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T1 Age 2 13 58-year-old T2 Personal_background 14 19 white T3 Personal_background 20 28 American T4 Sex 29 33 male T5 Clinical_event 34 43 presented E1 Clinical_event:T5 T6 Nonbiological_location 51 71 emergency department T7 Nonbiological_location 73 75 ED R1 IDENTICAL Arg1:T7 Arg2:T6 T8 Sign_symptom 97 106 confusion E2 Sign_symptom:T8 T9 Sign_symptom 108 122 disorientation E3 Sign_symptom:T9 T10 Sign_symptom 124 150 inability to walk steadily E4 Sign_symptom:T10 T11 Sign_symptom 156 167 dehydration E5 Sign_symptom:T11 T12 Sign_symptom 196 204 weakness E6 Sign_symptom:T12 T13 Sign_symptom 206 214 polyuria E7 Sign_symptom:T13 T14 Sign_symptom 220 230 polydipsia E8 Sign_symptom:T14 T15 Duration 231 253 over the previous week E9 Duration:T15 R2 MODIFY Arg1:E9 Arg2:E8 R3 MODIFY Arg1:E9 Arg2:E7 R4 MODIFY Arg1:E9 Arg2:E6 T16 Detailed_description 82 93 acute onset R5 MODIFY Arg1:T16 Arg2:E2 R6 MODIFY Arg1:T16 Arg2:E3 R7 MODIFY Arg1:T16 Arg2:E4 R8 MODIFY Arg1:T16 Arg2:E5 T17 Disease_disorder 282 285 CML E10 Disease_disorder:T17 #1 AnnotatorNotes E10 Chronic myeloid leukemia T18 Date 286 303 six years earlier E11 Date:T18 T19 Clinical_event 267 276 diagnosed E12 Clinical_event:T19 T20 Medication 348 360 chemotherapy E13 Medication:T20 T21 Detailed_description 339 347 multiple T22 Detailed_description 361 369 regimens R9 MODIFY Arg1:T22 Arg2:E13 R10 MODIFY Arg1:T21 Arg2:E13 T23 Medication 409 420 allopurinol E14 Medication:T23 T24 Clinical_event 425 433 awaiting E15 Clinical_event:T24 T25 Therapeutic_procedure 444 466 bone marrow transplant E16 Therapeutic_procedure:T25 A1 POLARITY E16 NEG #2 AnnotatorNotes E16 This event is Negative because it hadn't happened yet T26 Detailed_description 434 443 allogenic R11 MODIFY Arg1:T26 Arg2:E16 R12 MODIFY Arg1:E16 Arg2:E15 T27 Sign_symptom 313 335 hematological response E17 Sign_symptom:T27 A2 POLARITY E17 NEG T28 Diagnostic_procedure 468 479 Vital signs E18 Diagnostic_procedure:T28 T29 Clinical_event 483 492 admission E19 Clinical_event:T29 T30 Nonbiological_location 500 502 ED R13 MODIFY Arg1:T30 Arg2:E19 T31 Diagnostic_procedure 512 522 heart rate E20 Diagnostic_procedure:T31 T32 Lab_value 526 533 104 bpm R14 MODIFY Arg1:T32 Arg2:E20 T33 Diagnostic_procedure 535 549 blood pressure E21 Diagnostic_procedure:T33 T34 Lab_value 553 565 122/68 mm Hg R15 MODIFY Arg1:T34 Arg2:E21 T35 Diagnostic_procedure 570 581 temperature E22 Diagnostic_procedure:T35 T36 Lab_value 585 591 99.7°F T37 Lab_value 593 599 37.6°C R16 MODIFY Arg1:T36 Arg2:E22 R17 MODIFY Arg1:T37 Arg2:E22 T38 Diagnostic_procedure 639 659 physical examination E23 Diagnostic_procedure:T38 T39 Lab_value 613 635 no remarkable findings R18 MODIFY Arg1:T39 Arg2:E23 T41 Sign_symptom 697 708 dehydration E25 Sign_symptom:T41 T40 Sign_symptom 671 692 altered mental status E24 Sign_symptom:T40 T42 Diagnostic_procedure 710 732 Laboratory evaluations E26 Diagnostic_procedure:T42 T43 Diagnostic_procedure 739 749 hemoglobin E27 Diagnostic_procedure:T43 T44 Lab_value 750 759 13.3 g/dL R19 MODIFY Arg1:T44 Arg2:E27 T45 Diagnostic_procedure 761 783 white blood cell count E28 Diagnostic_procedure:T45 T46 Lab_value 784 794 18.3×109/L T47 Lab_value 796 813 neutrophils 79.6% T48 Lab_value 815 831 lymphocytes 7.2% T49 Lab_value 837 851 monocytes 8.3% R20 MODIFY Arg1:T46 Arg2:E28 R21 MODIFY Arg1:T47 Arg2:E28 R22 MODIFY Arg1:T48 Arg2:E28 R23 MODIFY Arg1:T49 Arg2:E28 T50 Diagnostic_procedure 858 872 platelet count E29 Diagnostic_procedure:T50 T51 Lab_value 873 882 910×109/L R24 MODIFY Arg1:T51 Arg2:E29 T52 Diagnostic_procedure 884 896 Serum levels E30 Diagnostic_procedure:T52 R25 SUB_PROCEDURE Arg1:E27 Arg2:E26 R26 SUB_PROCEDURE Arg1:E28 Arg2:E26 R27 SUB_PROCEDURE Arg1:E29 Arg2:E26 T53 Diagnostic_procedure 903 910 calcium E31 Diagnostic_procedure:T53 T54 Lab_value 911 921 18.6 mg/dL R28 MODIFY Arg1:T54 Arg2:E31 T55 Diagnostic_procedure 923 932 phosphate E32 Diagnostic_procedure:T55 T56 Lab_value 933 942 4.6 mg/dL R29 MODIFY Arg1:T56 Arg2:E32 T57 Diagnostic_procedure 944 950 sodium E33 Diagnostic_procedure:T57 T58 Lab_value 951 960 135 mEq/L R30 MODIFY Arg1:T58 Arg2:E33 T59 Diagnostic_procedure 962 971 potassium E34 Diagnostic_procedure:T59 T60 Lab_value 972 981 2.7 mg/dL R31 MODIFY Arg1:T60 Arg2:E34 T61 Diagnostic_procedure 983 990 albumin E35 Diagnostic_procedure:T61 T62 Lab_value 991 999 4.0 g/dL R32 MODIFY Arg1:T62 Arg2:E35 T63 Diagnostic_procedure 1001 1011 creatinine E36 Diagnostic_procedure:T63 T64 Lab_value 1012 1021 2.2 mg/dL R33 MODIFY Arg1:T64 Arg2:E36 T65 Diagnostic_procedure 1023 1038 total bilirubin E37 Diagnostic_procedure:T65 T66 Lab_value 1039 1048 0.9 mg/dL R34 MODIFY Arg1:T66 Arg2:E37 T67 Diagnostic_procedure 1050 1070 alkaline phosphatase E38 Diagnostic_procedure:T67 T68 Lab_value 1071 1079 125 IU/L R35 MODIFY Arg1:T68 Arg2:E38 T69 Diagnostic_procedure 1081 1107 aspartate aminotransferase E39 Diagnostic_procedure:T69 T70 Lab_value 1108 1115 41 IU/L R36 MODIFY Arg1:T70 Arg2:E39 T71 Diagnostic_procedure 1121 1145 alanine aminotransferase E40 Diagnostic_procedure:T71 T72 Lab_value 1146 1153 71 IU/L R37 MODIFY Arg1:T72 Arg2:E40 R38 SUB_PROCEDURE Arg1:E31 Arg2:E30 R39 SUB_PROCEDURE Arg1:E32 Arg2:E30 R40 SUB_PROCEDURE Arg1:E33 Arg2:E30 R41 SUB_PROCEDURE Arg1:E34 Arg2:E30 R42 SUB_PROCEDURE Arg1:E35 Arg2:E30 R43 SUB_PROCEDURE Arg1:E36 Arg2:E30 R44 SUB_PROCEDURE Arg1:E37 Arg2:E30 R45 SUB_PROCEDURE Arg1:E38 Arg2:E30 R46 SUB_PROCEDURE Arg1:E39 Arg2:E30 R47 SUB_PROCEDURE Arg1:E40 Arg2:E30 T73 Diagnostic_procedure 1155 1159 SPEP E41 Diagnostic_procedure:T73 #3 AnnotatorNotes E41 Serum protein electrophoresis T74 Lab_value 1164 1187 negative for an M spike R48 MODIFY Arg1:T74 Arg2:E41 T75 Diagnostic_procedure 1189 1217 Hormones and vitamins levels E42 Diagnostic_procedure:T75 T76 Diagnostic_procedure 1224 1227 PTH E43 Diagnostic_procedure:T76 T77 Diagnostic_procedure 1251 1256 PHTrP E44 Diagnostic_procedure:T77 T78 Lab_value 1228 1236 8.5 pg/L R49 MODIFY Arg1:T78 Arg2:E43 T79 Lab_value 1257 1265 1.4 pg/L R50 MODIFY Arg1:T79 Arg2:E44 T80 Diagnostic_procedure 1277 1292 25-OH vitamin D E45 Diagnostic_procedure:T80 T81 Lab_value 1293 1303 30.4 ng/mL R51 MODIFY Arg1:T81 Arg2:E45 T82 Diagnostic_procedure 1322 1340 1,25 OH vitamin D3 E46 Diagnostic_procedure:T82 T83 Lab_value 1341 1351 33.7 ng/mL R52 MODIFY Arg1:T83 Arg2:E46 T84 Diagnostic_procedure 1373 1380 CT scan E47 Diagnostic_procedure:T84 T85 Biological_structure 1367 1372 Chest R53 MODIFY Arg1:T85 Arg2:E47 T86 Sign_symptom 1402 1409 lesions E48 Sign_symptom:T86 T87 Detailed_description 1396 1401 lytic T88 Detailed_description 1388 1395 diffuse R54 MODIFY Arg1:T87 Arg2:E48 R55 MODIFY Arg1:T88 Arg2:E48 T89 Sign_symptom 1414 1430 bone destruction E49 Sign_symptom:T89 T90 Biological_structure 1457 1474 thoracic skeleton R56 MODIFY Arg1:T90 Arg2:E49 T91 Sign_symptom 1499 1522 bone marrow involvement E50 Sign_symptom:T91 A3 POLARITY E50 UNCERTAIN T92 Sign_symptom 1641 1652 blast phase E51 Sign_symptom:T92 T93 Disease_disorder 1592 1595 CML E52 Disease_disorder:T93 T94 Sign_symptom 1607 1620 hypercalcemia E53 Sign_symptom:T94 T95 Therapeutic_procedure 1680 1689 hydration E54 Therapeutic_procedure:T95 T96 Detailed_description 1669 1679 aggressive R57 MODIFY Arg1:T96 Arg2:E54 T97 Medication 1700 1706 saline E55 Medication:T97 T98 Medication 1711 1721 calcitonin E56 Medication:T98 T99 Lab_value 1695 1699 0.9% R58 MODIFY Arg1:T99 Arg2:E55 T100 Dosage 1722 1731 400 units T101 Administration 1732 1744 subcutaneous R59 MODIFY Arg1:T100 Arg2:E56 R60 MODIFY Arg1:T101 Arg2:E56 T102 Medication 1777 1792 zoledronic acid E57 Medication:T102 T103 Dosage 1793 1799 3.3 mg R61 MODIFY Arg1:T103 Arg2:E57 T104 Administration 1800 1811 intravenous R62 MODIFY Arg1:T104 Arg2:E57 T105 Detailed_description 1813 1845 adjusted for renal insufficiency R63 MODIFY Arg1:T105 Arg2:E57 T106 Duration 1858 1873 After five days E58 Duration:T106 T107 Sign_symptom 1905 1913 symptoms E59 Sign_symptom:T107 A4 POLARITY E59 NEG T108 Diagnostic_procedure 1918 1938 serum calcium levels E60 Diagnostic_procedure:T108 T109 Lab_value 1888 1901 normalization R64 MODIFY Arg1:T109 Arg2:E60 T110 Clinical_event 1960 1969 discharge E61 Clinical_event:T110 T111 Nonbiological_location 1979 1987 hospital R65 MODIFY Arg1:T111 Arg2:E61 T112 Therapeutic_procedure 2016 2036 palliative treatment E62 Therapeutic_procedure:T112 T113 Medication 2042 2051 ponatinib E63 Medication:T113 T114 Therapeutic_procedure 2056 2068 radiotherapy E64 Therapeutic_procedure:T114 R66 SUB_PROCEDURE Arg1:E63 Arg2:E62 R67 SUB_PROCEDURE Arg1:E64 Arg2:E62 T115 Diagnostic_procedure 2081 2101 serum calcium levels E65 Diagnostic_procedure:T115 T116 Lab_value 2107 2117 maintained R68 MODIFY Arg1:T116 Arg2:E65 T117 Medication 2123 2138 zoledronic acid E66 Medication:T117 T118 Dosage 2139 2161 4 mg every eight weeks R69 MODIFY Arg1:T118 Arg2:E66 T119 Disease_disorder 2192 2198 cancer E67 Disease_disorder:T119 A5 TREND E67 INC T120 Outcome 2217 2228 passed away E68 Outcome:T120 T121 Date 2243 2261 eight months after E69 Date:T121 * OVERLAP E1 E2 E3 E4 E5 R70 AFTER Arg1:E5 Arg2:E6 * OVERLAP E6 E7 E8 E9 R71 AFTER Arg1:E9 Arg2:E12 * OVERLAP E12 E10 E11 E17 E13 R72 BEFORE Arg1:E13 Arg2:E14 * OVERLAP E14 E15 E16 R73 BEFORE Arg1:E16 Arg2:E18 * OVERLAP E18 E19 E20 E21 E22 E23 E24 E25 E26 E30 E41 E42 E47 E48 E49 E50 R74 SUB_PROCEDURE Arg1:E43 Arg2:E42 R75 SUB_PROCEDURE Arg1:E44 Arg2:E42 R76 SUB_PROCEDURE Arg1:E45 Arg2:E42 R77 SUB_PROCEDURE Arg1:E46 Arg2:E42 T122 Clinical_event 1579 1588 diagnosis E70 Clinical_event:T122 R78 BEFORE Arg1:E50 Arg2:E70 * OVERLAP E70 E52 E53 E51 R79 BEFORE Arg1:E51 Arg2:E54 R80 SUB_PROCEDURE Arg1:E55 Arg2:E54 R81 SUB_PROCEDURE Arg1:E56 Arg2:E54 * OVERLAP E54 E57 R82 BEFORE Arg1:E57 Arg2:E58 * OVERLAP E58 E59 E60 R83 BEFORE Arg1:E60 Arg2:E61 R84 BEFORE Arg1:E61 Arg2:E62 * OVERLAP E62 E65 E66 R85 BEFORE Arg1:E66 Arg2:E67 R86 BEFORE Arg1:E67 Arg2:E68 * OVERLAP E68 E69