological, Time to first pain , analgesic request is a Outcome_Pain, return of motor function is a Outcome_Physical, visual analogue pain is a Outcome_Pain, sedation scores is a Outcome_Physical, Vital signs is a Outcome_Physical, time to analgesic need is a Outcome_Pain, total analgesic consumption is a Outcome_Pain | 20330_task0 | Sentence: Postoperative magnesium sulphate infusion reduces analgesic requirements in spinal anaesthesia . BACKGROUND AND OBJECTIVES Magnesium sulphate infusion during general anaesthesia reduces anaesthetic consumption and analgesic requirements . The aim of this study was to assess the effects of postoperative magnesium infusion on duration of block , sedation and analgesic consumption after spinal anaesthesia . METHODS Fifty ASA I-II patients were included in the randomized double blind study . Spinal anaesthesia was performed at L3-4 or L4-5 interspace with 12.5 mg 0.5 % heavy bupivacaine , using a 25 G Quincke needle . Patients received a 5 mg kg ( -1 ) bolus of magnesium sulphate followed by a 500 mg h ( -1 ) infusion or saline in the same volumes for 24 h. Time to first pain , analgesic request , return of motor function , visual analogue pain and sedation scores were evaluated every 4 h during the 24 h postoperative period . The t- and U-tests were used for statistical analyses . Data were expressed as mean +/- SD , with P < 0.05 being considered significant . RESULTS Vital signs were stable during spinal anaesthesia and postoperative period . When compared to the control group , time to analgesic need was increased and total analgesic consumption was reduced in the magnesium group ( meperidine consumption 60.0 +/- 73.1 mg control group , 31.8 +/- 30.7 mg magnesium group , P = 0.02 ) . CONCLUSIONS Magnesium sulphate infusion may be used as an adjunct for reducing analgesic consumption after spinal anaesthesia .
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] | Postoperative magnesium sulphate infusion reduces analgesic requirements in spinal anaesthesia . BACKGROUND AND OBJECTIVES Magnesium sulphate infusion during general anaesthesia reduces anaesthetic consumption and analgesic requirements . The aim of this study was to assess the effects of postoperative magnesium infusion on duration of block , sedation and analgesic consumption after spinal anaesthesia . METHODS Fifty ASA I-II patients were included in the randomized double blind study . Spinal anaesthesia was performed at L3-4 or L4-5 interspace with 12.5 mg 0.5 % heavy bupivacaine , using a 25 G Quincke needle . Patients received a 5 mg kg ( -1 ) bolus of magnesium sulphate followed by a 500 mg h ( -1 ) infusion or saline in the same volumes for 24 h. Time to first pain , analgesic request , return of motor function , visual analogue pain and sedation scores were evaluated every 4 h during the 24 h postoperative period . The t- and U-tests were used for statistical analyses . Data were expressed as mean +/- SD , with P < 0.05 being considered significant . RESULTS Vital signs were stable during spinal anaesthesia and postoperative period . When compared to the control group , time to analgesic need was increased and total analgesic consumption was reduced in the magnesium group ( meperidine consumption 60.0 +/- 73.1 mg control group , 31.8 +/- 30.7 mg magnesium group , P = 0.02 ) . CONCLUSIONS Magnesium sulphate infusion may be used as an adjunct for reducing analgesic consumption after spinal anaesthesia . | [
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magnesium sulphate infusion is a Intervention_Pharmacological, Magnesium sulphate is a Intervention_Pharmacological, anaesthetic consumption is a Outcome_Physical, analgesic requirements . is a Outcome_Physical, duration of block , sedation and analgesic consumption is a Outcome_Physical, after spinal anaesthesia is a Participant_Condition, Fifty is a Participant_Sample-size, ASA I - II patients is a Participant_Condition, Spinal anaesthesia was performed at L3 - 4 or L4 - 5 interspace with 12.5 mg 0.5 % heavy bupivacaine , using a 25 G Quincke needle is a Intervention_Surgical, 5 mg kg ( -1 ) bolus of magnesium sulphate followed by a 500 mg h ( -1 ) infusion or saline is a Intervention_Pharmacological, Time to first pain , analgesic request is a Outcome_Pain, return of motor function is a Outcome_Physical, visual analogue pain is a Outcome_Pain, sedation scores is a Outcome_Physical, Vital signs is a Outcome_Physical, time to analgesic need is a Outcome_Pain, total analgesic consumption is a Outcome_Pain | 20330_task1 | Sentence: Postoperative magnesium sulphate infusion reduces analgesic requirements in spinal anaesthesia . BACKGROUND AND OBJECTIVES Magnesium sulphate infusion during general anaesthesia reduces anaesthetic consumption and analgesic requirements . The aim of this study was to assess the effects of postoperative magnesium infusion on duration of block , sedation and analgesic consumption after spinal anaesthesia . METHODS Fifty ASA I-II patients were included in the randomized double blind study . Spinal anaesthesia was performed at L3-4 or L4-5 interspace with 12.5 mg 0.5 % heavy bupivacaine , using a 25 G Quincke needle . Patients received a 5 mg kg ( -1 ) bolus of magnesium sulphate followed by a 500 mg h ( -1 ) infusion or saline in the same volumes for 24 h. Time to first pain , analgesic request , return of motor function , visual analogue pain and sedation scores were evaluated every 4 h during the 24 h postoperative period . The t- and U-tests were used for statistical analyses . Data were expressed as mean +/- SD , with P < 0.05 being considered significant . RESULTS Vital signs were stable during spinal anaesthesia and postoperative period . When compared to the control group , time to analgesic need was increased and total analgesic consumption was reduced in the magnesium group ( meperidine consumption 60.0 +/- 73.1 mg control group , 31.8 +/- 30.7 mg magnesium group , P = 0.02 ) . CONCLUSIONS Magnesium sulphate infusion may be used as an adjunct for reducing analgesic consumption after spinal anaesthesia .
Instructions: please typing these entity words according to sentence: magnesium sulphate infusion, Magnesium sulphate, anaesthetic consumption, analgesic requirements ., duration of block , sedation and analgesic consumption, after spinal anaesthesia, Fifty, ASA I - II patients, Spinal anaesthesia was performed at L3 - 4 or L4 - 5 interspace with 12.5 mg 0.5 % heavy bupivacaine , using a 25 G Quincke needle, 5 mg kg ( -1 ) bolus of magnesium sulphate followed by a 500 mg h ( -1 ) infusion or saline, Time to first pain , analgesic request, return of motor function, visual analogue pain, sedation scores, Vital signs, time to analgesic need, total analgesic consumption
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] | Postoperative magnesium sulphate infusion reduces analgesic requirements in spinal anaesthesia . BACKGROUND AND OBJECTIVES Magnesium sulphate infusion during general anaesthesia reduces anaesthetic consumption and analgesic requirements . The aim of this study was to assess the effects of postoperative magnesium infusion on duration of block , sedation and analgesic consumption after spinal anaesthesia . METHODS Fifty ASA I-II patients were included in the randomized double blind study . Spinal anaesthesia was performed at L3-4 or L4-5 interspace with 12.5 mg 0.5 % heavy bupivacaine , using a 25 G Quincke needle . Patients received a 5 mg kg ( -1 ) bolus of magnesium sulphate followed by a 500 mg h ( -1 ) infusion or saline in the same volumes for 24 h. Time to first pain , analgesic request , return of motor function , visual analogue pain and sedation scores were evaluated every 4 h during the 24 h postoperative period . The t- and U-tests were used for statistical analyses . Data were expressed as mean +/- SD , with P < 0.05 being considered significant . RESULTS Vital signs were stable during spinal anaesthesia and postoperative period . When compared to the control group , time to analgesic need was increased and total analgesic consumption was reduced in the magnesium group ( meperidine consumption 60.0 +/- 73.1 mg control group , 31.8 +/- 30.7 mg magnesium group , P = 0.02 ) . CONCLUSIONS Magnesium sulphate infusion may be used as an adjunct for reducing analgesic consumption after spinal anaesthesia . | [
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magnesium sulphate infusion, Magnesium sulphate, anaesthetic consumption, analgesic requirements ., duration of block , sedation and analgesic consumption, after spinal anaesthesia, Fifty, ASA I - II patients, Spinal anaesthesia was performed at L3 - 4 or L4 - 5 interspace with 12.5 mg 0.5 % heavy bupivacaine , using a 25 G Quincke needle, 5 mg kg ( -1 ) bolus of magnesium sulphate followed by a 500 mg h ( -1 ) infusion or saline, Time to first pain , analgesic request, return of motor function, visual analogue pain, sedation scores, Vital signs, time to analgesic need, total analgesic consumption | 20330_task2 | Sentence: Postoperative magnesium sulphate infusion reduces analgesic requirements in spinal anaesthesia . BACKGROUND AND OBJECTIVES Magnesium sulphate infusion during general anaesthesia reduces anaesthetic consumption and analgesic requirements . The aim of this study was to assess the effects of postoperative magnesium infusion on duration of block , sedation and analgesic consumption after spinal anaesthesia . METHODS Fifty ASA I-II patients were included in the randomized double blind study . Spinal anaesthesia was performed at L3-4 or L4-5 interspace with 12.5 mg 0.5 % heavy bupivacaine , using a 25 G Quincke needle . Patients received a 5 mg kg ( -1 ) bolus of magnesium sulphate followed by a 500 mg h ( -1 ) infusion or saline in the same volumes for 24 h. Time to first pain , analgesic request , return of motor function , visual analogue pain and sedation scores were evaluated every 4 h during the 24 h postoperative period . The t- and U-tests were used for statistical analyses . Data were expressed as mean +/- SD , with P < 0.05 being considered significant . RESULTS Vital signs were stable during spinal anaesthesia and postoperative period . When compared to the control group , time to analgesic need was increased and total analgesic consumption was reduced in the magnesium group ( meperidine consumption 60.0 +/- 73.1 mg control group , 31.8 +/- 30.7 mg magnesium group , P = 0.02 ) . CONCLUSIONS Magnesium sulphate infusion may be used as an adjunct for reducing analgesic consumption after spinal anaesthesia .
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] | Postoperative magnesium sulphate infusion reduces analgesic requirements in spinal anaesthesia . BACKGROUND AND OBJECTIVES Magnesium sulphate infusion during general anaesthesia reduces anaesthetic consumption and analgesic requirements . The aim of this study was to assess the effects of postoperative magnesium infusion on duration of block , sedation and analgesic consumption after spinal anaesthesia . METHODS Fifty ASA I-II patients were included in the randomized double blind study . Spinal anaesthesia was performed at L3-4 or L4-5 interspace with 12.5 mg 0.5 % heavy bupivacaine , using a 25 G Quincke needle . Patients received a 5 mg kg ( -1 ) bolus of magnesium sulphate followed by a 500 mg h ( -1 ) infusion or saline in the same volumes for 24 h. Time to first pain , analgesic request , return of motor function , visual analogue pain and sedation scores were evaluated every 4 h during the 24 h postoperative period . The t- and U-tests were used for statistical analyses . Data were expressed as mean +/- SD , with P < 0.05 being considered significant . RESULTS Vital signs were stable during spinal anaesthesia and postoperative period . When compared to the control group , time to analgesic need was increased and total analgesic consumption was reduced in the magnesium group ( meperidine consumption 60.0 +/- 73.1 mg control group , 31.8 +/- 30.7 mg magnesium group , P = 0.02 ) . CONCLUSIONS Magnesium sulphate infusion may be used as an adjunct for reducing analgesic consumption after spinal anaesthesia . | [
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microtitre assay system is an other_name, glucocorticoid receptors is a protein_family_or_group, decreased receptor concentration is an other_name, myocardial infarction is an other_name | 87109_task1 | Sentence: A microtitre assay system for glucocorticoid receptors: decreased receptor concentration in myocardial infarction.
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cavitron ultrasonic surgical aspirator with bipolar cautery is a Intervention_Surgical, cavitron ultrasonic surgical aspirator with radiofrequency coagulator - A is a Intervention_Surgical, Cavitron ultrasonic surgical aspirator ( CUSA ) with bipolar cautery ( BP ) to CUSA with a radiofrequency coagulator is a Intervention_Surgical, CUSA with BP is a Intervention_Surgical, CUSA with TL is a Intervention_Surgical, Blood loss during parenchymal transection and is a Outcome_Physical, speed of transection is a Outcome_Other, degree of postoperative liver injury and morbidity is a Outcome_Physical, Median blood loss during liver transection is a Outcome_Physical, fewer ties is a Outcome_Other, morbidity rates is a Outcome_Other | 38415_task0 | Sentence: Two different methods for donor hepatic transection : cavitron ultrasonic surgical aspirator with bipolar cautery versus cavitron ultrasonic surgical aspirator with radiofrequency coagulator-A randomized controlled trial . The aim of this study was to compare the Cavitron ultrasonic surgical aspirator ( CUSA ) with bipolar cautery ( BP ) to CUSA with a radiofrequency coagulator [ TissueLink ( TL ) ] in terms of efficacy and safety for hepatic transection in living donor liver transplantation . Twenty-four living liver donors ( n = 12 for each group ) were randomized to undergo hepatic transection using CUSA with BP or CUSA with TL . Blood loss during parenchymal transection and speed of transection were the primary endpoints , whereas the degree of postoperative liver injury and morbidity were secondary endpoints . Median blood loss during liver transection was significantly lower in the TL group than in the BP group ( 195.2 +/- 84.5 versus 343.3 +/- 198.4 mL ; P = 0.023 ) , and liver transection was significantly faster in the TL group than in the BP group ( 0.7 +/- 0.2 versus 0.5 +/- 0.2 cm ( 2 ) /minute ; P = 0.048 ) . Significantly fewer ties were required during liver transection in the TL group than in the BP group ( 15.8 +/- 4.8 versus 22.8 +/- 7.9 ties ; P = 0.023 ) . The morbidity rates were similar for the 2 groups . In conclusion , CUSA with TL is superior to CUSA with BP for donor hepatectomy in terms of blood loss and speed of transection with no increase in morbidity .
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cavitron ultrasonic surgical aspirator with bipolar cautery is a Intervention_Surgical, cavitron ultrasonic surgical aspirator with radiofrequency coagulator - A is a Intervention_Surgical, Cavitron ultrasonic surgical aspirator ( CUSA ) with bipolar cautery ( BP ) to CUSA with a radiofrequency coagulator is a Intervention_Surgical, CUSA with BP is a Intervention_Surgical, CUSA with TL is a Intervention_Surgical, Blood loss during parenchymal transection and is a Outcome_Physical, speed of transection is a Outcome_Other, degree of postoperative liver injury and morbidity is a Outcome_Physical, Median blood loss during liver transection is a Outcome_Physical, fewer ties is a Outcome_Other, morbidity rates is a Outcome_Other | 38415_task1 | Sentence: Two different methods for donor hepatic transection : cavitron ultrasonic surgical aspirator with bipolar cautery versus cavitron ultrasonic surgical aspirator with radiofrequency coagulator-A randomized controlled trial . The aim of this study was to compare the Cavitron ultrasonic surgical aspirator ( CUSA ) with bipolar cautery ( BP ) to CUSA with a radiofrequency coagulator [ TissueLink ( TL ) ] in terms of efficacy and safety for hepatic transection in living donor liver transplantation . Twenty-four living liver donors ( n = 12 for each group ) were randomized to undergo hepatic transection using CUSA with BP or CUSA with TL . Blood loss during parenchymal transection and speed of transection were the primary endpoints , whereas the degree of postoperative liver injury and morbidity were secondary endpoints . Median blood loss during liver transection was significantly lower in the TL group than in the BP group ( 195.2 +/- 84.5 versus 343.3 +/- 198.4 mL ; P = 0.023 ) , and liver transection was significantly faster in the TL group than in the BP group ( 0.7 +/- 0.2 versus 0.5 +/- 0.2 cm ( 2 ) /minute ; P = 0.048 ) . Significantly fewer ties were required during liver transection in the TL group than in the BP group ( 15.8 +/- 4.8 versus 22.8 +/- 7.9 ties ; P = 0.023 ) . The morbidity rates were similar for the 2 groups . In conclusion , CUSA with TL is superior to CUSA with BP for donor hepatectomy in terms of blood loss and speed of transection with no increase in morbidity .
Instructions: please typing these entity words according to sentence: cavitron ultrasonic surgical aspirator with bipolar cautery, cavitron ultrasonic surgical aspirator with radiofrequency coagulator - A, Cavitron ultrasonic surgical aspirator ( CUSA ) with bipolar cautery ( BP ) to CUSA with a radiofrequency coagulator, CUSA with BP, CUSA with TL, Blood loss during parenchymal transection and, speed of transection, degree of postoperative liver injury and morbidity, Median blood loss during liver transection, fewer ties, morbidity rates
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No is a Negation, history is a Observation, seizure activity is a Condition, Pregnant is a Condition, breastfeeding is a Observation, Renal dysfunction is a Condition, CrCl < 30ml / min is a Scope, Beck 's Depression Inventory ( BDI ) is a Measurement, = 14 is a Value, Allergy is a Condition, levetiracetam is a Drug | NCT02334722_exc_task0 | Sentence: No known history of seizure activity.
Pregnant or breastfeeding.
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Beck's Depression Inventory (BDI) =14
Allergy to levetiracetam.
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Pregnant or breastfeeding.
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Beck's Depression Inventory (BDI) =14
Allergy to levetiracetam.
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No, history, seizure activity, Pregnant, breastfeeding, Renal dysfunction, CrCl < 30ml / min, Beck 's Depression Inventory ( BDI ), = 14, Allergy, levetiracetam | NCT02334722_exc_task2 | Sentence: No known history of seizure activity.
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CIITA is a Protein, IFN - gamma is a Protein, IFN - gamma is a Protein, CIITA is a Protein, IFN - gamma is a Protein, IFN - gamma is a Protein, CIITA is a Protein, IFN - gamma is a Protein | 8666795_task0 | Sentence: Induction of CIITA and modification of in vivo HLA-DR promoter occupancy in normal thymic epithelial cells treated with IFN-gamma: similarities and distinctions with respect to HLA-DR-constitutive B cells.
In this study, the IFN-gamma induction of MHC class II gene expression in primary cultures of thymic epithelial cells (TEC) was analyzed. This cellular system offers the advantage that MHC class II induction is studied in a "physiologic" cell lineage that, as a result of this expression within the thymus, is thought to participate to the selection and maturation of the T cells. It was found that the MHC class II gene expression was associated with the de novo transcription of the gene encoding the CIITA trans-activator, a crucial MHC class II gene regulatory factor. Furthermore, the anatomy of interaction between the MHC class II DRA promoter and corresponding binding factors was analyzed by in vivo DNAse I footprint. It was found that treatment with IFN-gamma induces changes in the occupancy of the DRA gene regulatory sequences by nuclear factors. The resulting occupancy displays strong similarities with the one observed in the MHC class II-constitutive B cells, represented by both the Burkitt lymphoma line Raji and normal tonsil- derived B cells. However, some peculiar differences were observed between the TEC, either IFN-gamma-induced or not, and the constitutive B cells. These results suggest that both common mechanisms, such as the one mediated by the CIITA trans-activator, and distinct tissue-specific constraints contribute to the transcriptional control of constitutive and IFN-gamma-induced MHC class II gene expression.
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In this study, the IFN-gamma induction of MHC class II gene expression in primary cultures of thymic epithelial cells (TEC) was analyzed. This cellular system offers the advantage that MHC class II induction is studied in a "physiologic" cell lineage that, as a result of this expression within the thymus, is thought to participate to the selection and maturation of the T cells. It was found that the MHC class II gene expression was associated with the de novo transcription of the gene encoding the CIITA trans-activator, a crucial MHC class II gene regulatory factor. Furthermore, the anatomy of interaction between the MHC class II DRA promoter and corresponding binding factors was analyzed by in vivo DNAse I footprint. It was found that treatment with IFN-gamma induces changes in the occupancy of the DRA gene regulatory sequences by nuclear factors. The resulting occupancy displays strong similarities with the one observed in the MHC class II-constitutive B cells, represented by both the Burkitt lymphoma line Raji and normal tonsil- derived B cells. However, some peculiar differences were observed between the TEC, either IFN-gamma-induced or not, and the constitutive B cells. These results suggest that both common mechanisms, such as the one mediated by the CIITA trans-activator, and distinct tissue-specific constraints contribute to the transcriptional control of constitutive and IFN-gamma-induced MHC class II gene expression. | [
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CIITA is a Protein, IFN - gamma is a Protein, IFN - gamma is a Protein, CIITA is a Protein, IFN - gamma is a Protein, IFN - gamma is a Protein, CIITA is a Protein, IFN - gamma is a Protein | 8666795_task1 | Sentence: Induction of CIITA and modification of in vivo HLA-DR promoter occupancy in normal thymic epithelial cells treated with IFN-gamma: similarities and distinctions with respect to HLA-DR-constitutive B cells.
In this study, the IFN-gamma induction of MHC class II gene expression in primary cultures of thymic epithelial cells (TEC) was analyzed. This cellular system offers the advantage that MHC class II induction is studied in a "physiologic" cell lineage that, as a result of this expression within the thymus, is thought to participate to the selection and maturation of the T cells. It was found that the MHC class II gene expression was associated with the de novo transcription of the gene encoding the CIITA trans-activator, a crucial MHC class II gene regulatory factor. Furthermore, the anatomy of interaction between the MHC class II DRA promoter and corresponding binding factors was analyzed by in vivo DNAse I footprint. It was found that treatment with IFN-gamma induces changes in the occupancy of the DRA gene regulatory sequences by nuclear factors. The resulting occupancy displays strong similarities with the one observed in the MHC class II-constitutive B cells, represented by both the Burkitt lymphoma line Raji and normal tonsil- derived B cells. However, some peculiar differences were observed between the TEC, either IFN-gamma-induced or not, and the constitutive B cells. These results suggest that both common mechanisms, such as the one mediated by the CIITA trans-activator, and distinct tissue-specific constraints contribute to the transcriptional control of constitutive and IFN-gamma-induced MHC class II gene expression.
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In this study, the IFN-gamma induction of MHC class II gene expression in primary cultures of thymic epithelial cells (TEC) was analyzed. This cellular system offers the advantage that MHC class II induction is studied in a "physiologic" cell lineage that, as a result of this expression within the thymus, is thought to participate to the selection and maturation of the T cells. It was found that the MHC class II gene expression was associated with the de novo transcription of the gene encoding the CIITA trans-activator, a crucial MHC class II gene regulatory factor. Furthermore, the anatomy of interaction between the MHC class II DRA promoter and corresponding binding factors was analyzed by in vivo DNAse I footprint. It was found that treatment with IFN-gamma induces changes in the occupancy of the DRA gene regulatory sequences by nuclear factors. The resulting occupancy displays strong similarities with the one observed in the MHC class II-constitutive B cells, represented by both the Burkitt lymphoma line Raji and normal tonsil- derived B cells. However, some peculiar differences were observed between the TEC, either IFN-gamma-induced or not, and the constitutive B cells. These results suggest that both common mechanisms, such as the one mediated by the CIITA trans-activator, and distinct tissue-specific constraints contribute to the transcriptional control of constitutive and IFN-gamma-induced MHC class II gene expression. | [
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In this study, the IFN-gamma induction of MHC class II gene expression in primary cultures of thymic epithelial cells (TEC) was analyzed. This cellular system offers the advantage that MHC class II induction is studied in a "physiologic" cell lineage that, as a result of this expression within the thymus, is thought to participate to the selection and maturation of the T cells. It was found that the MHC class II gene expression was associated with the de novo transcription of the gene encoding the CIITA trans-activator, a crucial MHC class II gene regulatory factor. Furthermore, the anatomy of interaction between the MHC class II DRA promoter and corresponding binding factors was analyzed by in vivo DNAse I footprint. It was found that treatment with IFN-gamma induces changes in the occupancy of the DRA gene regulatory sequences by nuclear factors. The resulting occupancy displays strong similarities with the one observed in the MHC class II-constitutive B cells, represented by both the Burkitt lymphoma line Raji and normal tonsil- derived B cells. However, some peculiar differences were observed between the TEC, either IFN-gamma-induced or not, and the constitutive B cells. These results suggest that both common mechanisms, such as the one mediated by the CIITA trans-activator, and distinct tissue-specific constraints contribute to the transcriptional control of constitutive and IFN-gamma-induced MHC class II gene expression.
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lung is a Organ, tumor is a Cancer, lung cancer is a Cancer, cancer is a Cancer, tumor is a Cancer, tumor is a Cancer, tumor is a Cancer, lung epithelial cells is a Cell, Tumor is a Cancer, pneumocyte is a Cell, myeloid cells is a Cell | PMID-20129250_task0 | Sentence: Tobacco smoke promotes lung tumorigenesis by triggering IKKbeta- and JNK1-dependent inflammation.
Chronic exposure to tobacco smoke, which contains over 60 tumor-initiating carcinogens, is the major risk factor for development of lung cancer, accounting for a large portion of cancer-related deaths worldwide. It is well established that tobacco smoke is a tumor initiator, but we asked whether it also acts as a tumor promoter once malignant initiation, such as caused by K-ras activation, has taken place. Here we demonstrate that repetitive exposure to tobacco smoke promotes tumor development both in carcinogen-treated mice and in transgenic mice undergoing sporadic K-ras activation in lung epithelial cells. Tumor promotion is due to induction of inflammation that results in enhanced pneumocyte proliferation and is abrogated by IKKbeta ablation in myeloid cells or inactivation of JNK1.
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Chronic exposure to tobacco smoke, which contains over 60 tumor-initiating carcinogens, is the major risk factor for development of lung cancer, accounting for a large portion of cancer-related deaths worldwide. It is well established that tobacco smoke is a tumor initiator, but we asked whether it also acts as a tumor promoter once malignant initiation, such as caused by K-ras activation, has taken place. Here we demonstrate that repetitive exposure to tobacco smoke promotes tumor development both in carcinogen-treated mice and in transgenic mice undergoing sporadic K-ras activation in lung epithelial cells. Tumor promotion is due to induction of inflammation that results in enhanced pneumocyte proliferation and is abrogated by IKKbeta ablation in myeloid cells or inactivation of JNK1.
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Chronic exposure to tobacco smoke, which contains over 60 tumor-initiating carcinogens, is the major risk factor for development of lung cancer, accounting for a large portion of cancer-related deaths worldwide. It is well established that tobacco smoke is a tumor initiator, but we asked whether it also acts as a tumor promoter once malignant initiation, such as caused by K-ras activation, has taken place. Here we demonstrate that repetitive exposure to tobacco smoke promotes tumor development both in carcinogen-treated mice and in transgenic mice undergoing sporadic K-ras activation in lung epithelial cells. Tumor promotion is due to induction of inflammation that results in enhanced pneumocyte proliferation and is abrogated by IKKbeta ablation in myeloid cells or inactivation of JNK1.
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lung, tumor, lung cancer, cancer, tumor, tumor, tumor, lung epithelial cells, Tumor, pneumocyte, myeloid cells | PMID-20129250_task2 | Sentence: Tobacco smoke promotes lung tumorigenesis by triggering IKKbeta- and JNK1-dependent inflammation.
Chronic exposure to tobacco smoke, which contains over 60 tumor-initiating carcinogens, is the major risk factor for development of lung cancer, accounting for a large portion of cancer-related deaths worldwide. It is well established that tobacco smoke is a tumor initiator, but we asked whether it also acts as a tumor promoter once malignant initiation, such as caused by K-ras activation, has taken place. Here we demonstrate that repetitive exposure to tobacco smoke promotes tumor development both in carcinogen-treated mice and in transgenic mice undergoing sporadic K-ras activation in lung epithelial cells. Tumor promotion is due to induction of inflammation that results in enhanced pneumocyte proliferation and is abrogated by IKKbeta ablation in myeloid cells or inactivation of JNK1.
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Chronic exposure to tobacco smoke, which contains over 60 tumor-initiating carcinogens, is the major risk factor for development of lung cancer, accounting for a large portion of cancer-related deaths worldwide. It is well established that tobacco smoke is a tumor initiator, but we asked whether it also acts as a tumor promoter once malignant initiation, such as caused by K-ras activation, has taken place. Here we demonstrate that repetitive exposure to tobacco smoke promotes tumor development both in carcinogen-treated mice and in transgenic mice undergoing sporadic K-ras activation in lung epithelial cells. Tumor promotion is due to induction of inflammation that results in enhanced pneumocyte proliferation and is abrogated by IKKbeta ablation in myeloid cells or inactivation of JNK1.
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Oct-1 is a Protein, protein kinase Calpha is a Protein, PKCalpha is a Protein, PKCalpha is a Protein, PKCalpha is a Protein | 9710582_task0 | Sentence: The small GTP-binding protein Rho potentiates AP-1 transcription in T cells.
The Rho family of small GTP-binding proteins is involved in the regulation of cytoskeletal structure, gene transcription, specific cell fate development, and transformation. We demonstrate in this report that overexpression of an activated form of Rho enhances AP-1 activity in Jurkat T cells in the presence of phorbol myristate acetate (PMA), but activated Rho (V14Rho) has little or no effect on NFAT, Oct-1, and NF-kappaB enhancer element activities under similar conditions. Overexpression of a V14Rho construct incapable of membrane localization (CAAX deleted) abolishes PMA-induced AP-1 transcriptional activation. The effect of Rho on AP-1 is independent of the mitogen-activated protein kinase pathway, as a dominant-negative MEK and a MEK inhibitor (PD98059) did not affect Rho-induced AP-1 activity. V14Rho binds strongly to protein kinase Calpha (PKCalpha) in vivo; however, deletion of the CAAX site on V14Rho severely diminished this association. Evidence for a role for PKCalpha as an effector of Rho was obtained by the observation that coexpression of the N-terminal domain of PKCalpha blocked the effects of activated Rho plus PMA on AP-1 transcriptional activity. These data suggest that Rho potentiates AP-1 transcription during T-cell activation.
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Oct-1 is a Protein, protein kinase Calpha is a Protein, PKCalpha is a Protein, PKCalpha is a Protein, PKCalpha is a Protein | 9710582_task1 | Sentence: The small GTP-binding protein Rho potentiates AP-1 transcription in T cells.
The Rho family of small GTP-binding proteins is involved in the regulation of cytoskeletal structure, gene transcription, specific cell fate development, and transformation. We demonstrate in this report that overexpression of an activated form of Rho enhances AP-1 activity in Jurkat T cells in the presence of phorbol myristate acetate (PMA), but activated Rho (V14Rho) has little or no effect on NFAT, Oct-1, and NF-kappaB enhancer element activities under similar conditions. Overexpression of a V14Rho construct incapable of membrane localization (CAAX deleted) abolishes PMA-induced AP-1 transcriptional activation. The effect of Rho on AP-1 is independent of the mitogen-activated protein kinase pathway, as a dominant-negative MEK and a MEK inhibitor (PD98059) did not affect Rho-induced AP-1 activity. V14Rho binds strongly to protein kinase Calpha (PKCalpha) in vivo; however, deletion of the CAAX site on V14Rho severely diminished this association. Evidence for a role for PKCalpha as an effector of Rho was obtained by the observation that coexpression of the N-terminal domain of PKCalpha blocked the effects of activated Rho plus PMA on AP-1 transcriptional activity. These data suggest that Rho potentiates AP-1 transcription during T-cell activation.
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The Rho family of small GTP-binding proteins is involved in the regulation of cytoskeletal structure, gene transcription, specific cell fate development, and transformation. We demonstrate in this report that overexpression of an activated form of Rho enhances AP-1 activity in Jurkat T cells in the presence of phorbol myristate acetate (PMA), but activated Rho (V14Rho) has little or no effect on NFAT, Oct-1, and NF-kappaB enhancer element activities under similar conditions. Overexpression of a V14Rho construct incapable of membrane localization (CAAX deleted) abolishes PMA-induced AP-1 transcriptional activation. The effect of Rho on AP-1 is independent of the mitogen-activated protein kinase pathway, as a dominant-negative MEK and a MEK inhibitor (PD98059) did not affect Rho-induced AP-1 activity. V14Rho binds strongly to protein kinase Calpha (PKCalpha) in vivo; however, deletion of the CAAX site on V14Rho severely diminished this association. Evidence for a role for PKCalpha as an effector of Rho was obtained by the observation that coexpression of the N-terminal domain of PKCalpha blocked the effects of activated Rho plus PMA on AP-1 transcriptional activity. These data suggest that Rho potentiates AP-1 transcription during T-cell activation. | [
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Oct-1, protein kinase Calpha, PKCalpha, PKCalpha, PKCalpha | 9710582_task2 | Sentence: The small GTP-binding protein Rho potentiates AP-1 transcription in T cells.
The Rho family of small GTP-binding proteins is involved in the regulation of cytoskeletal structure, gene transcription, specific cell fate development, and transformation. We demonstrate in this report that overexpression of an activated form of Rho enhances AP-1 activity in Jurkat T cells in the presence of phorbol myristate acetate (PMA), but activated Rho (V14Rho) has little or no effect on NFAT, Oct-1, and NF-kappaB enhancer element activities under similar conditions. Overexpression of a V14Rho construct incapable of membrane localization (CAAX deleted) abolishes PMA-induced AP-1 transcriptional activation. The effect of Rho on AP-1 is independent of the mitogen-activated protein kinase pathway, as a dominant-negative MEK and a MEK inhibitor (PD98059) did not affect Rho-induced AP-1 activity. V14Rho binds strongly to protein kinase Calpha (PKCalpha) in vivo; however, deletion of the CAAX site on V14Rho severely diminished this association. Evidence for a role for PKCalpha as an effector of Rho was obtained by the observation that coexpression of the N-terminal domain of PKCalpha blocked the effects of activated Rho plus PMA on AP-1 transcriptional activity. These data suggest that Rho potentiates AP-1 transcription during T-cell activation.
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The Rho family of small GTP-binding proteins is involved in the regulation of cytoskeletal structure, gene transcription, specific cell fate development, and transformation. We demonstrate in this report that overexpression of an activated form of Rho enhances AP-1 activity in Jurkat T cells in the presence of phorbol myristate acetate (PMA), but activated Rho (V14Rho) has little or no effect on NFAT, Oct-1, and NF-kappaB enhancer element activities under similar conditions. Overexpression of a V14Rho construct incapable of membrane localization (CAAX deleted) abolishes PMA-induced AP-1 transcriptional activation. The effect of Rho on AP-1 is independent of the mitogen-activated protein kinase pathway, as a dominant-negative MEK and a MEK inhibitor (PD98059) did not affect Rho-induced AP-1 activity. V14Rho binds strongly to protein kinase Calpha (PKCalpha) in vivo; however, deletion of the CAAX site on V14Rho severely diminished this association. Evidence for a role for PKCalpha as an effector of Rho was obtained by the observation that coexpression of the N-terminal domain of PKCalpha blocked the effects of activated Rho plus PMA on AP-1 transcriptional activity. These data suggest that Rho potentiates AP-1 transcription during T-cell activation. | [
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regulatory element is a DNA_family_or_group, CD95 ( APO-1 / Fas ) ligand promoter is a DNA_domain_or_region, TCR - mediated activation is an other_name | 72913_task0 | Sentence: A regulatory element in the CD95 (APO-1/Fas) ligand promoter is essential for responsiveness to TCR-mediated activation.
Instructions: please extract entities and their types from the input sentence, all entity types are in options
Options: DNA_family_or_group, DNA_domain_or_region, other_name
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regulatory element is a DNA_family_or_group, CD95 ( APO-1 / Fas ) ligand promoter is a DNA_domain_or_region, TCR - mediated activation is an other_name | 72913_task1 | Sentence: A regulatory element in the CD95 (APO-1/Fas) ligand promoter is essential for responsiveness to TCR-mediated activation.
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regulatory element, CD95 ( APO-1 / Fas ) ligand promoter, TCR - mediated activation | 72913_task2 | Sentence: A regulatory element in the CD95 (APO-1/Fas) ligand promoter is essential for responsiveness to TCR-mediated activation.
Instructions: please extract entity words from the input sentence
| [
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trans - acting activator is a protein_family_or_group, human CD5 antigen is a protein_molecule | 15504_task0 | Sentence: Evidence for a trans-acting activator function regulating the expression of the human CD5 antigen.
Instructions: please extract entities and their types from the input sentence, all entity types are in options
Options: protein_family_or_group, protein_molecule
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trans - acting activator is a protein_family_or_group, human CD5 antigen is a protein_molecule | 15504_task1 | Sentence: Evidence for a trans-acting activator function regulating the expression of the human CD5 antigen.
Instructions: please typing these entity words according to sentence: trans - acting activator, human CD5 antigen
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trans - acting activator, human CD5 antigen | 15504_task2 | Sentence: Evidence for a trans-acting activator function regulating the expression of the human CD5 antigen.
Instructions: please extract entity words from the input sentence
| [
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Patienten, formalinfixierte, paraffineingebettete, Patienten, Lymphknoten-, Fernmetastasen, Patienten, Tumorrezidive, Prognose, Analyse | DerChirurg.80690186.ger.abstr_task2 | Sentence: Zusammenfassung . In einer retrospektiven Untersuchung wurde die prognostische Relevanz von e-Cadherin beim papillaeren Schilddruesencarcinom analysiert . Von 78 von 113 Patienten , die zwischen dem 1. 9. 1985 und 31. 12. 1996 wegen eines papillaeren Schilddruesencarcinoms operiert wurden , waren formalinfixierte paraffineingebettete Praeparate , ihrer Schilddruesencarcinome zur immunhistochemischen e-Cadherin-Analyse verfuegbar . Von 74 dieser 78 Patienten ist der postoperative Verlauf ueber 2 Monate bis 35,2 Jahre bekannt ( Median 3,6 Jahre ; Mittel 4,9 +/- 4,8 Jahre ) . Eine schwache bzw. negative e-Cadherin-Expression ( = 20 % ) fand sich bei hoeheren T-Stadien , es bestanden vermehrt synchrone Lymphknoten- und Fernmetastasen . Diese Patienten entwickelten haeufiger locoregionaere Tumorrezidive und hatten eine unguenstigere Prognose . In der statistischen Analyse erwiesen sich die e-Cadherin-Expression ( = 20 %/ > 20 % ) , eine synchrone Fernmetastasierung ( M0/pM1, cM1) sowie die Radikalitaet des Eingriffs ( R0/R1, 2 ) als prognostisch relevant . Unsere Daten sprechen fuer eine prognostische Bedeutung der e-Cadherin-Expression beim papillaeren Schilddruesencarcinom .
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Medikamenten is an umlsterm, Fuehrung is an umlsterm, Methoden is an umlsterm, Anxiolytika is an umlsterm, Kinder is an umlsterm | DerAnaesthesist.70460850.ger.abstr_task0 | Sentence: Sowohl Anxiolyse mit Medikamenten als auch psychische Fuehrung sind anerkannte Methoden der praeoperativen Vorbereitung . Ein Vorteil von Anxiolytika ist aber fuer Kinder schwer zu beweisen .
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CYP4F2 is a Genes & Molecular Sequences, myocardial infarction is a Diseases & Disorders | 15001_task0 | Sentence: A haplotype of the CYP4F2 gene associated with myocardial infarction in Japanese men.
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CYP4F2 is a Genes & Molecular Sequences, myocardial infarction is a Diseases & Disorders | 15001_task1 | Sentence: A haplotype of the CYP4F2 gene associated with myocardial infarction in Japanese men.
Instructions: please typing these entity words according to sentence: CYP4F2, myocardial infarction
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CYP4F2, myocardial infarction | 15001_task2 | Sentence: A haplotype of the CYP4F2 gene associated with myocardial infarction in Japanese men.
Instructions: please extract entity words from the input sentence
| [
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COD is a protein, Na is a compound | DS.d43_task0 | Sentence: It has been shown that the removal efficiency of COD increased with the increasing applied current density and increasing PAC and Na (2)SO(4) dosage and the most effective removal capacity was achieved at the pH 7.
Instructions: please extract entities and their types from the input sentence, all entity types are in options
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COD is a protein, Na is a compound | DS.d43_task1 | Sentence: It has been shown that the removal efficiency of COD increased with the increasing applied current density and increasing PAC and Na (2)SO(4) dosage and the most effective removal capacity was achieved at the pH 7.
Instructions: please typing these entity words according to sentence: COD, Na
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COD, Na | DS.d43_task2 | Sentence: It has been shown that the removal efficiency of COD increased with the increasing applied current density and increasing PAC and Na (2)SO(4) dosage and the most effective removal capacity was achieved at the pH 7.
Instructions: please extract entity words from the input sentence
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poly - N - acetyllactosamine is a compound, LacNAc is a compound, glycoproteins is a protein | DS.d970_task0 | Sentence: Chemo-enzymatic synthesis of poly-N-acetyllactosamine (poly-LacNAc) structures and their characterization for CGL2-galectin-mediated binding of ECM glycoproteins to biomaterial surfaces.
Instructions: please extract entities and their types from the input sentence, all entity types are in options
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poly - N - acetyllactosamine is a compound, LacNAc is a compound, glycoproteins is a protein | DS.d970_task1 | Sentence: Chemo-enzymatic synthesis of poly-N-acetyllactosamine (poly-LacNAc) structures and their characterization for CGL2-galectin-mediated binding of ECM glycoproteins to biomaterial surfaces.
Instructions: please typing these entity words according to sentence: poly - N - acetyllactosamine, LacNAc, glycoproteins
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poly - N - acetyllactosamine, LacNAc, glycoproteins | DS.d970_task2 | Sentence: Chemo-enzymatic synthesis of poly-N-acetyllactosamine (poly-LacNAc) structures and their characterization for CGL2-galectin-mediated binding of ECM glycoproteins to biomaterial surfaces.
Instructions: please extract entity words from the input sentence
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Psychosen is an umlsterm, Klassifikation is an umlsterm, biologischen Psychiatrie is an umlsterm, Beobachtungen is an umlsterm, Patienten is an umlsterm, Schizophrenie is an umlsterm, affektiven Psychosen is an umlsterm, Klassifikation is an umlsterm, Autismus is an umlsterm, Schulddepression is an umlsterm, Phantasie is an umlsterm, Denkprozesses is an umlsterm, Denkprozess is an umlsterm, Polen is an umlsterm, Psychose is an umlsterm, Persoenlichkeitsstoerungen is an umlsterm, Neurosen is an umlsterm | Psychotherapeut.70420343.ger.abstr_task0 | Sentence: In diesem Beitrag wird ein psychodynamisches Modell der Psychosen dargestellt , welches auch gut mit der deskriptiven Klassifikation ( DSM ICD ) , korrespondiert und sich als kompatibel mit den Ergebnissen der biologischen Psychiatrie erweist . Viele klinische Beobachtungen sprechen dafuer , dass die Psychodynamik des psychotischen Patienten nicht so sehr durch den angeblichen primaeren " Defekt " , sondern vielmehr durch die spannungsreiche Widerspruechlichkeit bzw. die zugrundeliegenden Dilemmata charakterisiert ist . Letztere entstehen als pathologische Konfliktualisierungen von normalen " Bipolaritaeten . " Dabei geht es entweder ( bei der Schizophrenie ) um das Dilemma Selbstidentitaet versus Fusion oder um das fuer die affektiven Psychosen relevante Dilemma der Selbstwertigkeit versus Objektwertigkeit . Diese Gegenueberstellung ergibt das erste Kriterium bei der psychodynamischen Klassifikation . Es werden aber dann auch folgende zusaetzliche Kriterien beruecksichtigt : Die Selbstbezogenheit versus Objektbezogenheit der Abwehr und Kompensation ( z.B. Autismus versus Fusion , Manie versus Schulddepression ) . Eine weitere Dimension bezieht sich auf den Gegensatz zwischen Ueberstimulation , expandierende Phantasie , Ueberemotionalitaet , Vorherrschen des primaeren Denkprozesses einerseits und Unterstimulation , Restriktion , sekundaerer Denkprozess , emotionelle Entleerung andererseits . Waehrend das gemaessigte " Pendeln " zwischen den Polen einer normalen Psychodynamik entspricht , fuehren die defensiven Extremisierungen innerhalb der Psychose dazu , dass entweder eine expansive " produktive " oder wiederum eine Minussymptomatik entsteht . Dieses dreidimensionale System der Psychodynamik laesst sich auch auf die Persoenlichkeitsstoerungen , vielleicht auch auf die Neurosen extrapolieren .
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Psychosen is an umlsterm, Klassifikation is an umlsterm, biologischen Psychiatrie is an umlsterm, Beobachtungen is an umlsterm, Patienten is an umlsterm, Schizophrenie is an umlsterm, affektiven Psychosen is an umlsterm, Klassifikation is an umlsterm, Autismus is an umlsterm, Schulddepression is an umlsterm, Phantasie is an umlsterm, Denkprozesses is an umlsterm, Denkprozess is an umlsterm, Polen is an umlsterm, Psychose is an umlsterm, Persoenlichkeitsstoerungen is an umlsterm, Neurosen is an umlsterm | Psychotherapeut.70420343.ger.abstr_task1 | Sentence: In diesem Beitrag wird ein psychodynamisches Modell der Psychosen dargestellt , welches auch gut mit der deskriptiven Klassifikation ( DSM ICD ) , korrespondiert und sich als kompatibel mit den Ergebnissen der biologischen Psychiatrie erweist . Viele klinische Beobachtungen sprechen dafuer , dass die Psychodynamik des psychotischen Patienten nicht so sehr durch den angeblichen primaeren " Defekt " , sondern vielmehr durch die spannungsreiche Widerspruechlichkeit bzw. die zugrundeliegenden Dilemmata charakterisiert ist . Letztere entstehen als pathologische Konfliktualisierungen von normalen " Bipolaritaeten . " Dabei geht es entweder ( bei der Schizophrenie ) um das Dilemma Selbstidentitaet versus Fusion oder um das fuer die affektiven Psychosen relevante Dilemma der Selbstwertigkeit versus Objektwertigkeit . Diese Gegenueberstellung ergibt das erste Kriterium bei der psychodynamischen Klassifikation . Es werden aber dann auch folgende zusaetzliche Kriterien beruecksichtigt : Die Selbstbezogenheit versus Objektbezogenheit der Abwehr und Kompensation ( z.B. Autismus versus Fusion , Manie versus Schulddepression ) . Eine weitere Dimension bezieht sich auf den Gegensatz zwischen Ueberstimulation , expandierende Phantasie , Ueberemotionalitaet , Vorherrschen des primaeren Denkprozesses einerseits und Unterstimulation , Restriktion , sekundaerer Denkprozess , emotionelle Entleerung andererseits . Waehrend das gemaessigte " Pendeln " zwischen den Polen einer normalen Psychodynamik entspricht , fuehren die defensiven Extremisierungen innerhalb der Psychose dazu , dass entweder eine expansive " produktive " oder wiederum eine Minussymptomatik entsteht . Dieses dreidimensionale System der Psychodynamik laesst sich auch auf die Persoenlichkeitsstoerungen , vielleicht auch auf die Neurosen extrapolieren .
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infections is an umlsterm, talus is an umlsterm, talus is an umlsterm, open fractures is an umlsterm, defects is an umlsterm, prognosis is an umlsterm, talus is an umlsterm, Traumatology is an umlsterm, patients is an umlsterm, male is an umlsterm, age is an umlsterm, bone grafting is an umlsterm, infection is an umlsterm, talus is an umlsterm, open is an umlsterm, dislocation is an umlsterm, talus is an umlsterm, patient is an umlsterm, arthroscopy is an umlsterm, ankle is an umlsterm, hospital is an umlsterm, infection is an umlsterm, algorithm is an umlsterm, debridement is an umlsterm, tibia is an umlsterm, calcaneus is an umlsterm, defect is an umlsterm, PMMA is an umlsterm, technique is an umlsterm, immobilization is an umlsterm, treatment is an umlsterm, infection is an umlsterm, procedures is an umlsterm, flap is an umlsterm, tissue is an umlsterm, talus is an umlsterm, bone graft is an umlsterm, arthrodesis is an umlsterm, patient is an umlsterm, arthrodesis is an umlsterm, bone graft is an umlsterm, arthrodesis is an umlsterm, patients is an umlsterm, symptoms is an umlsterm, life is an umlsterm, open fractures is an umlsterm, talus is an umlsterm, infection is an umlsterm, bone is an umlsterm, talus is an umlsterm, bone grafting is an umlsterm, arthrodesis is an umlsterm, method is an umlsterm, function is an umlsterm, foot is an umlsterm | DerUnfallchirurg.71000497.eng.abstr_task0 | Sentence: Severe infections of the talus are often associated with complete septic collapse of the talus . In this connection , open fractures with defects or significant comminution have a bad prognosis is as far as reconstruction of the talus is concerned . In the Department of Traumatology , Braunschweig , in 1995 three patients ( all male , average age 35.3 +/- 10.2 years ) were treated with cancellous bone grafting after talectomy performed because of infection and complete septic collapse of the talus . In two of these cases third-degree open total dislocation of the talus had been sustained . The third patient came to us after undergoing arthroscopy of the ankle region in another hospital . In each case a fulminating infection was the outcome . Following a step-by-step algorithm , in a first step urgent radical debridement with talectomy was done . To maintain approximation between the tibia and calcaneus on one side and the os naviculare on the other , the bony defect was filled with PMMA chains and the external fixateur technique was used for immobilization during treatment of the infection . After second- and third-look procedures a free flap was grown for soft tissue coverage within the first 10 days . After 17.6 +/- 3.3 days the talus was replaced with a cancellous bone graft , combined with double arthrodesis in two cases , and external fixation for the next 4-5 weeks . In the third patient a triple arthrodesis was done . At follow-up after an average of 12 months ( range 8-17 months ) , the bone graft with arthrodesis had been completely integrated in all cases . All patients are free of symptoms in normal life . In the case of severe open fractures of the talus with significant comminution combined with infection and septic bone collapse conservation of the talus is often impossible . The combination of homologous cancellous bone grafting and arthrodesis after talectomy is therefore a good method of keeping any decrease in the function of the foot to a minimum .
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infections is an umlsterm, talus is an umlsterm, talus is an umlsterm, open fractures is an umlsterm, defects is an umlsterm, prognosis is an umlsterm, talus is an umlsterm, Traumatology is an umlsterm, patients is an umlsterm, male is an umlsterm, age is an umlsterm, bone grafting is an umlsterm, infection is an umlsterm, talus is an umlsterm, open is an umlsterm, dislocation is an umlsterm, talus is an umlsterm, patient is an umlsterm, arthroscopy is an umlsterm, ankle is an umlsterm, hospital is an umlsterm, infection is an umlsterm, algorithm is an umlsterm, debridement is an umlsterm, tibia is an umlsterm, calcaneus is an umlsterm, defect is an umlsterm, PMMA is an umlsterm, technique is an umlsterm, immobilization is an umlsterm, treatment is an umlsterm, infection is an umlsterm, procedures is an umlsterm, flap is an umlsterm, tissue is an umlsterm, talus is an umlsterm, bone graft is an umlsterm, arthrodesis is an umlsterm, patient is an umlsterm, arthrodesis is an umlsterm, bone graft is an umlsterm, arthrodesis is an umlsterm, patients is an umlsterm, symptoms is an umlsterm, life is an umlsterm, open fractures is an umlsterm, talus is an umlsterm, infection is an umlsterm, bone is an umlsterm, talus is an umlsterm, bone grafting is an umlsterm, arthrodesis is an umlsterm, method is an umlsterm, function is an umlsterm, foot is an umlsterm | DerUnfallchirurg.71000497.eng.abstr_task1 | Sentence: Severe infections of the talus are often associated with complete septic collapse of the talus . In this connection , open fractures with defects or significant comminution have a bad prognosis is as far as reconstruction of the talus is concerned . In the Department of Traumatology , Braunschweig , in 1995 three patients ( all male , average age 35.3 +/- 10.2 years ) were treated with cancellous bone grafting after talectomy performed because of infection and complete septic collapse of the talus . In two of these cases third-degree open total dislocation of the talus had been sustained . The third patient came to us after undergoing arthroscopy of the ankle region in another hospital . In each case a fulminating infection was the outcome . Following a step-by-step algorithm , in a first step urgent radical debridement with talectomy was done . To maintain approximation between the tibia and calcaneus on one side and the os naviculare on the other , the bony defect was filled with PMMA chains and the external fixateur technique was used for immobilization during treatment of the infection . After second- and third-look procedures a free flap was grown for soft tissue coverage within the first 10 days . After 17.6 +/- 3.3 days the talus was replaced with a cancellous bone graft , combined with double arthrodesis in two cases , and external fixation for the next 4-5 weeks . In the third patient a triple arthrodesis was done . At follow-up after an average of 12 months ( range 8-17 months ) , the bone graft with arthrodesis had been completely integrated in all cases . All patients are free of symptoms in normal life . In the case of severe open fractures of the talus with significant comminution combined with infection and septic bone collapse conservation of the talus is often impossible . The combination of homologous cancellous bone grafting and arthrodesis after talectomy is therefore a good method of keeping any decrease in the function of the foot to a minimum .
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infections, talus, talus, open fractures, defects, prognosis, talus, Traumatology, patients, male, age, bone grafting, infection, talus, open, dislocation, talus, patient, arthroscopy, ankle, hospital, infection, algorithm, debridement, tibia, calcaneus, defect, PMMA, technique, immobilization, treatment, infection, procedures, flap, tissue, talus, bone graft, arthrodesis, patient, arthrodesis, bone graft, arthrodesis, patients, symptoms, life, open fractures, talus, infection, bone, talus, bone grafting, arthrodesis, method, function, foot | DerUnfallchirurg.71000497.eng.abstr_task2 | Sentence: Severe infections of the talus are often associated with complete septic collapse of the talus . In this connection , open fractures with defects or significant comminution have a bad prognosis is as far as reconstruction of the talus is concerned . In the Department of Traumatology , Braunschweig , in 1995 three patients ( all male , average age 35.3 +/- 10.2 years ) were treated with cancellous bone grafting after talectomy performed because of infection and complete septic collapse of the talus . In two of these cases third-degree open total dislocation of the talus had been sustained . The third patient came to us after undergoing arthroscopy of the ankle region in another hospital . In each case a fulminating infection was the outcome . Following a step-by-step algorithm , in a first step urgent radical debridement with talectomy was done . To maintain approximation between the tibia and calcaneus on one side and the os naviculare on the other , the bony defect was filled with PMMA chains and the external fixateur technique was used for immobilization during treatment of the infection . After second- and third-look procedures a free flap was grown for soft tissue coverage within the first 10 days . After 17.6 +/- 3.3 days the talus was replaced with a cancellous bone graft , combined with double arthrodesis in two cases , and external fixation for the next 4-5 weeks . In the third patient a triple arthrodesis was done . At follow-up after an average of 12 months ( range 8-17 months ) , the bone graft with arthrodesis had been completely integrated in all cases . All patients are free of symptoms in normal life . In the case of severe open fractures of the talus with significant comminution combined with infection and septic bone collapse conservation of the talus is often impossible . The combination of homologous cancellous bone grafting and arthrodesis after talectomy is therefore a good method of keeping any decrease in the function of the foot to a minimum .
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Sandra is a NOMBRE_SUJETO_ASISTENCIA, De la Cruz Lorenzo is a NOMBRE_SUJETO_ASISTENCIA, 3478564 is a ID_SUJETO_ASISTENCIA, 78 43567091 65 is a ID_ASEGURAMIENTO, Madrid is a TERRITORIO, 28036 is a TERRITORIO, 08/11/1924 is a FECHAS, España is a PAIS, 92 años is a EDAD_SUJETO_ASISTENCIA, 03/03/2017 is a FECHAS, Miguel Jiménez Peñalba is a NOMBRE_PERSONAL_SANITARIO, 28 28 57894 is a ID_TITULACION_PERSONAL_SANITARIO, Mujer is a SEXO_SUJETO_ASISTENCIA, 92 años is a EDAD_SUJETO_ASISTENCIA, hija is a FAMILIARES_SUJETO_ASISTENCIA, calle embajadores , 23 , 2 A is a CALLE, Madrid is a TERRITORIO, Miguel Jiménez Peñalba is a NOMBRE_PERSONAL_SANITARIO, mijipeñ@hotmail.com is a CORREO_ELECTRONICO | 311_task0 | Sentence: Datos del paciente.
Nombre: Sandra .
Apellidos: De la Cruz Lorenzo.
NHC: 3478564.
NASS: 78 43567091 65.
Domicilio: C/ Santiesteban, 27, 3, A.
Localidad/ Provincia: Madrid.
CP: 28036.
Datos asistenciales.
Fecha de nacimiento: 08/11/1924.
País de nacimiento: España.
Edad: 92 años Sexo: M.
Fecha de Ingreso: 03/03/2017.
Médico: Miguel Jiménez Peñalba NºCol: 28 28 57894.
Informe clínico del paciente: Mujer de 92 años de edad, sin alergias medicamentosas conocidas, con antecedentes personales de hipertensión arterial, diabetes mellitus tipo 2, fibrilación auricular crónica y enfermedad de Alzheimer. Está a cargo de su hija con quién vive en la calle embajadores, 23, 2 A de Madrid. Ingresó por vómitos en posos de café, epigastralgia y pérdida de de peso en el último mes. La exploración física era irrelevante.
En la analítica destacaba: hemoglobina 7,1 g/dl, hematocrito 23,8%, VCM 77, leucocitos 11.940, VSG 40 mm. Glucosa 206 mg/dl. Hierro 28 ug/dl.
Se realizó una endoscopia oral en la que se visualizó una gran hernia de hiato y en tercio distal esofágico una úlcera profunda de aproximadamente 2 cm de diámetro con abundante exudado blanquecino en el cráter. Se realizó una biopsia y citología de la lesión. La histología demostró mucosa escamosa esofágica y numerosos gránulos de sulfuro conteniendo abundantes hifas consistentes con actinomicosis.
Se inició tratamiento con penicilina G intravenosa durante unos días y posteriormente dada de alta con penicilina oral. La paciente fue perdida en el seguimiento.
Responsable clínico: Dr. Miguel Jiménez Peñalba. Correo electrónico: mijipeñ@hotmail.com
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] | Datos del paciente.
Nombre: Sandra .
Apellidos: De la Cruz Lorenzo.
NHC: 3478564.
NASS: 78 43567091 65.
Domicilio: C/ Santiesteban, 27, 3, A.
Localidad/ Provincia: Madrid.
CP: 28036.
Datos asistenciales.
Fecha de nacimiento: 08/11/1924.
País de nacimiento: España.
Edad: 92 años Sexo: M.
Fecha de Ingreso: 03/03/2017.
Médico: Miguel Jiménez Peñalba NºCol: 28 28 57894.
Informe clínico del paciente: Mujer de 92 años de edad, sin alergias medicamentosas conocidas, con antecedentes personales de hipertensión arterial, diabetes mellitus tipo 2, fibrilación auricular crónica y enfermedad de Alzheimer. Está a cargo de su hija con quién vive en la calle embajadores, 23, 2 A de Madrid. Ingresó por vómitos en posos de café, epigastralgia y pérdida de de peso en el último mes. La exploración física era irrelevante.
En la analítica destacaba: hemoglobina 7,1 g/dl, hematocrito 23,8%, VCM 77, leucocitos 11.940, VSG 40 mm. Glucosa 206 mg/dl. Hierro 28 ug/dl.
Se realizó una endoscopia oral en la que se visualizó una gran hernia de hiato y en tercio distal esofágico una úlcera profunda de aproximadamente 2 cm de diámetro con abundante exudado blanquecino en el cráter. Se realizó una biopsia y citología de la lesión. La histología demostró mucosa escamosa esofágica y numerosos gránulos de sulfuro conteniendo abundantes hifas consistentes con actinomicosis.
Se inició tratamiento con penicilina G intravenosa durante unos días y posteriormente dada de alta con penicilina oral. La paciente fue perdida en el seguimiento.
Responsable clínico: Dr. Miguel Jiménez Peñalba. Correo electrónico: mijipeñ@hotmail.com
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Sandra is a NOMBRE_SUJETO_ASISTENCIA, De la Cruz Lorenzo is a NOMBRE_SUJETO_ASISTENCIA, 3478564 is a ID_SUJETO_ASISTENCIA, 78 43567091 65 is a ID_ASEGURAMIENTO, Madrid is a TERRITORIO, 28036 is a TERRITORIO, 08/11/1924 is a FECHAS, España is a PAIS, 92 años is a EDAD_SUJETO_ASISTENCIA, 03/03/2017 is a FECHAS, Miguel Jiménez Peñalba is a NOMBRE_PERSONAL_SANITARIO, 28 28 57894 is a ID_TITULACION_PERSONAL_SANITARIO, Mujer is a SEXO_SUJETO_ASISTENCIA, 92 años is a EDAD_SUJETO_ASISTENCIA, hija is a FAMILIARES_SUJETO_ASISTENCIA, calle embajadores , 23 , 2 A is a CALLE, Madrid is a TERRITORIO, Miguel Jiménez Peñalba is a NOMBRE_PERSONAL_SANITARIO, mijipeñ@hotmail.com is a CORREO_ELECTRONICO | 311_task1 | Sentence: Datos del paciente.
Nombre: Sandra .
Apellidos: De la Cruz Lorenzo.
NHC: 3478564.
NASS: 78 43567091 65.
Domicilio: C/ Santiesteban, 27, 3, A.
Localidad/ Provincia: Madrid.
CP: 28036.
Datos asistenciales.
Fecha de nacimiento: 08/11/1924.
País de nacimiento: España.
Edad: 92 años Sexo: M.
Fecha de Ingreso: 03/03/2017.
Médico: Miguel Jiménez Peñalba NºCol: 28 28 57894.
Informe clínico del paciente: Mujer de 92 años de edad, sin alergias medicamentosas conocidas, con antecedentes personales de hipertensión arterial, diabetes mellitus tipo 2, fibrilación auricular crónica y enfermedad de Alzheimer. Está a cargo de su hija con quién vive en la calle embajadores, 23, 2 A de Madrid. Ingresó por vómitos en posos de café, epigastralgia y pérdida de de peso en el último mes. La exploración física era irrelevante.
En la analítica destacaba: hemoglobina 7,1 g/dl, hematocrito 23,8%, VCM 77, leucocitos 11.940, VSG 40 mm. Glucosa 206 mg/dl. Hierro 28 ug/dl.
Se realizó una endoscopia oral en la que se visualizó una gran hernia de hiato y en tercio distal esofágico una úlcera profunda de aproximadamente 2 cm de diámetro con abundante exudado blanquecino en el cráter. Se realizó una biopsia y citología de la lesión. La histología demostró mucosa escamosa esofágica y numerosos gránulos de sulfuro conteniendo abundantes hifas consistentes con actinomicosis.
Se inició tratamiento con penicilina G intravenosa durante unos días y posteriormente dada de alta con penicilina oral. La paciente fue perdida en el seguimiento.
Responsable clínico: Dr. Miguel Jiménez Peñalba. Correo electrónico: mijipeñ@hotmail.com
Instructions: please typing these entity words according to sentence: Sandra, De la Cruz Lorenzo, 3478564, 78 43567091 65, Madrid, 28036, 08/11/1924, España, 92 años, 03/03/2017, Miguel Jiménez Peñalba, 28 28 57894, Mujer, 92 años, hija, calle embajadores , 23 , 2 A, Madrid, Miguel Jiménez Peñalba, mijipeñ@hotmail.com
Options: TERRITORIO, SEXO_SUJETO_ASISTENCIA, ID_SUJETO_ASISTENCIA, FECHAS, FAMILIARES_SUJETO_ASISTENCIA, CALLE, CORREO_ELECTRONICO, PAIS, EDAD_SUJETO_ASISTENCIA, ID_ASEGURAMIENTO, ID_TITULACION_PERSONAL_SANITARIO, NOMBRE_SUJETO_ASISTENCIA, NOMBRE_PERSONAL_SANITARIO
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Nombre: Sandra .
Apellidos: De la Cruz Lorenzo.
NHC: 3478564.
NASS: 78 43567091 65.
Domicilio: C/ Santiesteban, 27, 3, A.
Localidad/ Provincia: Madrid.
CP: 28036.
Datos asistenciales.
Fecha de nacimiento: 08/11/1924.
País de nacimiento: España.
Edad: 92 años Sexo: M.
Fecha de Ingreso: 03/03/2017.
Médico: Miguel Jiménez Peñalba NºCol: 28 28 57894.
Informe clínico del paciente: Mujer de 92 años de edad, sin alergias medicamentosas conocidas, con antecedentes personales de hipertensión arterial, diabetes mellitus tipo 2, fibrilación auricular crónica y enfermedad de Alzheimer. Está a cargo de su hija con quién vive en la calle embajadores, 23, 2 A de Madrid. Ingresó por vómitos en posos de café, epigastralgia y pérdida de de peso en el último mes. La exploración física era irrelevante.
En la analítica destacaba: hemoglobina 7,1 g/dl, hematocrito 23,8%, VCM 77, leucocitos 11.940, VSG 40 mm. Glucosa 206 mg/dl. Hierro 28 ug/dl.
Se realizó una endoscopia oral en la que se visualizó una gran hernia de hiato y en tercio distal esofágico una úlcera profunda de aproximadamente 2 cm de diámetro con abundante exudado blanquecino en el cráter. Se realizó una biopsia y citología de la lesión. La histología demostró mucosa escamosa esofágica y numerosos gránulos de sulfuro conteniendo abundantes hifas consistentes con actinomicosis.
Se inició tratamiento con penicilina G intravenosa durante unos días y posteriormente dada de alta con penicilina oral. La paciente fue perdida en el seguimiento.
Responsable clínico: Dr. Miguel Jiménez Peñalba. Correo electrónico: mijipeñ@hotmail.com
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Sandra, De la Cruz Lorenzo, 3478564, 78 43567091 65, Madrid, 28036, 08/11/1924, España, 92 años, 03/03/2017, Miguel Jiménez Peñalba, 28 28 57894, Mujer, 92 años, hija, calle embajadores , 23 , 2 A, Madrid, Miguel Jiménez Peñalba, mijipeñ@hotmail.com | 311_task2 | Sentence: Datos del paciente.
Nombre: Sandra .
Apellidos: De la Cruz Lorenzo.
NHC: 3478564.
NASS: 78 43567091 65.
Domicilio: C/ Santiesteban, 27, 3, A.
Localidad/ Provincia: Madrid.
CP: 28036.
Datos asistenciales.
Fecha de nacimiento: 08/11/1924.
País de nacimiento: España.
Edad: 92 años Sexo: M.
Fecha de Ingreso: 03/03/2017.
Médico: Miguel Jiménez Peñalba NºCol: 28 28 57894.
Informe clínico del paciente: Mujer de 92 años de edad, sin alergias medicamentosas conocidas, con antecedentes personales de hipertensión arterial, diabetes mellitus tipo 2, fibrilación auricular crónica y enfermedad de Alzheimer. Está a cargo de su hija con quién vive en la calle embajadores, 23, 2 A de Madrid. Ingresó por vómitos en posos de café, epigastralgia y pérdida de de peso en el último mes. La exploración física era irrelevante.
En la analítica destacaba: hemoglobina 7,1 g/dl, hematocrito 23,8%, VCM 77, leucocitos 11.940, VSG 40 mm. Glucosa 206 mg/dl. Hierro 28 ug/dl.
Se realizó una endoscopia oral en la que se visualizó una gran hernia de hiato y en tercio distal esofágico una úlcera profunda de aproximadamente 2 cm de diámetro con abundante exudado blanquecino en el cráter. Se realizó una biopsia y citología de la lesión. La histología demostró mucosa escamosa esofágica y numerosos gránulos de sulfuro conteniendo abundantes hifas consistentes con actinomicosis.
Se inició tratamiento con penicilina G intravenosa durante unos días y posteriormente dada de alta con penicilina oral. La paciente fue perdida en el seguimiento.
Responsable clínico: Dr. Miguel Jiménez Peñalba. Correo electrónico: mijipeñ@hotmail.com
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Nombre: Sandra .
Apellidos: De la Cruz Lorenzo.
NHC: 3478564.
NASS: 78 43567091 65.
Domicilio: C/ Santiesteban, 27, 3, A.
Localidad/ Provincia: Madrid.
CP: 28036.
Datos asistenciales.
Fecha de nacimiento: 08/11/1924.
País de nacimiento: España.
Edad: 92 años Sexo: M.
Fecha de Ingreso: 03/03/2017.
Médico: Miguel Jiménez Peñalba NºCol: 28 28 57894.
Informe clínico del paciente: Mujer de 92 años de edad, sin alergias medicamentosas conocidas, con antecedentes personales de hipertensión arterial, diabetes mellitus tipo 2, fibrilación auricular crónica y enfermedad de Alzheimer. Está a cargo de su hija con quién vive en la calle embajadores, 23, 2 A de Madrid. Ingresó por vómitos en posos de café, epigastralgia y pérdida de de peso en el último mes. La exploración física era irrelevante.
En la analítica destacaba: hemoglobina 7,1 g/dl, hematocrito 23,8%, VCM 77, leucocitos 11.940, VSG 40 mm. Glucosa 206 mg/dl. Hierro 28 ug/dl.
Se realizó una endoscopia oral en la que se visualizó una gran hernia de hiato y en tercio distal esofágico una úlcera profunda de aproximadamente 2 cm de diámetro con abundante exudado blanquecino en el cráter. Se realizó una biopsia y citología de la lesión. La histología demostró mucosa escamosa esofágica y numerosos gránulos de sulfuro conteniendo abundantes hifas consistentes con actinomicosis.
Se inició tratamiento con penicilina G intravenosa durante unos días y posteriormente dada de alta con penicilina oral. La paciente fue perdida en el seguimiento.
Responsable clínico: Dr. Miguel Jiménez Peñalba. Correo electrónico: mijipeñ@hotmail.com
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Methode is an umlsterm, Penisdeviationen is an umlsterm, Langzeitverlauf is an umlsterm, Patientenkollektivs is an umlsterm, Lebensqualitaet is an umlsterm, Analyse is an umlsterm, Fragebogen is an umlsterm, erwachsene is an umlsterm, Patienten is an umlsterm, Penisdeviationen is an umlsterm, Fragebogen is an umlsterm, Patienten is an umlsterm, angeborene is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Geschlechtsverkehr is an umlsterm, Patienten is an umlsterm, Lebensqualitaet is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Operationstechnik is an umlsterm, Patienten is an umlsterm, angeborener is an umlsterm, Patienten is an umlsterm, Induratio penis plastica is an umlsterm, Rezidivrate is an umlsterm, Patienten is an umlsterm, Operationstechnik is an umlsterm | DerUrologeA.00390440.ger.abstr_task0 | Sentence: Die Methode der Wahl zur Korrektur von Penisdeviationen ist weiterhin umstritten . Neben der Nesbit-Methode hat sich die Schroeder-Essed-Technik mittels Plikaturnaehten durchgesetzt . Waehrend die geringe perioperative Komplikationsrate mehrfach beschrieben ist , gibt es kaum Daten ueber den Langzeitverlauf dieses Patientenkollektivs . In der vorliegenden Studie untersuchten wir die postoperative Funktionalitaet und Aenderung der Lebensqualitaet ( LQ ineiner retrospektiven Analyse ) mittels einem detaillierten Fragebogen . Zwischen 01/94 und 01/99 wurden 40 erwachsene Patienten ( medianes Alter 26 Jahre ) mit Penisdeviationen ( DEV ) operiert . Der Fragebogen umfasste funktionelle kosmetische und Aspekte , zur LQ . Ein komplettes Follow-up liegt derzeit von 31/40 ( 77,5% ) Patienten vor angeborene DEV : ( 19 Patienten , erworbene DEV : 12 Patienten ) . Das mediane Follow-up betraegt 22 Monate . Vor dem Eingriff schaetzten 5 Patienten die DEV als leicht ( 45 Grad ) , 22 als mittelschwer ( 45-90 Grad ) und 4 Patienten als schwer ( > 90 Grad ) ein . Bei 21 Patienten war der Geschlechtsverkehr ( GV ) praeoperativ nur mit Beschwerden oder gar nicht moeglich ; 26 Patienten berichteten praeoperativ ueber eine erhebliche Einschraenkung in ihrer Lebensqualitaet . Nach dem Eingriff beurteilten 25 Patienten das kosmetische Ergebnis als gut oder zumindest zufriedenstellend ( 80,6% ) . Bei 25 Patienten ist der GV problemlos moeglich . Eine merkliche Verkuerzung ( > 2 cm ) berichteten 5 Patienten ( 12% ) . Etwa Haelfte der Patienten ( 48% ) berichten nach dem Eingriff ueber eine deutliche Verbesserung der LQ . Bei den Patienten mit erworbener DEV berichteten 6/12 50% ) ( ueber eine Verschlechterung der Rigiditaet und 2/12 ( 16,7% ) ueber eine postoperativ erneut aufgetretene DEV . Die einfache Operationstechnik ergibt insgesamt , v. a. bei Patienten mit angeborener Deviation , eine hohe Zufriedenheitsrate hinsichtlich des kosmetischen und funktionellen Ergebnisses . Bei Patienten mit Induratio penis plastica ( IPP muss ) ueber eine erhoehte Rezidivrate aufgeklaert werden . Bei diesen Patienten sollte eine andere Operationstechnik erwogen werden .
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Methode is an umlsterm, Penisdeviationen is an umlsterm, Langzeitverlauf is an umlsterm, Patientenkollektivs is an umlsterm, Lebensqualitaet is an umlsterm, Analyse is an umlsterm, Fragebogen is an umlsterm, erwachsene is an umlsterm, Patienten is an umlsterm, Penisdeviationen is an umlsterm, Fragebogen is an umlsterm, Patienten is an umlsterm, angeborene is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Geschlechtsverkehr is an umlsterm, Patienten is an umlsterm, Lebensqualitaet is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Operationstechnik is an umlsterm, Patienten is an umlsterm, angeborener is an umlsterm, Patienten is an umlsterm, Induratio penis plastica is an umlsterm, Rezidivrate is an umlsterm, Patienten is an umlsterm, Operationstechnik is an umlsterm | DerUrologeA.00390440.ger.abstr_task1 | Sentence: Die Methode der Wahl zur Korrektur von Penisdeviationen ist weiterhin umstritten . Neben der Nesbit-Methode hat sich die Schroeder-Essed-Technik mittels Plikaturnaehten durchgesetzt . Waehrend die geringe perioperative Komplikationsrate mehrfach beschrieben ist , gibt es kaum Daten ueber den Langzeitverlauf dieses Patientenkollektivs . In der vorliegenden Studie untersuchten wir die postoperative Funktionalitaet und Aenderung der Lebensqualitaet ( LQ ineiner retrospektiven Analyse ) mittels einem detaillierten Fragebogen . Zwischen 01/94 und 01/99 wurden 40 erwachsene Patienten ( medianes Alter 26 Jahre ) mit Penisdeviationen ( DEV ) operiert . Der Fragebogen umfasste funktionelle kosmetische und Aspekte , zur LQ . Ein komplettes Follow-up liegt derzeit von 31/40 ( 77,5% ) Patienten vor angeborene DEV : ( 19 Patienten , erworbene DEV : 12 Patienten ) . Das mediane Follow-up betraegt 22 Monate . Vor dem Eingriff schaetzten 5 Patienten die DEV als leicht ( 45 Grad ) , 22 als mittelschwer ( 45-90 Grad ) und 4 Patienten als schwer ( > 90 Grad ) ein . Bei 21 Patienten war der Geschlechtsverkehr ( GV ) praeoperativ nur mit Beschwerden oder gar nicht moeglich ; 26 Patienten berichteten praeoperativ ueber eine erhebliche Einschraenkung in ihrer Lebensqualitaet . Nach dem Eingriff beurteilten 25 Patienten das kosmetische Ergebnis als gut oder zumindest zufriedenstellend ( 80,6% ) . Bei 25 Patienten ist der GV problemlos moeglich . Eine merkliche Verkuerzung ( > 2 cm ) berichteten 5 Patienten ( 12% ) . Etwa Haelfte der Patienten ( 48% ) berichten nach dem Eingriff ueber eine deutliche Verbesserung der LQ . Bei den Patienten mit erworbener DEV berichteten 6/12 50% ) ( ueber eine Verschlechterung der Rigiditaet und 2/12 ( 16,7% ) ueber eine postoperativ erneut aufgetretene DEV . Die einfache Operationstechnik ergibt insgesamt , v. a. bei Patienten mit angeborener Deviation , eine hohe Zufriedenheitsrate hinsichtlich des kosmetischen und funktionellen Ergebnisses . Bei Patienten mit Induratio penis plastica ( IPP muss ) ueber eine erhoehte Rezidivrate aufgeklaert werden . Bei diesen Patienten sollte eine andere Operationstechnik erwogen werden .
Instructions: please typing these entity words according to sentence: Methode, Penisdeviationen, Langzeitverlauf, Patientenkollektivs, Lebensqualitaet, Analyse, Fragebogen, erwachsene, Patienten, Penisdeviationen, Fragebogen, Patienten, angeborene, Patienten, Patienten, Patienten, Patienten, Patienten, Geschlechtsverkehr, Patienten, Lebensqualitaet, Patienten, Patienten, Patienten, Patienten, Patienten, Operationstechnik, Patienten, angeborener, Patienten, Induratio penis plastica, Rezidivrate, Patienten, Operationstechnik
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Methode, Penisdeviationen, Langzeitverlauf, Patientenkollektivs, Lebensqualitaet, Analyse, Fragebogen, erwachsene, Patienten, Penisdeviationen, Fragebogen, Patienten, angeborene, Patienten, Patienten, Patienten, Patienten, Patienten, Geschlechtsverkehr, Patienten, Lebensqualitaet, Patienten, Patienten, Patienten, Patienten, Patienten, Operationstechnik, Patienten, angeborener, Patienten, Induratio penis plastica, Rezidivrate, Patienten, Operationstechnik | DerUrologeA.00390440.ger.abstr_task2 | Sentence: Die Methode der Wahl zur Korrektur von Penisdeviationen ist weiterhin umstritten . Neben der Nesbit-Methode hat sich die Schroeder-Essed-Technik mittels Plikaturnaehten durchgesetzt . Waehrend die geringe perioperative Komplikationsrate mehrfach beschrieben ist , gibt es kaum Daten ueber den Langzeitverlauf dieses Patientenkollektivs . In der vorliegenden Studie untersuchten wir die postoperative Funktionalitaet und Aenderung der Lebensqualitaet ( LQ ineiner retrospektiven Analyse ) mittels einem detaillierten Fragebogen . Zwischen 01/94 und 01/99 wurden 40 erwachsene Patienten ( medianes Alter 26 Jahre ) mit Penisdeviationen ( DEV ) operiert . Der Fragebogen umfasste funktionelle kosmetische und Aspekte , zur LQ . Ein komplettes Follow-up liegt derzeit von 31/40 ( 77,5% ) Patienten vor angeborene DEV : ( 19 Patienten , erworbene DEV : 12 Patienten ) . Das mediane Follow-up betraegt 22 Monate . Vor dem Eingriff schaetzten 5 Patienten die DEV als leicht ( 45 Grad ) , 22 als mittelschwer ( 45-90 Grad ) und 4 Patienten als schwer ( > 90 Grad ) ein . Bei 21 Patienten war der Geschlechtsverkehr ( GV ) praeoperativ nur mit Beschwerden oder gar nicht moeglich ; 26 Patienten berichteten praeoperativ ueber eine erhebliche Einschraenkung in ihrer Lebensqualitaet . Nach dem Eingriff beurteilten 25 Patienten das kosmetische Ergebnis als gut oder zumindest zufriedenstellend ( 80,6% ) . Bei 25 Patienten ist der GV problemlos moeglich . Eine merkliche Verkuerzung ( > 2 cm ) berichteten 5 Patienten ( 12% ) . Etwa Haelfte der Patienten ( 48% ) berichten nach dem Eingriff ueber eine deutliche Verbesserung der LQ . Bei den Patienten mit erworbener DEV berichteten 6/12 50% ) ( ueber eine Verschlechterung der Rigiditaet und 2/12 ( 16,7% ) ueber eine postoperativ erneut aufgetretene DEV . Die einfache Operationstechnik ergibt insgesamt , v. a. bei Patienten mit angeborener Deviation , eine hohe Zufriedenheitsrate hinsichtlich des kosmetischen und funktionellen Ergebnisses . Bei Patienten mit Induratio penis plastica ( IPP muss ) ueber eine erhoehte Rezidivrate aufgeklaert werden . Bei diesen Patienten sollte eine andere Operationstechnik erwogen werden .
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Therapieplanung is an umlsterm, malignen Lymphomen is an umlsterm, bildgebende is an umlsterm, Beurteilung is an umlsterm, Tumorgewebe is an umlsterm, Patienten is an umlsterm, malignen Lymphomen is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Wasser is an umlsterm, Patienten is an umlsterm, Gewebeperfusion is an umlsterm, Lymphknoten is an umlsterm, Rezidive is an umlsterm, Patienten is an umlsterm, Tumorperfusion is an umlsterm, Patienten is an umlsterm, Instrument is an umlsterm, Rezidivdiagnostik is an umlsterm, Therapieplanung is an umlsterm, malignen Lymphomen is an umlsterm | DerRadiologe.70370074.ger.abstr_task0 | Sentence: Funktionelle Verfahren sind fuer die Therapieplanung von malignen Lymphomen notwendig , da morphologische bildgebende Verfahren bei der Beurteilung von residuellem Tumorgewebe oft die Schluesselfrage der Vitalitaet offen lassen . Bei Patienten mit gesicherten malignen Lymphomen , die fuer eine Second-line-Chemotherapie vorgesehen waren , haben wir eine Positronenemissionstomographie ( PET ) durchgefuehrt . Im Rahmen dieser Studie konnten wir 20 Patienten ( 68 maligne Laesionen , 3 benigne Laesionen ) mit M. Hodgkin ( HL ) und 26 Patienten ( 46 maligne Laesionen , eine benigne Laesion ) mit Non-Hodgkin-Lymphomen ( NHL ) untersuchen . Dynamische PET-Messungen mit F-18-Fluordeoxyglukose ( FDG ) wurden ueber 60 min zur Erfassung des regionalen FDG-Stoffwechsels durchgefuehrt , sowie statische Aufnahmen in ausgewaehlten Faellen ; O-15-markiertes Wasser wurde zusaetzlich in 14 Patienten ( 25 Laesionen ) eingesetzt , um die Gewebeperfusion zu erfassen . Alle Laesionen wurden mit FDG ( 60 min SUV ) richtig klassifiziert . Wir konnten keinen statistisch signifikanten Unterschied der FDG-Akkumulation zwischen HL und NHL feststellen . Es war moeglich mit PET und FDG normal grosse , jedoch befallene Lymphknoten ( 1 cm ) zu erkennen . Eine Limitierung stellen entzuendliche Prozesse dar , da sie ebenfalls einen erhoehten FDG-Stoffwechsel aufweisen . Weiterhin koennen Rezidive therapierter Patienten einen relativ niedrigen FDG-Stoffwechsel haben und somit diagnostische Probleme bereiten . Ein Vergleich der Tumorperfusion und des regionalen FDG-Stoffwechsels ergab eine signifikante nicht-lineare Korrelation von r = 0,78 ; 2 Patienten mit Narbengewebe wurden von einer Blutstammzelltransplantation aufgrund des PET-Befunds ausgeschlossen . Diese Ergebnisse belegen , dass FDG-PET ein wichtiges Instrument fuer die Rezidivdiagnostik und die Therapieplanung von malignen Lymphomen darstellt .
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Therapieplanung is an umlsterm, malignen Lymphomen is an umlsterm, bildgebende is an umlsterm, Beurteilung is an umlsterm, Tumorgewebe is an umlsterm, Patienten is an umlsterm, malignen Lymphomen is an umlsterm, Patienten is an umlsterm, Patienten is an umlsterm, Wasser is an umlsterm, Patienten is an umlsterm, Gewebeperfusion is an umlsterm, Lymphknoten is an umlsterm, Rezidive is an umlsterm, Patienten is an umlsterm, Tumorperfusion is an umlsterm, Patienten is an umlsterm, Instrument is an umlsterm, Rezidivdiagnostik is an umlsterm, Therapieplanung is an umlsterm, malignen Lymphomen is an umlsterm | DerRadiologe.70370074.ger.abstr_task1 | Sentence: Funktionelle Verfahren sind fuer die Therapieplanung von malignen Lymphomen notwendig , da morphologische bildgebende Verfahren bei der Beurteilung von residuellem Tumorgewebe oft die Schluesselfrage der Vitalitaet offen lassen . Bei Patienten mit gesicherten malignen Lymphomen , die fuer eine Second-line-Chemotherapie vorgesehen waren , haben wir eine Positronenemissionstomographie ( PET ) durchgefuehrt . Im Rahmen dieser Studie konnten wir 20 Patienten ( 68 maligne Laesionen , 3 benigne Laesionen ) mit M. Hodgkin ( HL ) und 26 Patienten ( 46 maligne Laesionen , eine benigne Laesion ) mit Non-Hodgkin-Lymphomen ( NHL ) untersuchen . Dynamische PET-Messungen mit F-18-Fluordeoxyglukose ( FDG ) wurden ueber 60 min zur Erfassung des regionalen FDG-Stoffwechsels durchgefuehrt , sowie statische Aufnahmen in ausgewaehlten Faellen ; O-15-markiertes Wasser wurde zusaetzlich in 14 Patienten ( 25 Laesionen ) eingesetzt , um die Gewebeperfusion zu erfassen . Alle Laesionen wurden mit FDG ( 60 min SUV ) richtig klassifiziert . Wir konnten keinen statistisch signifikanten Unterschied der FDG-Akkumulation zwischen HL und NHL feststellen . Es war moeglich mit PET und FDG normal grosse , jedoch befallene Lymphknoten ( 1 cm ) zu erkennen . Eine Limitierung stellen entzuendliche Prozesse dar , da sie ebenfalls einen erhoehten FDG-Stoffwechsel aufweisen . Weiterhin koennen Rezidive therapierter Patienten einen relativ niedrigen FDG-Stoffwechsel haben und somit diagnostische Probleme bereiten . Ein Vergleich der Tumorperfusion und des regionalen FDG-Stoffwechsels ergab eine signifikante nicht-lineare Korrelation von r = 0,78 ; 2 Patienten mit Narbengewebe wurden von einer Blutstammzelltransplantation aufgrund des PET-Befunds ausgeschlossen . Diese Ergebnisse belegen , dass FDG-PET ein wichtiges Instrument fuer die Rezidivdiagnostik und die Therapieplanung von malignen Lymphomen darstellt .
Instructions: please typing these entity words according to sentence: Therapieplanung, malignen Lymphomen, bildgebende, Beurteilung, Tumorgewebe, Patienten, malignen Lymphomen, Patienten, Patienten, Wasser, Patienten, Gewebeperfusion, Lymphknoten, Rezidive, Patienten, Tumorperfusion, Patienten, Instrument, Rezidivdiagnostik, Therapieplanung, malignen Lymphomen
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Therapieplanung, malignen Lymphomen, bildgebende, Beurteilung, Tumorgewebe, Patienten, malignen Lymphomen, Patienten, Patienten, Wasser, Patienten, Gewebeperfusion, Lymphknoten, Rezidive, Patienten, Tumorperfusion, Patienten, Instrument, Rezidivdiagnostik, Therapieplanung, malignen Lymphomen | DerRadiologe.70370074.ger.abstr_task2 | Sentence: Funktionelle Verfahren sind fuer die Therapieplanung von malignen Lymphomen notwendig , da morphologische bildgebende Verfahren bei der Beurteilung von residuellem Tumorgewebe oft die Schluesselfrage der Vitalitaet offen lassen . Bei Patienten mit gesicherten malignen Lymphomen , die fuer eine Second-line-Chemotherapie vorgesehen waren , haben wir eine Positronenemissionstomographie ( PET ) durchgefuehrt . Im Rahmen dieser Studie konnten wir 20 Patienten ( 68 maligne Laesionen , 3 benigne Laesionen ) mit M. Hodgkin ( HL ) und 26 Patienten ( 46 maligne Laesionen , eine benigne Laesion ) mit Non-Hodgkin-Lymphomen ( NHL ) untersuchen . Dynamische PET-Messungen mit F-18-Fluordeoxyglukose ( FDG ) wurden ueber 60 min zur Erfassung des regionalen FDG-Stoffwechsels durchgefuehrt , sowie statische Aufnahmen in ausgewaehlten Faellen ; O-15-markiertes Wasser wurde zusaetzlich in 14 Patienten ( 25 Laesionen ) eingesetzt , um die Gewebeperfusion zu erfassen . Alle Laesionen wurden mit FDG ( 60 min SUV ) richtig klassifiziert . Wir konnten keinen statistisch signifikanten Unterschied der FDG-Akkumulation zwischen HL und NHL feststellen . Es war moeglich mit PET und FDG normal grosse , jedoch befallene Lymphknoten ( 1 cm ) zu erkennen . Eine Limitierung stellen entzuendliche Prozesse dar , da sie ebenfalls einen erhoehten FDG-Stoffwechsel aufweisen . Weiterhin koennen Rezidive therapierter Patienten einen relativ niedrigen FDG-Stoffwechsel haben und somit diagnostische Probleme bereiten . Ein Vergleich der Tumorperfusion und des regionalen FDG-Stoffwechsels ergab eine signifikante nicht-lineare Korrelation von r = 0,78 ; 2 Patienten mit Narbengewebe wurden von einer Blutstammzelltransplantation aufgrund des PET-Befunds ausgeschlossen . Diese Ergebnisse belegen , dass FDG-PET ein wichtiges Instrument fuer die Rezidivdiagnostik und die Therapieplanung von malignen Lymphomen darstellt .
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proteína C reactiva is a PROTEINAS, PCR is a PROTEINAS, amoxicilina is a NORMALIZABLES, anticuerpos antiestreptolisina O is a PROTEINAS, ASLO is a PROTEINAS | 463_task0 | Sentence: Paciente de ocho años sin antecedentes personales ni familiares de interés. Acude a Urgencias porque, coincidiendo con un proceso catarral con odinofagia sin fiebre, presenta de forma brusca coprolalia, trastorno selectivo de la memoria (no recuerda y confunde algunos nombres de personas que conoce), comportamiento anómalo con hiperactividad y movimientos compulsivos. No pierde la conciencia ni existe alteración del tono muscular ni de la fuerza. La familia describe el cuadro como una alteración conductual explosiva y sorprendente. El episodio dura unos minutos y cuando llega a Urgencias se encuentra más tranquilo, aunque sigue presentando alteración del lenguaje y confusión en relación con su familia y el entorno en el que se encuentra. Refiere síntomas catarrales y dolor de garganta. Está afebril.
En la exploración no se observan exantemas; la auscultación cardiopulmonar es normal. Exploración otorrinolaringológica: exudación amigdalar. Abdomen: blando, sin visceromegalias. La sensibilidad, el tono, la fuerza y los reflejos osteotendinosos son normales. No presenta signos de focalidad neurológica.
Se realiza analítica sanguínea, que muestra 18 400 leucocitos (86 segmentados, tres cayados, seis linfocitos, tres monocitos), y 260 000 plaquetas. Bioquímica sin alteraciones en el cribado básico, proteína C reactiva (PCR): 11 mg/l. Se le recoge frotis de garganta que es positivo para Streptococcus pyogenes (grupo A).
Ingresa para observación y estudio del proceso y se inicia tratamiento antibiótico con amoxicilina, que finaliza a los diez días. La clínica neuropsiquiátrica desaparece totalmente a las 24 horas tras el ingreso. Dada la rápida resolución y el buen estado general del niño, se decide dar el alta hospitalaria y continuar con estudio ambulatorio.
Cuando le vemos en la consulta de Atención Primaria el paciente está asintomático, con exploración física y neurológica sin alteraciones. Se solicita resonancia magnética craneal y electroencefalograma, que resultan normales. Es visto por un proceso catarral a los tres meses, sin que se repitan los síntomas descritos en el episodio de amigdalitis previo. Permanece sin recaídas.
Ha realizado estudio de exudado amigdalar en dos ocasiones por sendos procesos infecciosos, que han sido negativos. Se descarta así mismo su estado como portador, si bien no se han determinado los niveles de anticuerpos antiestreptolisina O (ASLO) por no haber vuelto a presentar recaídas clínicas.
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En la exploración no se observan exantemas; la auscultación cardiopulmonar es normal. Exploración otorrinolaringológica: exudación amigdalar. Abdomen: blando, sin visceromegalias. La sensibilidad, el tono, la fuerza y los reflejos osteotendinosos son normales. No presenta signos de focalidad neurológica.
Se realiza analítica sanguínea, que muestra 18 400 leucocitos (86 segmentados, tres cayados, seis linfocitos, tres monocitos), y 260 000 plaquetas. Bioquímica sin alteraciones en el cribado básico, proteína C reactiva (PCR): 11 mg/l. Se le recoge frotis de garganta que es positivo para Streptococcus pyogenes (grupo A).
Ingresa para observación y estudio del proceso y se inicia tratamiento antibiótico con amoxicilina, que finaliza a los diez días. La clínica neuropsiquiátrica desaparece totalmente a las 24 horas tras el ingreso. Dada la rápida resolución y el buen estado general del niño, se decide dar el alta hospitalaria y continuar con estudio ambulatorio.
Cuando le vemos en la consulta de Atención Primaria el paciente está asintomático, con exploración física y neurológica sin alteraciones. Se solicita resonancia magnética craneal y electroencefalograma, que resultan normales. Es visto por un proceso catarral a los tres meses, sin que se repitan los síntomas descritos en el episodio de amigdalitis previo. Permanece sin recaídas.
Ha realizado estudio de exudado amigdalar en dos ocasiones por sendos procesos infecciosos, que han sido negativos. Se descarta así mismo su estado como portador, si bien no se han determinado los niveles de anticuerpos antiestreptolisina O (ASLO) por no haber vuelto a presentar recaídas clínicas.
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proteína C reactiva is a PROTEINAS, PCR is a PROTEINAS, amoxicilina is a NORMALIZABLES, anticuerpos antiestreptolisina O is a PROTEINAS, ASLO is a PROTEINAS | 463_task1 | Sentence: Paciente de ocho años sin antecedentes personales ni familiares de interés. Acude a Urgencias porque, coincidiendo con un proceso catarral con odinofagia sin fiebre, presenta de forma brusca coprolalia, trastorno selectivo de la memoria (no recuerda y confunde algunos nombres de personas que conoce), comportamiento anómalo con hiperactividad y movimientos compulsivos. No pierde la conciencia ni existe alteración del tono muscular ni de la fuerza. La familia describe el cuadro como una alteración conductual explosiva y sorprendente. El episodio dura unos minutos y cuando llega a Urgencias se encuentra más tranquilo, aunque sigue presentando alteración del lenguaje y confusión en relación con su familia y el entorno en el que se encuentra. Refiere síntomas catarrales y dolor de garganta. Está afebril.
En la exploración no se observan exantemas; la auscultación cardiopulmonar es normal. Exploración otorrinolaringológica: exudación amigdalar. Abdomen: blando, sin visceromegalias. La sensibilidad, el tono, la fuerza y los reflejos osteotendinosos son normales. No presenta signos de focalidad neurológica.
Se realiza analítica sanguínea, que muestra 18 400 leucocitos (86 segmentados, tres cayados, seis linfocitos, tres monocitos), y 260 000 plaquetas. Bioquímica sin alteraciones en el cribado básico, proteína C reactiva (PCR): 11 mg/l. Se le recoge frotis de garganta que es positivo para Streptococcus pyogenes (grupo A).
Ingresa para observación y estudio del proceso y se inicia tratamiento antibiótico con amoxicilina, que finaliza a los diez días. La clínica neuropsiquiátrica desaparece totalmente a las 24 horas tras el ingreso. Dada la rápida resolución y el buen estado general del niño, se decide dar el alta hospitalaria y continuar con estudio ambulatorio.
Cuando le vemos en la consulta de Atención Primaria el paciente está asintomático, con exploración física y neurológica sin alteraciones. Se solicita resonancia magnética craneal y electroencefalograma, que resultan normales. Es visto por un proceso catarral a los tres meses, sin que se repitan los síntomas descritos en el episodio de amigdalitis previo. Permanece sin recaídas.
Ha realizado estudio de exudado amigdalar en dos ocasiones por sendos procesos infecciosos, que han sido negativos. Se descarta así mismo su estado como portador, si bien no se han determinado los niveles de anticuerpos antiestreptolisina O (ASLO) por no haber vuelto a presentar recaídas clínicas.
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Options: NORMALIZABLES, PROTEINAS
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Se realiza analítica sanguínea, que muestra 18 400 leucocitos (86 segmentados, tres cayados, seis linfocitos, tres monocitos), y 260 000 plaquetas. Bioquímica sin alteraciones en el cribado básico, proteína C reactiva (PCR): 11 mg/l. Se le recoge frotis de garganta que es positivo para Streptococcus pyogenes (grupo A).
Ingresa para observación y estudio del proceso y se inicia tratamiento antibiótico con amoxicilina, que finaliza a los diez días. La clínica neuropsiquiátrica desaparece totalmente a las 24 horas tras el ingreso. Dada la rápida resolución y el buen estado general del niño, se decide dar el alta hospitalaria y continuar con estudio ambulatorio.
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proteína C reactiva, PCR, amoxicilina, anticuerpos antiestreptolisina O, ASLO | 463_task2 | Sentence: Paciente de ocho años sin antecedentes personales ni familiares de interés. Acude a Urgencias porque, coincidiendo con un proceso catarral con odinofagia sin fiebre, presenta de forma brusca coprolalia, trastorno selectivo de la memoria (no recuerda y confunde algunos nombres de personas que conoce), comportamiento anómalo con hiperactividad y movimientos compulsivos. No pierde la conciencia ni existe alteración del tono muscular ni de la fuerza. La familia describe el cuadro como una alteración conductual explosiva y sorprendente. El episodio dura unos minutos y cuando llega a Urgencias se encuentra más tranquilo, aunque sigue presentando alteración del lenguaje y confusión en relación con su familia y el entorno en el que se encuentra. Refiere síntomas catarrales y dolor de garganta. Está afebril.
En la exploración no se observan exantemas; la auscultación cardiopulmonar es normal. Exploración otorrinolaringológica: exudación amigdalar. Abdomen: blando, sin visceromegalias. La sensibilidad, el tono, la fuerza y los reflejos osteotendinosos son normales. No presenta signos de focalidad neurológica.
Se realiza analítica sanguínea, que muestra 18 400 leucocitos (86 segmentados, tres cayados, seis linfocitos, tres monocitos), y 260 000 plaquetas. Bioquímica sin alteraciones en el cribado básico, proteína C reactiva (PCR): 11 mg/l. Se le recoge frotis de garganta que es positivo para Streptococcus pyogenes (grupo A).
Ingresa para observación y estudio del proceso y se inicia tratamiento antibiótico con amoxicilina, que finaliza a los diez días. La clínica neuropsiquiátrica desaparece totalmente a las 24 horas tras el ingreso. Dada la rápida resolución y el buen estado general del niño, se decide dar el alta hospitalaria y continuar con estudio ambulatorio.
Cuando le vemos en la consulta de Atención Primaria el paciente está asintomático, con exploración física y neurológica sin alteraciones. Se solicita resonancia magnética craneal y electroencefalograma, que resultan normales. Es visto por un proceso catarral a los tres meses, sin que se repitan los síntomas descritos en el episodio de amigdalitis previo. Permanece sin recaídas.
Ha realizado estudio de exudado amigdalar en dos ocasiones por sendos procesos infecciosos, que han sido negativos. Se descarta así mismo su estado como portador, si bien no se han determinado los niveles de anticuerpos antiestreptolisina O (ASLO) por no haber vuelto a presentar recaídas clínicas.
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Se realiza analítica sanguínea, que muestra 18 400 leucocitos (86 segmentados, tres cayados, seis linfocitos, tres monocitos), y 260 000 plaquetas. Bioquímica sin alteraciones en el cribado básico, proteína C reactiva (PCR): 11 mg/l. Se le recoge frotis de garganta que es positivo para Streptococcus pyogenes (grupo A).
Ingresa para observación y estudio del proceso y se inicia tratamiento antibiótico con amoxicilina, que finaliza a los diez días. La clínica neuropsiquiátrica desaparece totalmente a las 24 horas tras el ingreso. Dada la rápida resolución y el buen estado general del niño, se decide dar el alta hospitalaria y continuar con estudio ambulatorio.
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aim is an umlsterm, prospective study is an umlsterm, patent foramen ovale is an umlsterm, contrast is an umlsterm, risk factors is an umlsterm, atherosclerosis is an umlsterm, patients is an umlsterm, ischemic is an umlsterm, All is an umlsterm, patients is an umlsterm, neurological examination is an umlsterm, NMR is an umlsterm, transesophageal echocardiography is an umlsterm, patent foramen ovale is an umlsterm, patients is an umlsterm, risk factors is an umlsterm, atherosclerosis is an umlsterm, patients is an umlsterm, patent foramen ovale is an umlsterm, age is an umlsterm, hypertension is an umlsterm, diabetes is an umlsterm, use is an umlsterm, oral contraceptives is an umlsterm, atrial fibrillation is an umlsterm, aneurysm is an umlsterm, Multivariate analysis is an umlsterm, risk factors is an umlsterm, atherosclerosis is an umlsterm, hypertension is an umlsterm, diabetes is an umlsterm, age is an umlsterm, risk factors is an umlsterm, patients is an umlsterm, foramen ovale is an umlsterm, patients is an umlsterm, patent foramen ovale is an umlsterm, use is an umlsterm, oral contraceptives is an umlsterm, risk factor is an umlsterm, ischemic is an umlsterm, Patients is an umlsterm, ischemic is an umlsterm, foramen ovale is an umlsterm, age is an umlsterm, patients is an umlsterm, foramen ovale is an umlsterm, frequency is an umlsterm, hypertension is an umlsterm, diabetes is an umlsterm, patients is an umlsterm, atrial fibrillation is an umlsterm, Patients is an umlsterm, patent foramen ovale is an umlsterm, risk factors is an umlsterm, atherosclerosis is an umlsterm, use is an umlsterm, oral contraceptives is an umlsterm, aneurysm is an umlsterm | IntensiveMedizin.80350607.eng.abstr_task0 | Sentence: The aim of this prospective study was to assess the clinical and prognostic relevance of patent foramen ovale - in contrast to risk factors for atherosclerosis and cardioembolic sources - in 208 patients with cerebral ischemic events . All patients underwent neurological examination ( Doppler , CT , NMR ) as well as transthoracic and transesophageal echocardiography . A patent foramen ovale was found in 75 patients ( 36% ) . With regard to risk factors for atherosclerosis patients with closed resp. patent foramen ovale revealed significant differencies for age , hypertension , diabetes and use of oral contraceptives . Cardioembolic sources showed significant differencies for atrial fibrillation and atrial septal aneurysm . Multivariate analysis of risk factors for atherosclerosis and cardioembolic sources revealed hypertension and diabetes as age dependant risk factors in patients with closed foramen ovale . In patients with patent foramen ovale the use of oral contraceptives was found as an independant risk factor for cerebral ischemic event . Patients > 60 years with cerebral ischemic events had more often a closed foramen ovale . Dependant on age patients with closed foramen ovale showed a higher frequency of hypertension and diabetes . In addition these patients revealed more often atrial fibrillation . Patients with patent foramen ovale had fewer risk factors for atherosclerosis or cardioembolic sources but presented more frequent the use of oral contraceptives or atrial septal aneurysm .
Instructions: please extract entities and their types from the input sentence, all entity types are in options
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Instructions: please typing these entity words according to sentence: aim, prospective study, patent foramen ovale, contrast, risk factors, atherosclerosis, patients, ischemic, All, patients, neurological examination, NMR, transesophageal echocardiography, patent foramen ovale, patients, risk factors, atherosclerosis, patients, patent foramen ovale, age, hypertension, diabetes, use, oral contraceptives, atrial fibrillation, aneurysm, Multivariate analysis, risk factors, atherosclerosis, hypertension, diabetes, age, risk factors, patients, foramen ovale, patients, patent foramen ovale, use, oral contraceptives, risk factor, ischemic, Patients, ischemic, foramen ovale, age, patients, foramen ovale, frequency, hypertension, diabetes, patients, atrial fibrillation, Patients, patent foramen ovale, risk factors, atherosclerosis, use, oral contraceptives, aneurysm
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] | The aim of this prospective study was to assess the clinical and prognostic relevance of patent foramen ovale - in contrast to risk factors for atherosclerosis and cardioembolic sources - in 208 patients with cerebral ischemic events . All patients underwent neurological examination ( Doppler , CT , NMR ) as well as transthoracic and transesophageal echocardiography . A patent foramen ovale was found in 75 patients ( 36% ) . With regard to risk factors for atherosclerosis patients with closed resp. patent foramen ovale revealed significant differencies for age , hypertension , diabetes and use of oral contraceptives . Cardioembolic sources showed significant differencies for atrial fibrillation and atrial septal aneurysm . Multivariate analysis of risk factors for atherosclerosis and cardioembolic sources revealed hypertension and diabetes as age dependant risk factors in patients with closed foramen ovale . In patients with patent foramen ovale the use of oral contraceptives was found as an independant risk factor for cerebral ischemic event . Patients > 60 years with cerebral ischemic events had more often a closed foramen ovale . Dependant on age patients with closed foramen ovale showed a higher frequency of hypertension and diabetes . In addition these patients revealed more often atrial fibrillation . Patients with patent foramen ovale had fewer risk factors for atherosclerosis or cardioembolic sources but presented more frequent the use of oral contraceptives or atrial septal aneurysm . | [
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] | [
"umlsterm"
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