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T1 Age 25 36 16-year-old T2 Sex 37 41 girl T3 Sign_symptom 88 92 pain E1 Sign_symptom:T3 T4 Biological_structure 78 87 abdominal T5 Severity 71 77 severe R1 MODIFY Arg1:T4 Arg2:E1 R2 MODIFY Arg1:T5 Arg2:E1 T6 Sign_symptom 94 110 loss of appetite E2 Sign_symptom:T6 T7 Sign_symptom 112 118 nausea E3 Sign_symptom:T7 T8 Sign_symptom 124 132 vomiting E4 Sign_symptom:T8 T9 Family_history 184 201 family of potters T10 Diagnostic_procedure 138 147 anamnesis E5 Diagnostic_procedure:T10 T11 Occupation 221 259 participated in the process of pottery T12 Family_history 265 322 father being diagnosed with lead poisoning 2 years before T13 Date 385 395 1 year ago E6 Date:T13 T14 Sign_symptom 432 436 pain E7 Sign_symptom:T14 T15 Biological_structure 422 431 abdominal T16 Severity 415 421 severe R3 MODIFY Arg1:T15 Arg2:E7 R4 MODIFY Arg1:T16 Arg2:E7 T17 Disease_disorder 465 477 appendicitis E8 Disease_disorder:T17 T18 Detailed_description 459 464 acute R5 MODIFY Arg1:T18 Arg2:E8 T19 Therapeutic_procedure 496 508 appendectomy E9 Therapeutic_procedure:T19 T20 Sign_symptom 518 522 pain E10 Sign_symptom:T20 T21 Detailed_description 523 532 persisted R6 MODIFY Arg1:T21 Arg2:E10 T22 Family_history 546 578 family history of lead poisoning T23 Disease_disorder 597 612 saturnine colic E11 Disease_disorder:T23 T24 Disease_disorder 646 660 lead poisoning E12 Disease_disorder:T24 T25 Diagnostic_procedure 662 674 urinary lead E13 Diagnostic_procedure:T25 T26 Lab_value 676 684 219 μg/L R7 MODIFY Arg1:T26 Arg2:E13 T27 Therapeutic_procedure 709 730 symptomatic treatment E14 Therapeutic_procedure:T27 T28 Date 746 760 3 weeks before E15 Date:T28 T29 Clinical_event 794 802 admitted E16 Clinical_event:T29 T30 Nonbiological_location 810 827 regional hospital R8 MODIFY Arg1:T30 Arg2:E16 T31 Disease_disorder 852 867 saturnine colic E17 Disease_disorder:T31 T32 Diagnostic_procedure 869 879 blood lead E18 Diagnostic_procedure:T32 T33 Lab_value 881 892 113.2 μg/dL R9 MODIFY Arg1:T33 Arg2:E18 T34 Medication 899 916 chelation therapy E19 Medication:T34 T36 Date 928 941 4 days before E20 Date:T36 T35 Medication 922 926 EDTA E21 Medication:T35 R10 SUB_PROCEDURE Arg1:E21 Arg2:E19 T37 Dosage 1001 1016 2 tablets daily R11 MODIFY Arg1:T37 Arg2:E19 T38 Dosage 1018 1059 one in the morning and one in the evening R12 MODIFY Arg1:T38 Arg2:E19 T39 Medication 1076 1095 calcium supplements E22 Medication:T39 T40 Diagnostic_procedure 1101 1121 clinical examination E23 Diagnostic_procedure:T40 T41 Sign_symptom 1203 1228 influenced general status E24 Sign_symptom:T41 T42 Sign_symptom 1230 1241 ailing face E25 Sign_symptom:T42 T43 Sign_symptom 1243 1251 jaundice E26 Sign_symptom:T43 T44 Biological_structure 1259 1265 sclera R13 MODIFY Arg1:T44 Arg2:E26 T45 Sign_symptom 1272 1284 pigmentation E27 Sign_symptom:T45 T46 Color 1267 1271 blue R14 MODIFY Arg1:T46 Arg2:E27 T47 Biological_structure 1292 1297 nails R15 MODIFY Arg1:T47 Arg2:E27 T48 Sign_symptom 1299 1306 painful E28 Sign_symptom:T48 T49 Biological_structure 1307 1314 abdomen R16 MODIFY Arg1:T49 Arg2:E28 T50 Detailed_description 1318 1327 palpation R17 MODIFY Arg1:T50 Arg2:E28 T51 Diagnostic_procedure 1333 1339 weight E29 Diagnostic_procedure:T51 T52 Lab_value 1341 1346 45 kg R18 MODIFY Arg1:T52 Arg2:E29 T53 Diagnostic_procedure 1352 1367 laboratory test E30 Diagnostic_procedure:T53 T54 Sign_symptom 1414 1420 anemia E31 Sign_symptom:T54 T55 Detailed_description 1402 1413 hypochromic R19 MODIFY Arg1:T55 Arg2:E31 T56 Diagnostic_procedure 1422 1432 hemoglobin E32 Diagnostic_procedure:T56 T57 Diagnostic_procedure 1434 1436 Hb E33 Diagnostic_procedure:T57 T58 Lab_value 1439 1448 10.9 g/dl R20 MODIFY Arg1:T58 Arg2:E32 R21 IDENTICAL Arg1:E33 Arg2:E32 R22 SUB_PROCEDURE Arg1:E32 Arg2:E30 T59 Diagnostic_procedure 1450 1460 hematocrit E34 Diagnostic_procedure:T59 T60 Diagnostic_procedure 1462 1465 Htc E35 Diagnostic_procedure:T60 T61 Lab_value 1468 1473 31.6% R23 IDENTICAL Arg1:E35 Arg2:E34 R24 MODIFY Arg1:T61 Arg2:E34 T62 Diagnostic_procedure 1475 1497 medium cellular volume E36 Diagnostic_procedure:T62 T63 Diagnostic_procedure 1499 1502 MCV E37 Diagnostic_procedure:T63 R25 IDENTICAL Arg1:E37 Arg2:E36 T64 Lab_value 1505 1512 77.6 fL R26 MODIFY Arg1:T64 Arg2:E36 R27 SUB_PROCEDURE Arg1:E36 Arg2:E30 T65 Diagnostic_procedure 1534 1553 liver transaminases E38 Diagnostic_procedure:T65 T66 Lab_value 1515 1524 increased R28 MODIFY Arg1:T66 Arg2:E38 R29 SUB_PROCEDURE Arg1:E38 Arg2:E30 T67 Diagnostic_procedure 1555 1579 alanine-aminotransferase E39 Diagnostic_procedure:T67 T68 Diagnostic_procedure 1581 1585 ALAT E40 Diagnostic_procedure:T68 R30 IDENTICAL Arg1:E40 Arg2:E39 T69 Lab_value 1588 1597 158.9 U/L R31 MODIFY Arg1:T69 Arg2:E39 T70 Diagnostic_procedure 1599 1625 aspartate-aminotransferase E41 Diagnostic_procedure:T70 T71 Diagnostic_procedure 1627 1631 ASAT E42 Diagnostic_procedure:T71 R32 IDENTICAL Arg1:E42 Arg2:E41 T72 Lab_value 1634 1640 63 U/L R33 MODIFY Arg1:T72 Arg2:E41 T73 Diagnostic_procedure 1642 1668 gamma-glutamyl-transferase E43 Diagnostic_procedure:T73 T74 Diagnostic_procedure 1670 1673 GGT E44 Diagnostic_procedure:T74 R34 IDENTICAL Arg1:E44 Arg2:E43 T75 Lab_value 1676 1683 128 U/L R35 MODIFY Arg1:T75 Arg2:E43 R36 SUB_PROCEDURE Arg1:E39 Arg2:E38 R37 SUB_PROCEDURE Arg1:E41 Arg2:E38 R38 SUB_PROCEDURE Arg1:E43 Arg2:E38 T76 Sign_symptom 1686 1715 conjugated hyperbilirubinemia E45 Sign_symptom:T76 T77 Diagnostic_procedure 1717 1733 direct bilirubin E46 Diagnostic_procedure:T77 T78 Diagnostic_procedure 1735 1738 DBi E47 Diagnostic_procedure:T78 R39 IDENTICAL Arg1:E47 Arg2:E46 T79 Lab_value 1741 1752 1.432 mg/dL R40 MODIFY Arg1:T79 Arg2:E46 R41 SUB_PROCEDURE Arg1:E46 Arg2:E30 T80 Sign_symptom 1755 1767 hyponatremia E48 Sign_symptom:T80 T81 Diagnostic_procedure 1769 1771 Na E49 Diagnostic_procedure:T81 T82 Lab_value 1773 1783 132 mmol/L R42 MODIFY Arg1:T82 Arg2:E49 T83 Sign_symptom 1790 1804 hypopotassemia E50 Sign_symptom:T83 T84 Diagnostic_procedure 1806 1807 K E51 Diagnostic_procedure:T84 T85 Lab_value 1809 1820 2.85 mmol/L R43 MODIFY Arg1:T85 Arg2:E51 T86 Diagnostic_procedure 1836 1853 arterial pressure E52 Diagnostic_procedure:T86 T87 Lab_value 1858 1867 156 mm Hg T88 Detailed_description 1827 1835 systolic R44 MODIFY Arg1:T88 Arg2:T87 T89 Lab_value 1891 1899 96 mm Hg T90 Detailed_description 1877 1886 diastolic R45 MODIFY Arg1:T90 Arg2:T89 R46 MODIFY Arg1:T87 Arg2:E52 R47 MODIFY Arg1:T89 Arg2:E52 T91 Diagnostic_procedure 1911 1915 lead E53 Diagnostic_procedure:T91 T92 Lab_value 1926 1937 66.28 μg/dL T93 Lab_value 1959 1969 419.7 μg/L T95 Diagnostic_procedure 2005 2030 delta-aminolevulinic acid E54 Diagnostic_procedure:T95 T96 Lab_value 2035 2044 7.66 mg/L R51 MODIFY Arg1:T96 Arg2:E54 T97 Diagnostic_procedure 2093 2103 ultrasound E55 Diagnostic_procedure:T97 T98 Biological_structure 2083 2092 abdominal R52 MODIFY Arg1:T98 Arg2:E55 T99 Sign_symptom 2121 2134 disappearance E56 Sign_symptom:T99 T100 Detailed_description 2142 2194 delimitation between the cortical and medullar parts R53 MODIFY Arg1:T100 Arg2:E56 T101 Biological_structure 2198 2210 both kidneys R54 MODIFY Arg1:T101 Arg2:T100 T102 Clinical_event 2225 2237 consultation E57 Clinical_event:T102 T103 Nonbiological_location 2246 2280 occupational healthcare specialist R55 MODIFY Arg1:T103 Arg2:E57 T104 Medication 2318 2335 chelation therapy E58 Medication:T104 T105 Medication 2341 2345 EDTA E59 Medication:T105 R56 SUB_PROCEDURE Arg1:E59 Arg2:E58 T106 Dosage 2370 2383 4 tablets/day R57 MODIFY Arg1:T106 Arg2:E58 T107 Clinical_event 2417 2429 consultation E60 Clinical_event:T107 T108 Detailed_description 2404 2416 neurological R58 MODIFY Arg1:T108 Arg2:E60 T109 Disease_disorder 2479 2499 behavioral disorders E61 Disease_disorder:T109 T110 Disease_disorder 2505 2515 depressive E62 Disease_disorder:T110 T111 Diagnostic_procedure 2542 2555 psychotherapy E63 Diagnostic_procedure:T111 A1 POLARITY E63 UNCERTAIN T112 Disease_disorder 2642 2656 lead poisoning E64 Disease_disorder:T112 T113 Medication 2687 2696 hydration E65 Medication:T113 T114 Administration 2682 2686 i.v. R59 MODIFY Arg1:T114 Arg2:E65 T115 Dosage 2747 2768 3 liters per 24 hours R60 MODIFY Arg1:T115 Arg2:E65 T116 Sign_symptom 2843 2848 vomit E66 Sign_symptom:T116 A2 POLARITY E66 NEG T117 Sign_symptom 2862 2885 able to consume liquids E67 Sign_symptom:T117 T118 Medication 2901 2910 diuretics E68 Medication:T118 T119 Medication 2922 2932 furosemide E69 Medication:T119 T120 Administration 2933 2940 by vein R61 MODIFY Arg1:T120 Arg2:E69 R62 SUB_PROCEDURE Arg1:E69 Arg2:E68 T121 Diagnostic_procedure 2964 2981 arterial pressure E70 Diagnostic_procedure:T121 T122 Lab_value 2992 3013 above the upper limit R63 MODIFY Arg1:T122 Arg2:E70 T123 Medication 3061 3100 angiotensin-converting enzyme inhibitor E71 Medication:T123 T124 Sign_symptom 3124 3145 arterial hypertension E72 Sign_symptom:T124 A3 TREND E72 DEC T125 Medication 3193 3204 amino acids E73 Medication:T125 T126 Administration 3205 3218 intravenously R64 MODIFY Arg1:T126 Arg2:E73 T127 Medication 3236 3252 liver protectors E74 Medication:T127 T128 Administration 3253 3261 by mouth R65 MODIFY Arg1:T128 Arg2:E74 T129 Medication 3284 3309 vitamins of the B complex E75 Medication:T129 T130 Diagnostic_procedure 3363 3372 evolution E76 Diagnostic_procedure:T130 T131 Lab_value 3377 3395 slightly favorable R66 MODIFY Arg1:T131 Arg2:E76 T132 Date 3410 3422 3 days after E77 Date:T132 T133 Sign_symptom 3488 3492 pain E78 Sign_symptom:T133 T134 Sign_symptom 3494 3502 vomiting E79 Sign_symptom:T134 T135 Sign_symptom 3531 3535 pain E80 Sign_symptom:T135 T136 Biological_structure 3478 3487 abdominal T137 Severity 3471 3477 severe R67 MODIFY Arg1:T136 Arg2:E78 R68 MODIFY Arg1:T137 Arg2:E78 T138 Biological_structure 3543 3554 lumbar area R69 MODIFY Arg1:T138 Arg2:E80 T139 Diagnostic_procedure 3564 3585 laboratory parameters E81 Diagnostic_procedure:T139 T140 Lab_value 3596 3609 normalization R70 MODIFY Arg1:T140 Arg2:E81 T141 Duration 3630 3651 approximately 10 days E82 Duration:T141 T142 Therapeutic_procedure 3655 3664 treatment E83 Therapeutic_procedure:T142 T143 Date 3673 3680 6th day E84 Date:T143 T144 Medication 3709 3726 chelation therapy E85 Medication:T144 T145 Medication 3732 3736 EDTA E86 Medication:T145 R71 SUB_PROCEDURE Arg1:E86 Arg2:E85 A4 POLARITY E85 NEG T146 Clinical_event 3865 3876 discharging E87 Clinical_event:T146 T147 Diagnostic_procedure 3777 3781 lead E88 Diagnostic_procedure:T147 T148 Biological_structure 3759 3764 blood T149 Biological_structure 3769 3776 urinary R72 MODIFY Arg1:T149 Arg2:E88 R73 MODIFY Arg1:T148 Arg2:E88 T94 Biological_structure 1905 1910 blood T150 Biological_structure 1943 1950 urinary R48 MODIFY Arg1:T150 Arg2:T93 R49 MODIFY Arg1:T94 Arg2:T92 R50 MODIFY Arg1:T92 Arg2:E53 R74 MODIFY Arg1:T93 Arg2:E53 T151 Lab_value 3810 3821 45.57 μg/dL T152 Lab_value 3847 3857 836.4 μg/L T153 Coreference 3800 3805 level E89 Coreference:T153 R75 IDENTICAL Arg1:E89 Arg2:E88 T154 Biological_structure 3794 3799 blood T155 Biological_structure 3831 3838 urinary R76 MODIFY Arg1:T154 Arg2:T151 R77 MODIFY Arg1:T155 Arg2:T152 R78 MODIFY Arg1:T152 Arg2:E89 R79 MODIFY Arg1:T151 Arg2:E89 T156 Diagnostic_procedure 3904 3914 ultrasound E90 Diagnostic_procedure:T156 T157 Biological_structure 3894 3903 abdominal R80 MODIFY Arg1:T157 Arg2:E90 T158 Sign_symptom 3940 3966 pathological modifications E91 Sign_symptom:T158 A5 POLARITY E91 NEG T159 Date 3968 3981 After 14 days E92 Date:T159 T160 Clinical_event 4012 4022 discharged E93 Clinical_event:T160 T161 Sign_symptom 4035 4045 complaints E94 Sign_symptom:T161 A6 POLARITY E94 NEG T162 Other_entity 4240 4428 Nevertheless, we intend to repeat the blood lead levels after 12 and 24 months, assessing also the renal (urea, creatinine, urinary exam) and hepatic functions (ASAT, ALAT, GGT, bilirubin) #1 AnnotatorNotes T162 Omitted as this is planned work T163 Other_entity 4047 4155;4156 4238 and we recommended no further exposure to lead, avoiding the contact and the working in the pottery process. The long-term outcome of this case depends on further exposure to this heavy metal #2 AnnotatorNotes T163 Omitted as this is recommendation only T164 Clinical_event 43 51 admitted E95 Clinical_event:T164 T165 Nonbiological_location 59 65 clinic R81 MODIFY Arg1:T165 Arg2:E95 * OVERLAP E95 E1 E2 E3 E4 E5 R82 AFTER Arg1:E5 Arg2:E6 * OVERLAP E6 E7 E8 E9 R83 BEFORE Arg1:E9 Arg2:E10 * OVERLAP E10 E11 E12 E13 E14 R84 BEFORE Arg1:E14 Arg2:E15 * OVERLAP E15 E16 E17 E18 R85 BEFORE Arg1:E18 Arg2:E19 * OVERLAP E19 E20 E22 R86 BEFORE Arg1:E22 Arg2:E23 * OVERLAP E23 E24 E25 E26 E27 E28 E29 E30 E31 E45 E48 E50 E52 E53 E54 E55 E56 R87 BEFORE Arg1:E56 Arg2:E57 * OVERLAP E57 E58 R88 BEFORE Arg1:E58 Arg2:E60 * OVERLAP E60 E61 E62 E63 R89 BEFORE Arg1:E63 Arg2:E64 R90 BEFORE Arg1:E64 Arg2:E65 R91 BEFORE Arg1:E65 Arg2:E66 * OVERLAP E66 E67 R92 BEFORE Arg1:E67 Arg2:E68 R93 BEFORE Arg1:E68 Arg2:E70 * OVERLAP E70 E71 R94 BEFORE Arg1:E71 Arg2:E72 * OVERLAP E72 E73 E74 E75 R95 BEFORE Arg1:E75 Arg2:E76 * OVERLAP E76 E77 E78 E79 E80 R96 BEFORE Arg1:E80 Arg2:E81 * OVERLAP E81 E82 E83 R97 AFTER Arg1:E83 Arg2:E84 * OVERLAP E84 E85 E88 E89 R98 BEFORE Arg1:E89 Arg2:E87 R99 AFTER Arg1:E87 Arg2:E90 * OVERLAP E90 E91 R100 BEFORE Arg1:E91 Arg2:E92 * OVERLAP E92 E93 E94