368 lines (367 with data), 13.3 kB

T1	Age 2 13	3-month-old
T2	Personal_background 21 33	from the UAE
T3	History 41 97	genetically-confirmed diagnosis of Jarcho-Levin syndrome
T4	History 102 149	dependent on mechanical ventilation since birth
T5	Therapeutic_procedure 185 207	implantation of VEPTRs
E1	Therapeutic_procedure:T5 
#1	AnnotatorNotes E1	vertical expandable prosthetic titanium rib
T6	Therapeutic_procedure 224 233	intubated
E2	Therapeutic_procedure:T6 
T7	Therapeutic_procedure 256 266	ventilated
E3	Therapeutic_procedure:T7 
T8	Detailed_description 243 255	mechanically
R1	MODIFY Arg1:T8 Arg2:E3	
T9	Detailed_description 272 294	volume-controlled mode
R2	MODIFY Arg1:T9 Arg2:E3	
T10	Lab_value 303 340	0.30–0.45 fraction of inspired oxygen
R3	MODIFY Arg1:T10 Arg2:E3	
T11	Lab_value 349 397	peak inspiratory pressures (PIP) of 23–45 cm H2O
T12	Lab_value 399 450	positive end-expiratory pressure (PEEP) of 7 cm H2O
T13	Lab_value 452 486	backup respiratory rate (RR) of 34
R4	MODIFY Arg1:T11 Arg2:E3	
R5	MODIFY Arg1:T12 Arg2:E3	
R6	MODIFY Arg1:T13 Arg2:E3	
T14	Diagnostic_procedure 497 502	X-ray
E4	Diagnostic_procedure:T14 
T15	Biological_structure 491 496	chest
T16	Biological_structure 510 516	thorax
R7	MODIFY Arg1:T15 Arg2:E4	
R8	MODIFY Arg1:T16 Arg2:E4	
T17	Clinical_event 534 543	admission
E5	Clinical_event:T17 
T18	Date 561 574	a month after
E6	Date:T18 
T19	Disease_disorder 653 664	atelectasis
E7	Disease_disorder:T19 
A1	TREND E7 DEC
T20	Biological_structure 672 689	base of the lungs
R9	MODIFY Arg1:T20 Arg2:E7	
T21	Detailed_description 643 652	posterior
R10	MODIFY Arg1:T21 Arg2:E7	
T22	Detailed_description 633 642	bilateral
R11	MODIFY Arg1:T22 Arg2:E7	
T23	Sign_symptom 4926 4938	able to walk
E8	Sign_symptom:T23 
T24	Diagnostic_procedure 4947 4963	neurodevelopment
E9	Diagnostic_procedure:T24 
T25	Lab_value 4976 4982	normal
R12	MODIFY Arg1:T25 Arg2:E9	
T26	Therapeutic_procedure 837 849	bronchoscopy
E10	Therapeutic_procedure:T26 
T27	Disease_disorder 873 887	bronchomalacia
E11	Disease_disorder:T27 
T28	Biological_structure 905 929	both upper lobar bronchi
R13	MODIFY Arg1:T28 Arg2:E11	
T29	Therapeutic_procedure 955 966	ventilation
E12	Therapeutic_procedure:T29 
T30	Detailed_description 944 954	mechanical
T31	Detailed_description 934 943	prolonged
R14	MODIFY Arg1:T30 Arg2:E12	
R15	MODIFY Arg1:T31 Arg2:E12	
T32	Therapeutic_procedure 983 995	tracheostomy
E13	Therapeutic_procedure:T32 
T33	Diagnostic_procedure 1039 1041	CT
E14	Diagnostic_procedure:T33 
T34	Diagnostic_procedure 1072 1074	CT
E15	Diagnostic_procedure:T34 
T35	Date 1092 1105	a month after
E16	Date:T35 
T36	Disease_disorder 1161 1172	atelectasis
E17	Disease_disorder:T36 
A2	POLARITY E17 NEG
T37	Detailed_description 1145 1160	posterior-basal
R16	MODIFY Arg1:T37 Arg2:E17	
T38	Diagnostic_procedure 1204 1208	FiO2
E18	Diagnostic_procedure:T38 
T39	Lab_value 1192 1200	decrease
R17	MODIFY Arg1:T39 Arg2:E18	
T40	Lab_value 1212 1216	0.21
R18	MODIFY Arg1:T40 Arg2:E18	
T41	Therapeutic_procedure 1266 1276	ventilator
E19	Therapeutic_procedure:T41 
T42	Detailed_description 1258 1265	Servo-i
R19	MODIFY Arg1:T42 Arg2:E19	
T43	Detailed_description 1282 1304	volume-controlled mode
R20	MODIFY Arg1:T43 Arg2:E19	
T44	Diagnostic_procedure 1325 1329	PIPs
E20	Diagnostic_procedure:T44 
T45	Detailed_description 1316 1324	variable
R21	MODIFY Arg1:T45 Arg2:E20	
T46	Lab_value 1330 1354	between 25 and 45 cm H2O
T47	Lab_value 1374 1385	7–11 cm H2O
T48	Diagnostic_procedure 1359 1363	PEEP
E21	Diagnostic_procedure:T48 
#2	AnnotatorNotes E21	Positive End Expiratory Pressure
R22	MODIFY Arg1:T47 Arg2:E21	
#3	AnnotatorNotes E20	Peak inspiratory pressure
R23	MODIFY Arg1:T46 Arg2:E20	
T49	Medication 1551 1564	sedoanalgesia
E22	Medication:T49 
T50	Sign_symptom 1620 1632	desaturation
E23	Sign_symptom:T50 
T51	Sign_symptom 1657 1668	bradycardia
E24	Sign_symptom:T51 
T52	Disease_disorder 1684 1702	bronchial collapse
E25	Disease_disorder:T52 
T53	Sign_symptom 1725 1735	asynchrony
E26	Sign_symptom:T53 
T54	Medication 1762 1770	sedation
E27	Medication:T54 
T55	Medication 1830 1838	fentanyl
E28	Medication:T55 
T56	Medication 1843 1852	midazolam
E29	Medication:T56 
T57	Administration 1863 1887	continuous infusion pump
R24	MODIFY Arg1:T57 Arg2:E29	
R25	MODIFY Arg1:T57 Arg2:E28	
T58	Dosage 1893 1926	progressive increase in the doses
R26	MODIFY Arg1:T58 Arg2:E28	
R27	MODIFY Arg1:T58 Arg2:E29	
T59	Medication 1949 1962	cisatracurium
E30	Medication:T59 
T60	Dosage 1938 1948	continuous
R28	MODIFY Arg1:T60 Arg2:E30	
T61	Medication 1968 1985	muscular relaxant
E31	Medication:T61 
R29	SUB_PROCEDURE Arg1:E30 Arg2:E31	
T62	Sign_symptom 2036 2058	clinical stabilisation
E32	Sign_symptom:T62 
T63	Medication 2077 2094	muscular relaxant
E33	Medication:T63 
A3	POLARITY E33 NEG
T64	Medication 2139 2147	sedation
E34	Medication:T64 
A4	TREND E34 DEC
T65	Dosage 2115 2135	progressive decrease
R30	MODIFY Arg1:T65 Arg2:E34	
T66	Sign_symptom 2248 2262	ocular flutter
E35	Sign_symptom:T66 
T67	Diagnostic_procedure 2369 2372	EEG
E36	Diagnostic_procedure:T67 
T68	Lab_value 2362 2368	normal
R31	MODIFY Arg1:T68 Arg2:E36	
T69	Diagnostic_procedure 2374 2388	ophthalmoscopy
E37	Diagnostic_procedure:T69 
T70	Diagnostic_procedure 2390 2406	metabolic workup
E38	Diagnostic_procedure:T70 
T71	Diagnostic_procedure 2419 2422	MRI
E39	Diagnostic_procedure:T71 
T72	Biological_structure 2411 2418	cranial
R32	MODIFY Arg1:T72 Arg2:E39	
T73	Date 2427 2442	5 months of age
E40	Date:T73 
T74	Duration 2701 2713	for 7 months
E41	Duration:T74 
T75	Date 4908 4921	19 months old
E42	Date:T75 
T76	Clinical_event 154 162	admitted
E43	Clinical_event:T76 
T77	Nonbiological_location 170 176	centre
R33	MODIFY Arg1:T77 Arg2:E43	
T78	Therapeutic_procedure 2448 2457	NAVA mode
E44	Therapeutic_procedure:T78 
T79	Diagnostic_procedure 2491 2519	adaptation to the ventilator
E45	Diagnostic_procedure:T79 
T80	Lab_value 2469 2476	improve
R34	MODIFY Arg1:T80 Arg2:E45	
T81	Therapeutic_procedure 2541 2555	neural trigger
E46	Therapeutic_procedure:T81 
R35	SUB_PROCEDURE Arg1:E46 Arg2:E44	
T82	Therapeutic_procedure 2561 2574	NAVA catheter
E47	Therapeutic_procedure:T82 
R36	SUB_PROCEDURE Arg1:E47 Arg2:E44	
T83	Detailed_description 2588 2618	costs around €200 per catheter
R37	MODIFY Arg1:T83 Arg2:E47	
T84	Other_entity 2620 2683	according to the manufacturer it should be changed every 5 days
#4	AnnotatorNotes T84	ignored
T85	Therapeutic_procedure 2732 2754	catheters were changed
E48	Therapeutic_procedure:T85 
T86	Frequency 2755 2768	every 15 days
R38	MODIFY Arg1:T86 Arg2:E48	
T87	Sign_symptom 2789 2820	deterioration of the Edi signal
E49	Sign_symptom:T87 
A5	POLARITY E49 NEG
T88	Other_entity 2822 3092	According to the literature, Jarcho-Levin syndrome does not appear with mental retardation and life expectancy is pretty long, so ethically, we considered that this patient should have an opportunity to overcome his thoracic insufficiency if it were technically possible
#5	AnnotatorNotes T88	ignored as discussion
T89	Sign_symptom 3094 3104	Tachypnoea
E50	Sign_symptom:T89 
T90	Diagnostic_procedure 3135 3137	RR
E51	Diagnostic_procedure:T90 
#6	AnnotatorNotes E51	respiratory rate
T91	Lab_value 3141 3143	55
R39	MODIFY Arg1:T91 Arg2:E51	
T92	Sign_symptom 3183 3200	work of breathing
E52	Sign_symptom:T92 
A6	POLARITY E52 NEG
T93	Diagnostic_procedure 3209 3211	RR
E53	Diagnostic_procedure:T93 
T94	Lab_value 3235 3241	normal
R40	MODIFY Arg1:T94 Arg2:E53	
T95	Lab_value 3255 3257	40
R41	MODIFY Arg1:T95 Arg2:E53	
#7	AnnotatorNotes T95	this is a challenging example: it looks like it's saying the patient's age is 40
T96	Medication 3364 3377	sedoanalgesia
E54	Medication:T96 
A7	TREND E54 DEC
T98	Coreference 3396 3398	it
E56	Coreference:T98 
R42	IDENTICAL Arg1:E56 Arg2:E54	
A8	POLARITY E56 NEG
T97	Date 3427 3434	10 days
E55	Date:T97 
T99	Medication 3470 3478	sedation
E57	Medication:T99 
A9	POLARITY E57 NEG
T100	Therapeutic_procedure 3315 3325	ventilator
E58	Therapeutic_procedure:T100 
T101	Sign_symptom 3287 3296	synchrony
E59	Sign_symptom:T101 
T102	Sign_symptom 3547 3561	ocular flutter
E60	Sign_symptom:T102 
A10	POLARITY E60 NEG
T103	Diagnostic_procedure 3616 3639	psychomotor development
E61	Diagnostic_procedure:T103 
T104	Lab_value 3600 3608	progress
R43	MODIFY Arg1:T104 Arg2:E61	
#8	AnnotatorNotes E44	Neurally Adjusted Ventilatory Assist
T107	Diagnostic_procedure 3744 3757	tidal volumes
E63	Diagnostic_procedure:T107 
T108	Diagnostic_procedure 3759 3761	Vt
E64	Diagnostic_procedure:T108 
R45	IDENTICAL Arg1:E64 Arg2:E63	
T109	Lab_value 3766 3775	6–7 mL/kg
R46	MODIFY Arg1:T109 Arg2:E63	
T110	Date 3788 3801	After 10 days
E65	Date:T110 
T111	Therapeutic_procedure 3809 3818	NAVA mode
E66	Therapeutic_procedure:T111 
T112	Medication 3851 3859	sedation
E67	Medication:T112 
A11	POLARITY E67 NEG
T113	Disease_disorder 3889 3907	bronchial collapse
E68	Disease_disorder:T113 
A12	POLARITY E68 MAYBE_NEG
T114	Diagnostic_procedure 3947 3951	PEEP
E69	Diagnostic_procedure:T114 
T115	Lab_value 3955 3964	20 cm H2O
R47	MODIFY Arg1:T115 Arg2:E69	
T116	Therapeutic_procedure 3975 3986	ventilation
E70	Therapeutic_procedure:T116 
T117	Detailed_description 3968 3974	manual
R48	MODIFY Arg1:T117 Arg2:E70	
T118	Detailed_description 3996 4014	self-inflating bag
R49	MODIFY Arg1:T118 Arg2:E70	
T119	Therapeutic_procedure 4046 4055	NAVA mode
E71	Therapeutic_procedure:T119 
T124	Diagnostic_procedure 4186 4188	CT
E74	Diagnostic_procedure:T124 
T125	Biological_structure 4176 4185	pulmonary
T126	Detailed_description 4166 4175	posterior
R52	MODIFY Arg1:T125 Arg2:E74	
R53	MODIFY Arg1:T126 Arg2:E74	
T127	Date 4204 4218	2 months after
E75	Date:T127 
T128	Disease_disorder 4360 4371	atelectases
E76	Disease_disorder:T128 
A13	TREND E76 DEC
T129	Detailed_description 4347 4359	posterobasal
R54	MODIFY Arg1:T129 Arg2:E76	
T130	Date 4420 4430	1 year old
E77	Date:T130 
T131	Diagnostic_procedure 4755 4759	PIPs
E78	Diagnostic_procedure:T131 
T132	Lab_value 4765 4781	around 30 cm H2O
R55	MODIFY Arg1:T132 Arg2:E78	
T133	Sign_symptom 4794 4802	tolerate
E79	Sign_symptom:T133 
A14	POLARITY E79 NEG
T134	Therapeutic_procedure 4870 4880	ventilator
E80	Therapeutic_procedure:T134 
T135	Detailed_description 4840 4860	short disconnections
R56	MODIFY Arg1:T135 Arg2:E80	
R57	CAUSE Arg1:E80 Arg2:E79	
T136	Diagnostic_procedure 4817 4821	PEEP
E81	Diagnostic_procedure:T136 
T137	Lab_value 4822 4836	below 9 cm H2O
T138	Lab_value 4805 4813	decrease
R58	MODIFY Arg1:T138 Arg2:E81	
R59	MODIFY Arg1:T137 Arg2:E81	
R60	CAUSE Arg1:E81 Arg2:E79	
T139	Therapeutic_procedure 4460 4477	different devices
E82	Therapeutic_procedure:T139 
A15	POLARITY E82 MAYBE_POS
T140	Detailed_description 4478 4499	Trilogy 100 (Philips)
T141	Detailed_description 4501 4520	Astral 150 (ResMed)
R61	MODIFY Arg1:T140 Arg2:E82	
R62	MODIFY Arg1:T141 Arg2:E82	
T142	Therapeutic_procedure 4563 4574	ventilation
E83	Therapeutic_procedure:T142 
T143	Detailed_description 4552 4562	mechanical
R63	MODIFY Arg1:T143 Arg2:E83	
T144	Detailed_description 4582 4597	home ventilator
T145	Detailed_description 4599 4623	Monnal T-50, Air Liquide
R64	MODIFY Arg1:T144 Arg2:E83	
R65	MODIFY Arg1:T145 Arg2:T144	
T146	Detailed_description 4630 4689	volume assisted/controlled mode with the following settings
R66	MODIFY Arg1:T146 Arg2:E83	
T105	Lab_value 3665 3690	NAVA level of 1 cm H2O/µV
T106	Lab_value 3692 3706	PEEP 11 cm H2O
T120	Lab_value 3708 3726	Edi trigger 0.5 µV
#9	AnnotatorNotes T105	these resemble diagnostics but are actually settings for the ventilator
R44	MODIFY Arg1:T105 Arg2:E58	
R50	MODIFY Arg1:T106 Arg2:E58	
R51	MODIFY Arg1:T120 Arg2:E58	
T121	Lab_value 4691 4709	Vt 80 mL (9 mL/kg)
T122	Lab_value 4711 4725	PEEP 10 cm H2O
T123	Lab_value 4727 4749	flow trigger 0.5 L/min
R67	MODIFY Arg1:T121 Arg2:E83	
R68	MODIFY Arg1:T122 Arg2:E83	
R69	MODIFY Arg1:T123 Arg2:E83	
R70	BEFORE Arg1:E43 Arg2:E1	
R71	AFTER Arg1:E1 Arg2:E2	
*	OVERLAP E2 E3
R72	BEFORE Arg1:E3 Arg2:E4	
*	OVERLAP E4 E5
R73	BEFORE Arg1:E5 Arg2:E6	
T147	Therapeutic_procedure 585 592	surgery
E62	Therapeutic_procedure:T147 
*	OVERLAP E6 E62
R74	AFTER Arg1:E62 Arg2:E7	
*	OVERLAP E7 E10 E11
R75	BEFORE Arg1:E11 Arg2:E12	
R76	AFTER Arg1:E12 Arg2:E13	
*	OVERLAP E13 E14
R77	BEFORE Arg1:E14 Arg2:E15	
*	OVERLAP E15 E16 E17 E18
R78	BEFORE Arg1:E18 Arg2:E19	
*	OVERLAP E19 E20 E21
R79	BEFORE Arg1:E21 Arg2:E22	
*	OVERLAP E22 E23 E24 E25
R80	BEFORE Arg1:E25 Arg2:E26	
*	OVERLAP E26 E27 E28 E29 E30
R81	BEFORE Arg1:E30 Arg2:E32	
*	OVERLAP E32 E33 E34 E35 E36 E37 E38 E39
R82	BEFORE Arg1:E39 Arg2:E40	
*	OVERLAP E40 E44 E45
R83	BEFORE Arg1:E45 Arg2:E41	
*	OVERLAP E41 E48 E49 E50 E51 E52
R84	BEFORE Arg1:E52 Arg2:E53	
*	OVERLAP E53 E59 E58 E54
R85	BEFORE Arg1:E54 Arg2:E56	
*	OVERLAP E56 E55 E57 E60 E61 E63 E65 E66 E67 E68 E69 E70 E71 E72 E73
T148	Diagnostic_procedure 4061 4064	PIP
E72	Diagnostic_procedure:T148 
T149	Lab_value 4077 4101	between 15 and 45 cm H2O
R86	MODIFY Arg1:T149 Arg2:E72	
T150	Lab_value 4109 4126	NAVA level of 0.4
R87	MODIFY Arg1:T150 Arg2:E71	
T151	Diagnostic_procedure 4131 4140	Edi peaks
E73	Diagnostic_procedure:T151 
T152	Lab_value 4141 4162	between 15 and 100 µV
R88	MODIFY Arg1:T152 Arg2:E73	
R89	BEFORE Arg1:E73 Arg2:E74	
*	OVERLAP E74 E75 E76
R90	BEFORE Arg1:E76 Arg2:E77	
*	OVERLAP E77 E82 E83 E78 E79 E81 E80
R91	BEFORE Arg1:E80 Arg2:E42	
*	OVERLAP E42 E8 E9