7961 lines (7960 with data), 2.6 MB

{"text":"she had a workup by her neurologist and an mri revealed a c5-6 disc herniation with cord compression and a t2 signal change at that level .","problem":["cord compression","a c5-6 disc herniation","a t2 signal change"],"test":["a workup","an mri"],"treatment":[],"problem_indices_start":[56,84,105],"problem_indices_end":[78,100,123],"test_indices_start":[8,40],"test_indices_end":[16,46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. percocet , 5\/325 , 1-2 tabs po q4-6h prn pain .","problem":["pain"],"test":[],"treatment":["percocet"],"problem_indices_start":[44],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"microscopic anterior cervical diskectomy at c5-6 and fusion .","problem":[],"test":[],"treatment":["microscopic anterior cervical diskectomy at c5-6","fusion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,53],"treatment_indices_end":[48,59]}
{"text":"significant for hypertension , hyperlipidemia .","problem":["hyperlipidemia","hypertension"],"test":[],"treatment":[],"problem_indices_start":[16,31],"problem_indices_end":[28,45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her pain was under good control with po pain medications and she was deemed suitable for discharge .","problem":["her pain"],"test":[],"treatment":["po pain medications"],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37],"treatment_indices_end":[56]}
{"text":"the patient was asked to call dr. miezetri gach 's office for a follow-up appointment and wound check .","problem":[],"test":["wound check"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[95],"test_indices_end":[106],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lipitor , flexeril , hydrochlorothiazide and norvasc .","problem":[],"test":[],"treatment":["flexeril","lipitor","norvasc","hydrochlorothiazide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,10,21,45],"treatment_indices_end":[7,18,40,52]}
{"text":"she is asked to call with any fevers , chills , increasing weakness or numbness or any bowel and bladder disruption .","problem":["chills","fevers","numbness","bowel and bladder disruption","increasing weakness"],"test":[],"treatment":[],"problem_indices_start":[30,39,48,71,87],"problem_indices_end":[36,45,67,79,115],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had hyperreflexia in both the bilateral upper and lower extremities .","problem":["hyperreflexia"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. colace , 100 mg po bid .","problem":[],"test":[],"treatment":["colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"she had a postoperative ct scan that revealed partial decompression of the spinal canal and good placement of her hardware .","problem":["partial decompression of the spinal canal"],"test":["a postoperative ct scan"],"treatment":["her hardware"],"problem_indices_start":[46],"problem_indices_end":[87],"test_indices_start":[8],"test_indices_end":[31],"treatment_indices_start":[110],"treatment_indices_end":[122]}
{"text":"she had a hoffman 's sign greater on the right than the left and she had 10 beats of clonus in the right foot and 3-5 beats in the left foot .","problem":["10 beats of clonus","3-5 beats in the left foot"],"test":["a hoffman 's sign"],"treatment":[],"problem_indices_start":[78,119],"problem_indices_end":[96,145],"test_indices_start":[8],"test_indices_end":[30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 63-year-old female with a three-year history of bilateral hand numbness and occasional weakness .","problem":["bilateral hand numbness","occasional weakness"],"test":[],"treatment":[],"problem_indices_start":[65,93],"problem_indices_end":[88,112],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"c5-6 disc herniation with cord compression and myelopathy .","problem":["c5-6 disc herniation","cord compression","myelopathy"],"test":[],"treatment":[],"problem_indices_start":[0,26,47],"problem_indices_end":[20,42,57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"within the past year , these symptoms have progressively gotten worse , to encompass also her feet .","problem":["these symptoms"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. hydrochlorothiazide , 25 mg po daily .","problem":[],"test":[],"treatment":["hydrochlorothiazide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"immediately postop , her exam only improved slightly in her hyperreflexia .","problem":["her hyperreflexia"],"test":["her exam"],"treatment":[],"problem_indices_start":[56],"problem_indices_end":[73],"test_indices_start":[21],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. norvasc , 5 mg po daily .","problem":[],"test":[],"treatment":["norvasc"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"she has no known drug allergy .","problem":["known drug allergy"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient tolerated a c5-6 acdf by dr. miezetri gach quite well .","problem":[],"test":[],"treatment":["a c5-6 acdf"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[33]}
{"text":"4. lipitor , 10 mg po daily .","problem":[],"test":[],"treatment":["lipitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"2. zantac , 150 mg po bid .","problem":[],"test":[],"treatment":["zantac"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"dilaudid 2mg po x 1 flexeril 10 mg x 1","problem":[],"test":[],"treatment":["flexeril","dilaudid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,20],"treatment_indices_end":[8,28]}
{"text":"take codeine prescribed by pcp with food and water to prevent nausea and constipation .","problem":["constipation","nausea"],"test":[],"treatment":["codeine"],"problem_indices_start":[62,73],"problem_indices_end":[68,85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[5],"treatment_indices_end":[12]}
{"text":"left shoulder \/ neck strain \/ sprain .","problem":["left shoulder \/ neck strain \/ sprain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"do not drive if taking flexeril and codeine .","problem":[],"test":[],"treatment":["codeine","flexeril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23,36],"treatment_indices_end":[31,43]}
{"text":"l shoulder inj","problem":["l shoulder inj"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given printed instructions for neck strains ( english ) .","problem":["neck strains"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"flexeril 10mg tid","problem":[],"test":[],"treatment":["flexeril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"ivf , cbc ( hct 36 ) , normal chem 7 , negative cardiac enzymes , negative stool guaiac , normal cxr","problem":[],"test":["cbc","hct"],"treatment":["ivf"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[6,12],"test_indices_end":[9,15],"treatment_indices_start":[0],"treatment_indices_end":[3]}
{"text":"near syncope , dehydration vs cardiogenic","problem":["near syncope","dehydration","cardiogenic"],"test":[],"treatment":[],"problem_indices_start":[0,15,30],"problem_indices_end":[12,26,41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is to return to the ed for recurrent dizziness , chest pain , shortness of breath or weakness .","problem":["recurrent dizziness","chest pain","shortness of breath","weakness"],"test":[],"treatment":[],"problem_indices_start":[39,61,74,97],"problem_indices_end":[58,71,93,105],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dr. foutchner will arrange for an outpatient holter monitor .","problem":[],"test":["an outpatient holter monitor"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[31],"test_indices_end":[59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given printed instructions for dizziness ( english ) .","problem":["dizziness"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"near syncope standardized discharge instructions :","problem":["near syncope"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cv - ischemia asa , lisinopril pump no evidence of failure","problem":["ischemia","failure"],"test":[],"treatment":["lisinopril pump","asa"],"problem_indices_start":[5,51],"problem_indices_end":[13,58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14,20],"treatment_indices_end":[17,35]}
{"text":"75 y \/ o f with dm , copd on 2l nc and bipap at night p \/ w generalized weakness and fatigue , urinary incontinence and shaking as well as increased sputum production .","problem":["copd","fatigue","generalized weakness","increased sputum production","dm","shaking","urinary incontinence"],"test":[],"treatment":["bipap","2l nc"],"problem_indices_start":[16,21,60,85,95,120,139],"problem_indices_end":[18,25,80,92,115,127,166],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29,39],"treatment_indices_end":[34,44]}
{"text":"nad , pleasant , speaking in complete sentences , poor air movement bilaterally , l > r , no wheezes or rales , rrr , distant , abd benign , no edema , alert and oriented times three , no focal deficits , conversant studies :","problem":["nad","wheezes","focal deficits","poor air movement bilaterally","edema","rales"],"test":[],"treatment":[],"problem_indices_start":[0,50,96,107,147,191],"problem_indices_end":[3,79,103,112,152,205],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"flare - steroids , cont prednisone 60 , taper slowly as tolerated , duonebs , advair , singulair , spiriva , claritin azithromycin for atypical bronchitis to complete a 5 day course , keep o2 sat 90-94 , home nocturnal cpap not tolerated in house , does well on nc , appears ato be at baseline","problem":["flare","atypical bronchitis"],"test":["o2 sat"],"treatment":["nc","advair","duonebs","singulair","steroids","azithromycin","claritin","prednisone","spiriva","home nocturnal cpap"],"problem_indices_start":[0,135],"problem_indices_end":[5,154],"test_indices_start":[189],"test_indices_end":[195],"treatment_indices_start":[8,24,68,78,87,99,109,118,204,262],"treatment_indices_end":[16,34,75,84,96,106,117,130,223,264]}
{"text":"- ekg sinus 92 , no st changes","problem":["st changes"],"test":["ekg"],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[30],"test_indices_start":[2],"test_indices_end":[5],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cr 0.8 , stress incontinence by symptoms with increased cough , no evidence of uti , cont to closely monitor","problem":["symptoms","uti","stress incontinence","increased cough"],"test":["cr"],"treatment":[],"problem_indices_start":[9,32,46,79],"problem_indices_end":[28,40,61,82],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"improving , but still poor air movement , diffusely wheezy on exam , at baseline 2l o2 requirement","problem":["diffusely wheezy","still poor air movement"],"test":["exam"],"treatment":["2l o2 requirement"],"problem_indices_start":[16,42],"problem_indices_end":[39,58],"test_indices_start":[62],"test_indices_end":[66],"treatment_indices_start":[81],"treatment_indices_end":[98]}
{"text":"acetylsalicylic acid 81 mg po daily albuterol nebulizer 2.5 mg neb q4h starting today ( 03\/17 ) prn shortness of breath lisinopril 10 mg po daily niferex-150 150 mg po bid prednisone taper po give 50 mg q 24 h x 1 dose ( s ) , then give 40 mg q 24 h x 1 dose ( s ) , then give 30 mg q 24 h x 1 dose ( s ) , then give 20 mg q 24 h x 1 dose ( s ) , then give 10 mg q 24 h x 1 dose ( s ) , then starting today ( 03\/17 ) claritin ( loratadine ) 10 mg po daily","problem":["shortness of breath"],"test":[],"treatment":["acetylsalicylic acid","albuterol nebulizer","claritin ( loratadine )","lisinopril","prednisone taper po","niferex-150"],"problem_indices_start":[100],"problem_indices_end":[119],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,36,120,146,172,417],"treatment_indices_end":[20,55,130,157,191,440]}
{"text":"walk with assist per pt eval","problem":[],"test":["pt eval"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[21],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if bs is less than 125 , then give 0 units subcutaneously if bs is 125-150 , then give 2 units subcutaneously if bs is 151-200 , then give 3 units subcutaneously if bs is 201-250 , then give 4 units subcutaneously if bs is 251-300 , then give 6 units subcutaneously if bs is 301-350 , then give 8 units subcutaneously if bs is 351-400 , then give 10 units subcutaneously and call ho call ho if bs is greater than 400 protonix ( pantoprazole ) 40 mg po daily combivent ( ipratropium and albuterol sulfate ) 2 puff inh qid fosamax ( alendronate ) 70 mg po qweek","problem":[],"test":["bs","bs","bs","bs","bs","bs","bs","bs"],"treatment":["combivent ( ipratropium and albuterol sulfate )","fosamax ( alendronate )","protonix ( pantoprazole )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3,61,113,165,217,269,321,394],"test_indices_end":[5,63,115,167,219,271,323,396],"treatment_indices_start":[417,458,521],"treatment_indices_end":[442,505,544]}
{"text":"standing pre-meal novolog .","problem":[],"test":[],"treatment":["standing pre-meal novolog"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[25]}
{"text":"per daughter these symptoms are typical of copd flare .","problem":["these symptoms","copd flare"],"test":[],"treatment":[],"problem_indices_start":[13,43],"problem_indices_end":[27,53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"give on an empty stomach ( give 1hr before or 2hr after food ) singulair ( montelukast ) 10 mg po bedtime advair diskus 500\/50 ( fluticasone propionate\/... ) 1 puff inh bid caltrate + d 1 tab po bid lantus ( insulin glargine ) 35 units sc qam duoneb ( albuterol and ipratropium nebulizer ) 3\/0.5 mg neb q6h starting today ( 03\/17 ) prn shortness of breath , wheezing novolog ( insulin aspart ) 4 units sc ac","problem":["shortness of breath","wheezing"],"test":[],"treatment":["duoneb ( albuterol and ipratropium nebulizer )","singulair ( montelukast )","novolog ( insulin aspart )","advair diskus 500\/50 ( fluticasone propionate\/... )","caltrate + d","lantus ( insulin glargine )"],"problem_indices_start":[336,358],"problem_indices_end":[355,366],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[63,106,173,199,243,367],"treatment_indices_end":[88,157,185,226,289,393]}
{"text":"novolog ( insulin aspart ) sliding scale ( subcutaneously ) sc ac","problem":[],"test":[],"treatment":["novolog ( insulin aspart )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[26]}
{"text":"t97.5 , hr 117 , bp156\/81 , rr28 , o2 sats 87% ra ; 95% 4l","problem":[],"test":["o2 sats","hr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[8,35],"test_indices_end":[10,42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"take with 8 oz of plain water spiriva ( tiotropium ) 18","problem":[],"test":[],"treatment":["spiriva ( tiotropium )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30],"treatment_indices_end":[52]}
{"text":"id - afebrile , no wbc , started on azithromycin for copd flare","problem":["copd flare","afebrile"],"test":["wbc"],"treatment":["azithromycin"],"problem_indices_start":[5,53],"problem_indices_end":[13,63],"test_indices_start":[19],"test_indices_end":[22],"treatment_indices_start":[36],"treatment_indices_end":[48]}
{"text":"75 y \/ o f with h \/ o copd c \/ b frequent exacerbations p \/ w typical flare symptoms .","problem":["typical flare symptoms","copd","frequent exacerbations"],"test":[],"treatment":[],"problem_indices_start":[22,33,62],"problem_indices_end":[26,55,84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dispo - to rehab when resp status improved , pt consulted","problem":["resp status"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"responsible after study for causing admission ) copd flare","problem":["copd flare"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"f \/ u with pcp and dr. pump as scheduled , return to ed with worsening sob or increased cough or sputum production","problem":["sputum production","increased cough","worsening sob"],"test":[],"treatment":[],"problem_indices_start":[61,78,97],"problem_indices_end":[74,93,114],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"copd ( chronic obstructive pulmonary disease ) dm cervical djd ( ) iron deficiency anemia ( iron deficiency anemia ) cervical and lumbar djd ( 12 ) osa ( sleep apnea ) s \/ p tb treatment ( 5 )","problem":["dm","iron deficiency anemia ( iron deficiency anemia )","copd ( chronic obstructive pulmonary disease )","osa ( sleep apnea )","cervical djd","cervical and lumbar djd"],"test":[],"treatment":["tb treatment"],"problem_indices_start":[0,47,50,67,117,148],"problem_indices_end":[46,49,62,116,140,167],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[174],"treatment_indices_end":[186]}
{"text":"heme - chronic fe deficiency anemia , cont iron","problem":["chronic fe deficiency anemia"],"test":[],"treatment":["iron"],"problem_indices_start":[7],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[43],"treatment_indices_end":[47]}
{"text":"- cxr no focal consolidation or edema , old biapical scarring abg 7.34\/79\/74 u \/ a negative","problem":["focal consolidation","edema","old biapical scarring"],"test":["cxr","abg","u \/ a"],"treatment":[],"problem_indices_start":[9,32,40],"problem_indices_end":[28,37,61],"test_indices_start":[2,62,77],"test_indices_end":[5,65,82],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rec'd duonebs , solumedrol 125","problem":[],"test":[],"treatment":["solumedrol","duonebs"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[11,21],"treatment_indices_end":[18,31]}
{"text":"endo - dm on insulin with steroids","problem":["dm"],"test":[],"treatment":["insulin","steroids"],"problem_indices_start":[7],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,26],"treatment_indices_end":[20,34]}
{"text":"ppx - lovenox , ppi","problem":[],"test":[],"treatment":["ppi","lovenox"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6,16],"treatment_indices_end":[13,19]}
{"text":"gi - bowel regimen","problem":[],"test":[],"treatment":["bowel regimen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[5],"treatment_indices_end":[18]}
{"text":"weakness","problem":["weakness"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"copd flare","problem":["copd flare"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rhythm resp - copd","problem":["copd"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"copd flare","problem":["copd flare"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"give in addition to standing pre-meal novolog when patient will eat and food is in the room .","problem":[],"test":[],"treatment":["standing pre-meal novolog"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[45]}
{"text":"dizziness","problem":["dizziness"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"benign positional vertigo vs labyrinthitis","problem":["benign positional vertigo","labyrinthitis"],"test":[],"treatment":[],"problem_indices_start":[0,29],"problem_indices_end":[25,42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"meclizine 25 mg po bid .","problem":[],"test":[],"treatment":["meclizine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"return to ed or call pcp if symptoms worsen or if fever with headache .","problem":["fever","headache","symptoms"],"test":[],"treatment":[],"problem_indices_start":[28,50,61],"problem_indices_end":[36,55,69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given printed instructions for dizziness ( english ) .","problem":["dizziness"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head ct negative .","problem":[],"test":["head ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"return immediately for worsening signs of infection ( increased swelling , pain , redness ) or for any neurologic changes ( blurry or double vision , headaches , trouble walking , etc ) .","problem":["blurry or double vision","any neurologic changes","headaches","trouble walking","increased swelling","pain","infection","redness"],"test":[],"treatment":[],"problem_indices_start":[42,54,75,82,99,124,150,162],"problem_indices_end":[51,72,79,89,121,147,159,177],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"l upper lip \/ l nostril abscess","problem":["l upper lip \/ l nostril abscess"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5 cc of purulent material drained by needle aspiration","problem":["purulent material"],"test":[],"treatment":["needle aspiration"],"problem_indices_start":[8],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37],"treatment_indices_end":[54]}
{"text":"swollen painful l side fc","problem":["swollen painful l side fc"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"augmentin 875 mg twice a day for 10 days .","problem":[],"test":[],"treatment":["augmentin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"the neuro-oncologist felt that because of the tremendous tumor burden that was likely causing his symptoms the patient will require open debulking as well as obtaining issue for a pathologic diagnosis .","problem":["his symptoms","the tremendous tumor burden"],"test":["a pathologic diagnosis"],"treatment":["open debulking"],"problem_indices_start":[42,94],"problem_indices_end":[69,106],"test_indices_start":[178],"test_indices_end":[200],"treatment_indices_start":[132],"treatment_indices_end":[146]}
{"text":"chest xray reveals no consolidation or signs of edema .","problem":["signs of edema","consolidation"],"test":["chest xray"],"treatment":[],"problem_indices_start":[22,39],"problem_indices_end":[35,53],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hypertension , cva 2001 , 2002 diabetes , laryngeal cancer , right cea , prostatectomy for bph , total knee replacement , status post appendectomy .","problem":["laryngeal cancer","bph","hypertension","diabetes","cva"],"test":[],"treatment":["appendectomy","total knee replacement","prostatectomy","right cea"],"problem_indices_start":[0,15,31,42,91],"problem_indices_end":[12,18,39,58,94],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61,73,97,134],"treatment_indices_end":[70,86,119,146]}
{"text":"no other masses or thyromegaly noted .","problem":["thyromegaly","other masses"],"test":[],"treatment":[],"problem_indices_start":[3,19],"problem_indices_end":[15,30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nkda .","problem":["nkda"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[4],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has an intention tremor with the left hand .","problem":["an intention tremor with the left hand"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient can have voiding trials at rehab and he is being maintained on flomax .","problem":[],"test":[],"treatment":["flomax","voiding trials"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21,75],"treatment_indices_end":[35,81]}
{"text":"the patient was taken off fluid restriction .","problem":[],"test":[],"treatment":["fluid restriction"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[43]}
{"text":"the patient is status post radiation therapy and resection and reconstruction for his laryngeal cancer .","problem":["his laryngeal cancer"],"test":[],"treatment":["radiation therapy","resection","reconstruction"],"problem_indices_start":[82],"problem_indices_end":[102],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,49,63],"treatment_indices_end":[44,58,77]}
{"text":"over the next several days his sodium levels were followed and by 5\/12\/05 his plasma sodium was back to 136 .","problem":[],"test":["his plasma sodium","his sodium levels"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[27,74],"test_indices_end":[44,91],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"afebrile , vital signs stable but notable for a blood pressure of 164\/80 .","problem":["afebrile"],"test":["vital signs","a blood pressure"],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[11,46],"test_indices_end":[22,62],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"positive weakness , otherwise negative .","problem":["positive weakness"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was admitted to the neurologic service for workup of his tumor .","problem":["his tumor"],"test":["workup"],"treatment":[],"problem_indices_start":[65],"problem_indices_end":[74],"test_indices_start":[55],"test_indices_end":[61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a postoperative mri was obtained which revealed no remarkable findings but only post surgical changes .","problem":["post surgical changes","remarkable findings"],"test":["a postoperative mri"],"treatment":[],"problem_indices_start":[51,80],"problem_indices_end":[70,101],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he reported that he began with difficulty buttoning his shirt for many years since after a stroke but now reports that on occasion she would ask him why he was doing certain things and he could not give a concrete example .","problem":["difficulty buttoning his shirt","a stroke"],"test":[],"treatment":[],"problem_indices_start":[31,89],"problem_indices_end":[61,97],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no hepato or splenomegaly .","problem":["hepato","splenomegaly"],"test":[],"treatment":[],"problem_indices_start":[3,13],"problem_indices_end":[9,25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no cervical , para-auricular or clavicular lymphadenopathy .","problem":["cervical , para-auricular or clavicular lymphadenopathy"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is asked to see a physician immediately or go to the nearest emergency room if any bleeding , wound infection , fever greater than 100.8 , intractable nausea and vomiting , headache , dizziness , numbness , pain or weakness occurs .","problem":["fever","any bleeding","headache","numbness","intractable nausea and vomiting","pain","weakness","wound infection","dizziness"],"test":[],"treatment":[],"problem_indices_start":[91,106,124,151,185,196,208,219,227],"problem_indices_end":[103,121,129,182,193,205,216,223,235],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white blood cell count on admission 6.1 , inr on admission 1.0 , relevant imaging .","problem":[],"test":["white blood cell count","inr","relevant imaging"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,42,65],"test_indices_end":[22,45,81],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was referred to the neurology service for further workup of the mass .","problem":["the mass"],"test":["further workup"],"treatment":[],"problem_indices_start":[72],"problem_indices_end":[80],"test_indices_start":[54],"test_indices_end":[68],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 5\/11\/05 repeat imaging revealed some edema and mass affect .","problem":["mass affect","some edema"],"test":["repeat imaging"],"treatment":[],"problem_indices_start":[35,50],"problem_indices_end":[45,61],"test_indices_start":[11],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient denied blurry vision , headache , nausea , vomiting , paresthesias , pain in mental status , confusion or seizures .","problem":["blurry vision","confusion","paresthesias","headache","nausea","vomiting","seizures","pain in mental status"],"test":[],"treatment":[],"problem_indices_start":[19,35,46,55,66,81,105,118],"problem_indices_end":[32,43,52,63,78,102,114,126],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's pain was initially controlled with iv pain medications but at the time of discharge to the rehab facility he was able to control his pain on po pain medications .","problem":["his pain","the patient 's pain"],"test":[],"treatment":["po pain medications","iv pain medications"],"problem_indices_start":[0,149],"problem_indices_end":[24,157],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[55,161],"treatment_indices_end":[74,180]}
{"text":"his pathology came back as a large grade iv glioma .","problem":["a large grade iv glioma"],"test":["his pathology"],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[50],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"since that time he had been ambulating with a walker and has had increasing difficulty with falls in the last two weeks .","problem":["increasing difficulty with falls"],"test":[],"treatment":["a walker"],"problem_indices_start":[65],"problem_indices_end":[97],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[44],"treatment_indices_end":[52]}
{"text":"the patient was started on fragmin for dvt prophylaxis and the patient was also started on dilantin levels .","problem":[],"test":["dilantin levels"],"treatment":["dvt prophylaxis","fragmin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[91],"test_indices_end":[106],"treatment_indices_start":[27,39],"treatment_indices_end":[34,54]}
{"text":"the patient was in previously good health when he reports starting to notice problems ambulating about six months ago .","problem":["problems ambulating"],"test":[],"treatment":[],"problem_indices_start":[77],"problem_indices_end":[96],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. zinc 220 mg po every day .","problem":[],"test":[],"treatment":["zinc"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[7]}
{"text":"right lower quadrant scar and inferior midline scar that are well healed .","problem":["right lower quadrant scar","inferior midline scar"],"test":[],"treatment":[],"problem_indices_start":[0,30],"problem_indices_end":[25,51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"father with cad at 90 , diabetes , cva , hypercholesterolemia .","problem":["cva","diabetes","hypercholesterolemia","cad"],"test":[],"treatment":[],"problem_indices_start":[12,24,35,41],"problem_indices_end":[15,32,38,61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"transcranial dopplers were checked following surgery and the patient was started on decadron 4 mg q6 to prevent swelling .","problem":["swelling"],"test":["transcranial dopplers"],"treatment":["decadron","surgery"],"problem_indices_start":[112],"problem_indices_end":[120],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[45,84],"treatment_indices_end":[52,92]}
{"text":"moist buccal mucosa , poor dentition , no erythema or exudates in the posterior pharynx .","problem":["erythema or exudates in the posterior pharynx","poor dentition"],"test":[],"treatment":[],"problem_indices_start":[22,42],"problem_indices_end":[36,87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at the time of transfer , a 16 coude catheter was in place and draining well .","problem":[],"test":[],"treatment":["a 16 coude catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[45]}
{"text":"the patient was again seen by his primary care physician and a cg scan revealed a mass in the right parietal lobe .","problem":["a mass in the right parietal lobe"],"test":["a cg scan"],"treatment":[],"problem_indices_start":[80],"problem_indices_end":[113],"test_indices_start":[61],"test_indices_end":[70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the staples were removed prior to discharge .","problem":[],"test":[],"treatment":["the staples"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"16. neutra-phos 1.25 grams po as needed .","problem":[],"test":[],"treatment":["neutra-phos"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[15]}
{"text":"there is increased tone in his right upper extremity with a slight left pronator drift .","problem":["a slight left pronator drift","increased tone in his right upper extremity"],"test":[],"treatment":[],"problem_indices_start":[9,58],"problem_indices_end":[52,86],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"echocardiogram june 2004 showed an ef of 77% .","problem":[],"test":["an ef","echocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,32],"test_indices_end":[14,37],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"generally a well developed elderly man in no apparent distress sitting in bed .","problem":["apparent distress"],"test":[],"treatment":[],"problem_indices_start":[45],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. lipitor 40 mg po every day .","problem":[],"test":[],"treatment":["lipitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"of note the patient was seen by cardiology for preoperative assessment .","problem":[],"test":["preoperative assessment"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[47],"test_indices_end":[70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cranial nerves ii through xii grossly intact with a slight deviation of the uvula and tongue to the right .","problem":["a slight deviation of the uvula and tongue"],"test":[],"treatment":[],"problem_indices_start":[50],"problem_indices_end":[92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right parietal occipital temporal tumor .","problem":["right parietal occipital temporal tumor"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3\/6 systolic ejection murmur heard best at the apex .","problem":["3\/6 systolic ejection murmur"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the finding was most consistent with metastatic disease and less likely primary cns neoplasm such as glioblastoma .","problem":["primary cns neoplasm","glioblastoma","metastatic disease"],"test":[],"treatment":[],"problem_indices_start":[37,72,101],"problem_indices_end":[55,92,113],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient did have a postoperative serum sodium in the 120s from the 130s three days postoperatively .","problem":[],"test":["a postoperative serum sodium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[21],"test_indices_end":[49],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"plavix 75 mg every day , lipitor 40 mg every day , hctz 50 mg , monopril 10 mg every day , viagra 100 mg prn .","problem":[],"test":[],"treatment":["lipitor","hctz","monopril","plavix","viagra"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,25,51,64,91],"treatment_indices_end":[6,32,55,72,97]}
{"text":"the patient has a history of laryngeal cancer in 2000 and 2001 , cva in 2001 to 2002 and hypertension , who has a six month history of progressive difficulty in ambulation .","problem":["hypertension","cva","laryngeal cancer","progressive difficulty in ambulation"],"test":[],"treatment":[],"problem_indices_start":[29,65,89,135],"problem_indices_end":[45,68,101,171],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 5\/14\/05 mannitol was tapered and then d \/ c'd.","problem":[],"test":[],"treatment":["mannitol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[11],"treatment_indices_end":[19]}
{"text":"no nystagmus .","problem":["nystagmus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he continued to progress until two weeks prior to admission when he was found in the bathtub , unsteady and fell trying to steady himself .","problem":["unsteady"],"test":[],"treatment":[],"problem_indices_start":[95],"problem_indices_end":[103],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"prominent salivary glands bilaterally .","problem":["prominent salivary glands bilaterally"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. dilantin 100 mg iv tid which can be changed to a po regimen in seven days .","problem":[],"test":[],"treatment":["dilantin","a po regimen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,50],"treatment_indices_end":[11,62]}
{"text":"no cva tenderness .","problem":["cva tenderness"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given an iv load of decadron and restarted on iv decadron which was eventually transferred to po decadron .","problem":[],"test":[],"treatment":["iv decadron","po decadron","an iv load of decadron"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,62,110],"treatment_indices_end":[44,73,121]}
{"text":"he has had uncoordination of his feet and began having a cane four to five months ago with the increasing weakness .","problem":["the increasing weakness","uncoordination of his feet"],"test":[],"treatment":["a cane"],"problem_indices_start":[11,91],"problem_indices_end":[37,114],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[55],"treatment_indices_end":[61]}
{"text":"the abdomen was soft , nontender , nondistended , positive bowel sounds .","problem":["nontender","nondistended"],"test":[],"treatment":[],"problem_indices_start":[23,35],"problem_indices_end":[32,47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct shows a right parietal hyperdense and heterogenously enhancing mass measuring 6.5 x 5 cm with the surrounding vasogenic edema in effacement of the right lateral ventricle .","problem":["a right parietal hyperdense and heterogenously enhancing mass","the surrounding vasogenic edema"],"test":["ct"],"treatment":[],"problem_indices_start":[9,97],"problem_indices_end":[70,128],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"12. levofloxacin 500 mg po q daily x10 days .","problem":[],"test":[],"treatment":["levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[16]}
{"text":"at the time of transfer the patient was stable and needed only physical and occupational therapy .","problem":[],"test":[],"treatment":["physical and occupational therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[63],"treatment_indices_end":[96]}
{"text":"on may 5 , 2005 the patient was taken to the operating room for a right parietal occipital craniotomy and debulking of the tumor using stulz neuro navigation .","problem":["the tumor"],"test":[],"treatment":["stulz neuro navigation","a right parietal occipital craniotomy","debulking"],"problem_indices_start":[119],"problem_indices_end":[128],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[64,106,135],"treatment_indices_end":[101,115,157]}
{"text":"the patient instructed to call dr. coma 's office at 496-260-3297 to arrange for a follow up appointment in the saintaelfoote hospital at the first available time , one to two months after surgery .","problem":[],"test":[],"treatment":["surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[194],"treatment_indices_end":[201]}
{"text":"3. nexium 40 mg po every day .","problem":[],"test":[],"treatment":["nexium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"an endocrine consult was obtained to help manage his serum electrolytes .","problem":[],"test":["his serum electrolytes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[49],"test_indices_end":[71],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. captopril 12.5 mg po tid .","problem":[],"test":[],"treatment":["captopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"of note on 5\/9\/05 the patient was seen by urology due to an inability to void and a 16 french coude catheter was placed .","problem":["an inability to void"],"test":[],"treatment":["a 16 french coude catheter"],"problem_indices_start":[57],"problem_indices_end":[77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[82],"treatment_indices_end":[108]}
{"text":"no petechiae .","problem":["petechiae"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had a relatively unremarkable course and his neurologic status continued to improve following the operation .","problem":[],"test":[],"treatment":["the operation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[106],"treatment_indices_end":[119]}
{"text":"5. ativan 0.5 mg po q4 hours prn for anxiety .","problem":["anxiety"],"test":[],"treatment":["ativan"],"problem_indices_start":[37],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"6. allegra 60 mg po bid .","problem":[],"test":[],"treatment":["allegra"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"mri showed a large heterogenous enhancing right parietal mass lesion with a possible ependymal spread .","problem":["a large heterogenous enhancing right parietal mass lesion","ependymal spread"],"test":["mri"],"treatment":[],"problem_indices_start":[11,85],"problem_indices_end":[68,101],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. vitamin c 500 mg po bid .","problem":[],"test":[],"treatment":["vitamin c"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"the patient had no complaints of pain .","problem":["complaints of pain"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5\/5\/05 right parietal occipital craniotomy and debulking of tumor using stulz neuro navigation .","problem":[],"test":[],"treatment":["stulz neuro navigation","debulking of tumor","right parietal occipital craniotomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[7,47,72],"treatment_indices_end":[42,65,94]}
{"text":"10. flomax 0.4 mg po every day .","problem":[],"test":[],"treatment":["flomax"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"please see the separately dictated operative report for further details of the procedure .","problem":[],"test":[],"treatment":["the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[75],"treatment_indices_end":[88]}
{"text":"the patient then was given voiding trials but eventually he needed to be straight cathed prn .","problem":[],"test":[],"treatment":["voiding trials"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[41]}
{"text":"the patient is a pleasant 83-year-old retired psychiatrist who presents with a chief complaint of gait difficulty for the last five to six months .","problem":["gait difficulty"],"test":[],"treatment":[],"problem_indices_start":[98],"problem_indices_end":[113],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has seen his primary care physician who referred him to physical therapy for his gait weakness but his symptoms failed to improve .","problem":["his symptoms","his gait weakness"],"test":[],"treatment":[],"problem_indices_start":[89,111],"problem_indices_end":[106,123],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was started on three grams of sodium , 3x a day with fluid restriction .","problem":[],"test":[],"treatment":["sodium","fluid restriction"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[42,65],"treatment_indices_end":[48,82]}
{"text":"the patient is hard of hearing .","problem":["hard of hearing"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no egophony .","problem":["egophony"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was having a hard time walking and reports that he has felt weaker .","problem":["a hard time walking"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no palpable thrill or heave .","problem":["heave","palpable thrill"],"test":[],"treatment":[],"problem_indices_start":[3,22],"problem_indices_end":[18,27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his partner also reports that he has been having more difficulty with adls .","problem":["more difficulty with adls"],"test":[],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"11. fragmin 2500 units subcut every day .","problem":[],"test":[],"treatment":["fragmin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[11]}
{"text":"the patient was also started on mannitol .","problem":[],"test":[],"treatment":["mannitol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32],"treatment_indices_end":[40]}
{"text":"the patient is asked to take a course of dilantin for ten more days .","problem":[],"test":[],"treatment":["dilantin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[41],"treatment_indices_end":[49]}
{"text":"4. colace 100 mg po bid .","problem":[],"test":[],"treatment":["colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"13. dexamethasone 4 mg po q6 hours .","problem":[],"test":[],"treatment":["dexamethasone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[17]}
{"text":"crackles in the right lung field .","problem":["crackles in the right lung field"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no retinal hemorrhages .","problem":["retinal hemorrhages"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"15. regular insulin sliding scale with finger sticks qac and qhs .","problem":[],"test":[],"treatment":["regular insulin sliding scale"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[33]}
{"text":"14. the steroid will be kept for now and tapered at a later date on follow up with dr. coma .","problem":[],"test":[],"treatment":["the steroid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[15]}
{"text":"is significant for spinal stenosis and a series of operations including repair of a ureteral stricture ; cataract implants ; two partial hysterectomies ; and an appendectomy .","problem":["spinal stenosis","a ureteral stricture"],"test":[],"treatment":["an appendectomy","cataract implants","operations","two partial hysterectomies","repair"],"problem_indices_start":[19,82],"problem_indices_end":[34,102],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[51,72,105,125,158],"treatment_indices_end":[61,78,122,151,173]}
{"text":"the blood pressure was 150\/86 ; pulse 82 ; respirations 16 .","problem":[],"test":["pulse","the blood pressure","respirations"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,32,43],"test_indices_end":[18,37,55],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"aspirin 325 mg po q.day .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"there were no complications , and the patient tolerated the procedure well .","problem":["complications"],"test":[],"treatment":["the procedure"],"problem_indices_start":[14],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[56],"treatment_indices_end":[69]}
{"text":"she described the pain as being exacerbated by eating and described an associated weight loss .","problem":["the pain","an associated weight loss"],"test":[],"treatment":[],"problem_indices_start":[14,68],"problem_indices_end":[22,93],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"findings included no gross evidence seating in the abdominal wall ; one nodule on the posterior surface of the right lobe of the liver ; one nodule in the inferior edge of the falciform ligament .","problem":["no gross evidence seating in the abdominal wall","one nodule","one nodule"],"test":[],"treatment":[],"problem_indices_start":[18,68,137],"problem_indices_end":[65,78,147],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at the time of discharge , cytopathology specimens had been negative , and surgical pathology specimens were still pending .","problem":[],"test":["surgical pathology specimens","cytopathology specimens"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[27,75],"test_indices_end":[50,103],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"oxycontin 10 mg po q.day .","problem":[],"test":[],"treatment":["oxycontin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"specimens sent to pathology included peritoneal washings and permanent specimens from the liver and falciform nodules .","problem":["falciform nodules"],"test":["permanent specimens from the liver","peritoneal washings","specimens"],"treatment":[],"problem_indices_start":[100],"problem_indices_end":[117],"test_indices_start":[0,37,61],"test_indices_end":[9,56,95],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pancreatic carcinoma .","problem":["pancreatic carcinoma"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was then referred to the fairm of ijordcompmac hospital under the el memorial and was seen by dr. blinjesc , who scheduled her for an exploratory laparoscopy .","problem":[],"test":["an exploratory laparoscopy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[135],"test_indices_end":[161],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she presented to her primary care physician , dr. tlandtaze , in aersing rocuch sun , who obtained a ct scan , which demonstrated a mass in the tail of the pancreas .","problem":["a mass"],"test":["a ct scan"],"treatment":[],"problem_indices_start":[130],"problem_indices_end":[136],"test_indices_start":[99],"test_indices_end":[108],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"postoperatively , the patient had some abdominal bloating with evidence of subcutaneous emphysema over the abdomen .","problem":["subcutaneous emphysema over the abdomen","some abdominal bloating"],"test":[],"treatment":[],"problem_indices_start":[34,75],"problem_indices_end":[57,114],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"regular s1 and s2 ; no murmurs .","problem":["murmurs"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lungs were clear to auscultation bilaterally .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"estratab one po q.day .","problem":[],"test":[],"treatment":["estratab"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"the patient was admitted through same day surgery and taken to the operating room where dr. blinjesc , assisted by dr. zockbeathe , performed a diagnostic laparoscopy with peritoneal washings .","problem":[],"test":["a diagnostic laparoscopy"],"treatment":["peritoneal washings"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[142],"test_indices_end":[166],"treatment_indices_start":[172],"treatment_indices_end":[191]}
{"text":"she tolerated a full diet well , but continued to have abdominal cramping and a mild ileus for the following three days .","problem":["a mild ileus","abdominal cramping"],"test":[],"treatment":[],"problem_indices_start":[55,78],"problem_indices_end":[73,90],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"included aspirin 325 mg po q.day .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9],"treatment_indices_end":[16]}
{"text":"soft ; nontender ; no palpable masses .","problem":["palpable masses"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"laparoscopy with biopsy for diagnosis .","problem":[],"test":["laparoscopy","biopsy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,17],"test_indices_end":[11,23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"percocet one to two whenever necessary q. four to six hours for pain .","problem":["pain"],"test":[],"treatment":["percocet"],"problem_indices_start":[64],"problem_indices_end":[68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"estratab .","problem":[],"test":[],"treatment":["estratab"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"darvocet .","problem":[],"test":[],"treatment":["darvocet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"she was uncomfortable and slow to have bowel movements , although she did have flatus .","problem":["uncomfortable"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ms. sterpkoteneish is a 69-year-old woman , who over the past six months has noted increasing pain in her left upper quadrant radiating to the back .","problem":["increasing pain in her left upper quadrant"],"test":[],"treatment":[],"problem_indices_start":[83],"problem_indices_end":[125],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was treated with repeated fleet 's enemas , and on postoperative day three , she had a number of bowel movements , was considerably more comfortable , and deemed ready for discharge .","problem":[],"test":[],"treatment":["repeated fleet 's enemas"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[50]}
{"text":"she was instructed to call dr. blinjesc for the results of these tests and to follow up with him for further management if necessary .","problem":[],"test":["these tests"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[59],"test_indices_end":[70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"docusate sodium 100 mg po bid prn ibuprofen 200-600 mg po q4-6h prn pain","problem":["pain"],"test":[],"treatment":["ibuprofen","docusate sodium"],"problem_indices_start":[68],"problem_indices_end":[72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,34],"treatment_indices_end":[15,43]}
{"text":"nothing in the vagina for 6 weeks - no tampons , no douching , no intercourse .","problem":[],"test":[],"treatment":["tampons","douching"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39,52],"treatment_indices_end":[46,60]}
{"text":"post dates","problem":["post dates"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if you experience fever > 100.4 , bleeding > 1 pad \/ hour , foul smelling discharge , abdominal pain , or other worrisome symptoms , please call your doctor or return to the hospital .","problem":["fever","bleeding","abdominal pain","foul smelling discharge","other worrisome symptoms"],"test":[],"treatment":[],"problem_indices_start":[18,37,66,92,112],"problem_indices_end":[23,45,89,106,136],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no observed abnormalities","problem":["observed abnormalities"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"responsible after study for causing admission ) s \/ p nsvd","problem":["nsvd"],"test":[],"treatment":[],"problem_indices_start":[54],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ho evaluation","problem":[],"test":["ho evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"initial newborn exam :","problem":[],"test":["initial newborn exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"apgars 8,9","problem":[],"test":["apgars"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ob clinic 2 weeks and 6 weeks , no known allergies","problem":["known allergies"],"test":[],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"postdates pregnancy","problem":["postdates pregnancy"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"weight :","problem":[],"test":["weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had a magnetic resonance imaging study and magnetic resonance imaging angiogram performed which showed a large hemorrhagic lesion on the occipital lobe .","problem":["a large hemorrhagic lesion on the occipital lobe"],"test":["a magnetic resonance imaging study","magnetic resonance imaging angiogram"],"treatment":[],"problem_indices_start":[107],"problem_indices_end":[155],"test_indices_start":[8,47],"test_indices_end":[42,83],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient underwent a number of tests .","problem":[],"test":["tests"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[34],"test_indices_end":[39],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on physical examination , she was a very pleasant , moderately obese female in no apparent distress .","problem":["apparent distress"],"test":["physical examination"],"treatment":[],"problem_indices_start":[82],"problem_indices_end":[99],"test_indices_start":[3],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sensation was intact to light touch and pin prick bilaterally .","problem":[],"test":["pin prick","light touch"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24,40],"test_indices_end":[35,49],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was a dense hemianopsia on the left side .","problem":["a dense hemianopsia on the left side"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"father and mother died in their eighties of heart disease .","problem":["heart disease"],"test":[],"treatment":[],"problem_indices_start":[44],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was also scattered t2 hyperintense foci within the periventricular and left frontal white matter consistent with small vessel disease , gliosis or demyelination .","problem":["scattered t2 hyperintense foci within the periventricular and left frontal white matter","small vessel disease","gliosis","demyelination"],"test":[],"treatment":[],"problem_indices_start":[15,119,142,153],"problem_indices_end":[102,139,149,166],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the head was normocephalic and atraumatic .","problem":["atraumatic"],"test":[],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the lungs were clear to auscultation bilaterally , without rales or wheezes .","problem":["rales","wheezes"],"test":["auscultation"],"treatment":[],"problem_indices_start":[59,68],"problem_indices_end":[64,75],"test_indices_start":[24],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"laboratory studies on admission demonstrated a sodium of 144 , potassium 4.1 , chloride 106 , bicarbonate 20.0 , bun and creatinine 12\/0.7 , glucose 99 , white blood count of 5.7 , hematocrit of 40.6 , platelet count of 226 , prothrombin time was 9.4 , partial thromboplastin time was 29 .","problem":[],"test":["platelet count","a sodium","white blood count","potassium","glucose","prothrombin time","creatinine","partial thromboplastin time","chloride","hematocrit","bun","bicarbonate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[45,63,79,94,113,121,141,154,181,202,226,253],"test_indices_end":[53,72,87,105,116,131,148,171,191,216,242,280],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an echocardiogram was obtained and showed that the ejection fraction was 60% and there was no thrombus .","problem":["thrombus"],"test":["the ejection fraction","an echocardiogram"],"treatment":[],"problem_indices_start":[94],"problem_indices_end":[102],"test_indices_start":[0,47],"test_indices_end":[17,68],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she also developed what appeared to be urinary tract infection and was placed on po bactrim .","problem":["urinary tract infection"],"test":[],"treatment":["po bactrim"],"problem_indices_start":[39],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[81],"treatment_indices_end":[91]}
{"text":"the computerized tomography scan was performed and showed a right occipital hemorrhage .","problem":["a right occipital hemorrhage"],"test":["the computerized tomography scan"],"treatment":[],"problem_indices_start":[58],"problem_indices_end":[86],"test_indices_start":[0],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she continued to have a dense left hemianopsia , but otherwise was neurologically intact .","problem":["a dense left hemianopsia"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there were some very rare atrial premature contractions .","problem":["some very rare atrial premature contractions"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was admitted to the hospital for further evaluation and work up .","problem":[],"test":["further evaluation","work up"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[45,68],"test_indices_end":[63,75],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at that time , she was afebrile and her vital signs were stable .","problem":["afebrile"],"test":["her vital signs"],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[31],"test_indices_start":[36],"test_indices_end":[51],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had considerable difficulty with left finger-to-nose movement , most likely secondary to hemianopsia .","problem":["hemianopsia","considerable difficulty with left finger-to-nose movement"],"test":[],"treatment":[],"problem_indices_start":[16,101],"problem_indices_end":[73,112],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sensation was intact to light touch , pin prick , and proprioception .","problem":[],"test":["proprioception","pin prick","light touch"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24,38,54],"test_indices_end":[35,47,68],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ms. tlandkotesmitskote is a patient who came complaining of feeling dizzy and bumping into objects on her left side .","problem":["dizzy"],"test":[],"treatment":[],"problem_indices_start":[68],"problem_indices_end":[73],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the heart rate was 53 to 106 .","problem":[],"test":["the heart rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"over the ensuing days , the patient had several episodes of confusion at night .","problem":["confusion"],"test":[],"treatment":[],"problem_indices_start":[60],"problem_indices_end":[69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right occipital hemorrhagic stroke .","problem":["right occipital hemorrhagic stroke"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"so an magnetic resonance imaging angiogram was obtained and showed the right parietal occipital hemorrhage .","problem":["the right parietal occipital hemorrhage"],"test":["an magnetic resonance imaging angiogram"],"treatment":[],"problem_indices_start":[67],"problem_indices_end":[106],"test_indices_start":[3],"test_indices_end":[42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a seventy-one year old female with a history of hypertension who now presents with a right occipital hemorrhagic stroke .","problem":["hypertension","a right occipital hemorrhagic stroke"],"test":[],"treatment":[],"problem_indices_start":[63,98],"problem_indices_end":[75,134],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no pronator drift .","problem":["pronator drift"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she also felt dizzy and the room was spinning .","problem":["dizzy"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient had difficulty with tandem gait and fell forward while standing on his his toes .","problem":["difficulty with tandem gait"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she also denies having hoarseness , difficulties in finding words , speaking , hiccups , or diplopia .","problem":["diplopia","hoarseness","difficulties in finding words","hiccups"],"test":[],"treatment":[],"problem_indices_start":[23,36,79,92],"problem_indices_end":[33,65,86,100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the abdomen was soft , nontender , nondistended .","problem":["nontender","nondistended"],"test":[],"treatment":[],"problem_indices_start":[23,35],"problem_indices_end":[32,47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"symptoms lasted about five hours and then gradually resolved except for the change in vision .","problem":["the change in vision","symptoms"],"test":[],"treatment":[],"problem_indices_start":[0,72],"problem_indices_end":[8,92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she denied having any weakness , numbness , or pain .","problem":["numbness","pain","weakness"],"test":[],"treatment":[],"problem_indices_start":[22,33,47],"problem_indices_end":[30,41,51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extremities revealed 2+ pitting edema in the knees bilaterally .","problem":["2+ pitting edema in the knees bilaterally"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no clear enhancing mass , but follow up was suggested .","problem":["clear enhancing mass"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was discharged on tenormin , 25 mg po qd ; bactrim ds , one po bid x5 days .","problem":[],"test":[],"treatment":["bactrim ds","tenormin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30,55],"treatment_indices_end":[38,65]}
{"text":"a neurosurgery service consultation was obtained and they felt that no surgical intervention was required .","problem":[],"test":[],"treatment":["surgical intervention"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[71],"treatment_indices_end":[92]}
{"text":"she was afebrile and her vital signs were stable .","problem":["afebrile"],"test":["her vital signs"],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[16],"test_indices_start":[21],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , she was soon moved out of there as her examination appeared to be stable .","problem":[],"test":["her examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[45],"test_indices_end":[60],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there were no ventricular premature contractions .","problem":["ventricular premature contractions"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the mra showed mild narrowing of the left ica just distal to the bifurcation .","problem":["mild narrowing of the left ica"],"test":["the mra"],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[45],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a holter monitor was obtained and showed that the patient was in normal sinus rhythm .","problem":[],"test":["a holter monitor"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no nystagmus , except for some fine fast beat nystagmus bilateral extremes of abduction .","problem":["nystagmus","some fine fast beat nystagmus bilateral extremes of abduction"],"test":[],"treatment":[],"problem_indices_start":[13,36],"problem_indices_end":[22,97],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she is a seventy-one year old female with a history of hypertension who is in otherwise good health .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[55],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"atenolol , 25 mg po qd .","problem":[],"test":[],"treatment":["atenolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"she was able to subtract serial sevens , remember three out of three objects after five minutes , and there was notable aphasia or word finding difficulty .","problem":["word finding difficulty .","notable aphasia"],"test":[],"treatment":[],"problem_indices_start":[112,131],"problem_indices_end":[127,156],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the neurological examination revealed that the patient was awake , alert and oriented to person , place and time .","problem":[],"test":["the neurological examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on review of systems , the patient denied any history of transient ischemic attacks .","problem":["transient ischemic attacks"],"test":[],"treatment":[],"problem_indices_start":[57],"problem_indices_end":[83],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the past medical history is significant for hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[44],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cerebellar examination revealed in intention tremor on the right side .","problem":["intention tremor on the right side"],"test":["cerebellar examination"],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[69],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she also complained of a dull , right sided headache over the right eyebrow .","problem":["a dull , right sided headache over the right eyebrow"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right occipital hemorrhagic stroke .","problem":["right occipital hemorrhagic stroke"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his melanoma was originally diagnosed last fall when he presented with lesions in the liver and spleen , and a chest ct showed left upper lobe nodules .","problem":["left upper lobe nodules","lesions in the liver and spleen","his melanoma"],"test":["a chest ct"],"treatment":[],"problem_indices_start":[0,71,127],"problem_indices_end":[12,102,150],"test_indices_start":[109],"test_indices_end":[119],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the neurological examination was nonfocal .","problem":[],"test":["the neurological examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a head ct scan was negative , but an mri scan of the spine showed an l5 metastasis with a fracture and had with epidural and paraspinal extension .","problem":["l5 metastasis","epidural and paraspinal extension","a fracture"],"test":["a head ct scan","an mri scan of the spine"],"treatment":[],"problem_indices_start":[69,88,112],"problem_indices_end":[82,98,145],"test_indices_start":[0,34],"test_indices_end":[14,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the episode of potential seizure activity occurred in the setting of a bowel movement and may have been associated with vasovagal activity .","problem":["vasovagal activity","potential seizure activity"],"test":[],"treatment":[],"problem_indices_start":[15,120],"problem_indices_end":[41,138],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the blood pressure was 113\/70 , pulse 66 , respirations 20 , and a temperature of 96.8 .","problem":[],"test":["pulse","respirations","the blood pressure","a temperature"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,32,43,65],"test_indices_end":[18,37,55,78],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at that time , he also began radiation therapy to his lumbosacral spine .","problem":[],"test":[],"treatment":["radiation therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[46]}
{"text":"mr. patient underwent venogram and inferior vena cava filter placement on february 23 , 1993 and was then he was admitted to the fairm of ijordcompmac hospital for postoperative care .","problem":[],"test":["venogram"],"treatment":["inferior vena cava filter placement","postoperative care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22],"test_indices_end":[30],"treatment_indices_start":[35,164],"treatment_indices_end":[70,182]}
{"text":"first , he had right lower extremity swelling and lower extremity noninvasives confirmed the diagnosis of a femoral deep venous thrombosis .","problem":["right lower extremity swelling","a femoral deep venous thrombosis"],"test":["lower extremity noninvasives"],"treatment":[],"problem_indices_start":[15,106],"problem_indices_end":[45,138],"test_indices_start":[50],"test_indices_end":[78],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he will be scheduled for an mri scan , neurology consult , and an eeg next week as an out patient .","problem":[],"test":["an mri scan","neurology consult","an eeg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[25,39,63],"test_indices_end":[36,56,69],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"approximately one week ago , he was admitted to the fairm of ijordcompmac hospital for chemotherapy with dtic and tamoxifen .","problem":[],"test":[],"treatment":["chemotherapy","dtic","tamoxifen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[87,105,114],"treatment_indices_end":[99,109,123]}
{"text":"in addition , the second major event that had occurred yesterday was a neurologic event of some kind .","problem":["a neurologic event"],"test":[],"treatment":[],"problem_indices_start":[69],"problem_indices_end":[87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the physical examination reveals a pleasant 70 year old male in no acute distress .","problem":["acute distress"],"test":["the physical examination"],"treatment":[],"problem_indices_start":[67],"problem_indices_end":[81],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ivc filter placement .","problem":[],"test":[],"treatment":["ivc filter placement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[20]}
{"text":"he is continuing on the radiation therapy to date .","problem":[],"test":[],"treatment":["the radiation therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[41]}
{"text":"an ivc filter placement was accomplished without complication .","problem":["complication"],"test":[],"treatment":["an ivc filter placement"],"problem_indices_start":[49],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[23]}
{"text":"in addition , there was a t11 metastasis with cord compression .","problem":["cord compression","a t11 metastasis"],"test":[],"treatment":[],"problem_indices_start":[24,46],"problem_indices_end":[40,62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mr. patient was a poor candidate for anticoagulation because of his history of metastatic melanoma and the question of cns metastases .","problem":["metastatic melanoma","cns metastases"],"test":[],"treatment":["anticoagulation"],"problem_indices_start":[79,119],"problem_indices_end":[98,133],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37],"treatment_indices_end":[52]}
{"text":"deep venous thrombosis of right lower extremity .","problem":["deep venous thrombosis of right lower extremity"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the extremity exam was notable for 2+ pitting edema in the right lower extremity extending to the knee .","problem":["2+ pitting edema in the right lower extremity"],"test":["the extremity exam"],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[80],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the neck was supple , without jugular venous distention or increased thyroid .","problem":["jugular venous distention","increased thyroid"],"test":[],"treatment":[],"problem_indices_start":[30,59],"problem_indices_end":[55,76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the chest was clear to auscultation and percussion .","problem":[],"test":["auscultation","percussion"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[23,40],"test_indices_end":[35,50],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"deep venous thrombosis of right lower extremity .","problem":["deep venous thrombosis of right lower extremity"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"second , he had a witnessed episode in which his eyes rolled to the back of his head and there was a question of some seizure activity .","problem":["some seizure activity","a witnessed episode"],"test":[],"treatment":[],"problem_indices_start":[16,113],"problem_indices_end":[35,134],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he tolerated the procedure well .","problem":[],"test":[],"treatment":["the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[26]}
{"text":"in the past , he has not been known to have a history of cns metastases .","problem":["cns metastases"],"test":[],"treatment":[],"problem_indices_start":[57],"problem_indices_end":[71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"decadron 4 mg po bid , dilantin 100 mg po tid .","problem":[],"test":[],"treatment":["decadron","dilantin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,23],"treatment_indices_end":[8,31]}
{"text":"metastatic melanoma .","problem":["metastatic melanoma"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no appreciable cervical , supraclavicular , axillary , or inguinal adenopathy .","problem":["appreciable cervical , supraclavicular , axillary , or inguinal adenopathy"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the review of systems is negative , except as above .","problem":[],"test":["the review of systems"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"regular rate and rhythm , with a i \/ vi systolic ejection murmur .","problem":["a i \/ vi systolic ejection murmur"],"test":[],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent showed pupils equal , round , reactive to light and accommodation , and extra ocular movements intact .","problem":[],"test":["heent"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[5],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is the second fairm of ijordcompmac hospital admission for taroby patient , a 70 year old male with a history of metastatic melanoma .","problem":["metastatic melanoma"],"test":[],"treatment":[],"problem_indices_start":[118],"problem_indices_end":[137],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"over the 24 hours of in house hospitalization , he did not have any further neurologic activity and was able to ambulate without assistance prior to discharge .","problem":["any further neurologic activity"],"test":[],"treatment":[],"problem_indices_start":[64],"problem_indices_end":[95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on february 23 , mr. patient presented to dr. patient 's office with two major symptoms .","problem":["two major symptoms"],"test":[],"treatment":[],"problem_indices_start":[74],"problem_indices_end":[92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"41 yo man with crfs of dm type ii , high cholesterol , smoking history , family hx , htn p \/ w episodes of atypical cp x 1 week , with rest and exertion .","problem":["htn","high cholesterol","dm type ii","crfs","episodes of atypical cp x 1 week"],"test":[],"treatment":[],"problem_indices_start":[15,23,36,85,95],"problem_indices_end":[19,33,52,88,127],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"atypical chest pain","problem":["atypical chest pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please use with spacer ( please instruct patient ) ecasa ( aspirin enteric coated ) 325 mg po qd wellbutrin ( bupropion hcl ) 150 mg po bid gemfibrozil 600 mg po bid zestril ( lisinopril ) 20 mg po qd zantac ( ranitidine hcl ) 150 mg po bid serzone ( nefazodone ) 300 mg po qhs zyprexa ( olanzapine ) 5 mg po qhs","problem":[],"test":[],"treatment":["wellbutrin ( bupropion hcl )","serzone ( nefazodone )","ecasa ( aspirin enteric coated )","zyprexa ( olanzapine )","spacer","zestril ( lisinopril )","gemfibrozil","zantac ( ranitidine hcl )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16,51,97,140,166,201,241,278],"treatment_indices_end":[22,83,125,151,188,226,263,300]}
{"text":"will plan on ett .","problem":[],"test":["ett"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"had chest ct to r \/ o dissection ( due to back pain ) which was neg.","problem":["dissection","back pain"],"test":["chest ct"],"treatment":[],"problem_indices_start":[22,42],"problem_indices_end":[32,51],"test_indices_start":[4],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"other diagnosis ; conditions , infections , complications , affecting treatment \/ stay dm ( diabetes mellitus ) anxiety ( anxiety ) htn ( hypertension ) gerd ( esophageal reflux )","problem":["anxiety ( anxiety )","gerd ( esophageal reflux )","htn ( hypertension )","dm ( diabetes mellitus )"],"test":[],"treatment":[],"problem_indices_start":[87,112,132,153],"problem_indices_end":[111,131,152,179],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"holding metformin until friday due to ct with contrast .","problem":[],"test":["ct with contrast"],"treatment":["metformin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[38],"test_indices_end":[54],"treatment_indices_start":[8],"treatment_indices_end":[17]}
{"text":"ruled out for mi .","problem":["mi"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"here , had t wave flattening laterally and inferiorly with pain that resolved pain free , but not clear that lead placement is the same .","problem":["pain","pain","t wave flattening laterally and inferiorly"],"test":["lead placement"],"treatment":[],"problem_indices_start":[11,59,78],"problem_indices_end":[53,63,82],"test_indices_start":[109],"test_indices_end":[123],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"glucophage ( metformin ) 850 mg po tid starting on 10\/03\/00 ( 10\/03 ) actos 30 mg po qd","problem":[],"test":[],"treatment":["glucophage ( metformin )","actos"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,70],"treatment_indices_end":[24,75]}
{"text":"also has h \/ o anxiety and gerd .","problem":["anxiety","gerd"],"test":[],"treatment":[],"problem_indices_start":[15,27],"problem_indices_end":[22,31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"albuterol inhaler 2 puff inh qid","problem":[],"test":[],"treatment":["albuterol inhaler"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[17]}
{"text":"penicillins","problem":[],"test":[],"treatment":["penicillins"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"atypical cp","problem":["atypical cp"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no assoicated sx .","problem":["assoicated sx"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"principal discharge diagnosis ; responsible after study for causing admission ) atypical chest pain","problem":["atypical chest pain"],"test":[],"treatment":[],"problem_indices_start":[80],"problem_indices_end":[99],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"repeat exam one month later showed a firm left-sided lobe .","problem":["a firm left-sided lobe"],"test":["repeat exam"],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[57],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his chest x-ray was normal .","problem":[],"test":["his chest x-ray"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sodium 141 , potassium 4.1 , chloride 104 , bicarbonate 28.8 , bun 17 , creatinine 0.9 , glucose 118 .","problem":[],"test":["bicarbonate","chloride","glucose","bun","creatinine","potassium","sodium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,29,44,63,72,89],"test_indices_end":[6,22,37,55,66,82,96],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"radical retropubic prostatectomy , bilateral lymph node dissection .","problem":[],"test":[],"treatment":["radical retropubic prostatectomy","bilateral lymph node dissection"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,35],"treatment_indices_end":[32,66]}
{"text":"he was discharged home on percocet and keflex .","problem":[],"test":[],"treatment":["keflex","percocet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,39],"treatment_indices_end":[34,45]}
{"text":"transrectal ultrasound showed a hypoechoic left-sided mass in the peripheral zone .","problem":["a hypoechoic left-sided mass in the peripheral zone"],"test":["transrectal ultrasound"],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[81],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his neck was supple with no jugular venous distention or thyromegaly .","problem":["jugular venous distention","thyromegaly"],"test":[],"treatment":[],"problem_indices_start":[28,57],"problem_indices_end":[53,68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was found on physical exam to have an asymmetric prostate with prominence on the left and a question of a nodule .","problem":["a nodule","prominence on the left","an asymmetric prostate"],"test":["physical exam"],"treatment":[],"problem_indices_start":[38,66,107],"problem_indices_end":[60,88,115],"test_indices_start":[16],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on postoperative day # 6 his low grade temperature resolved .","problem":["his low grade temperature"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had no symptoms of chest pain or myocardial ischemia .","problem":["chest pain","symptoms","myocardial ischemia"],"test":[],"treatment":[],"problem_indices_start":[10,22,36],"problem_indices_end":[18,32,55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his potassium was 3.7 and his hematocrit 33 .","problem":[],"test":["his hematocrit","his potassium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,26],"test_indices_end":[13,40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was a firm nodule in the left lobe of the prostate in the lateral aspect .","problem":["a firm nodule"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest was clear to percussion and auscultation .","problem":[],"test":["percussion","auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19,34],"test_indices_end":[29,46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a cardiology consult was obtained for this episode of diaphoresis with tachycardia , as well as for an ekg being read as having anterolateral changes .","problem":["anterolateral changes","tachycardia","diaphoresis"],"test":["a cardiology consult","an ekg"],"treatment":[],"problem_indices_start":[54,71,128],"problem_indices_end":[65,82,149],"test_indices_start":[0,100],"test_indices_end":[20,106],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his blood cultures and chest x-ray were negative .","problem":[],"test":["chest x-ray","his blood cultures"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,23],"test_indices_end":[18,34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the abdomen was soft and non-tender with no masses or organomegaly .","problem":["organomegaly","non-tender","masses"],"test":[],"treatment":[],"problem_indices_start":[25,44,54],"problem_indices_end":[35,50,66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a repeat ekg showed no changes .","problem":["changes"],"test":["a repeat ekg"],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[30],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 67 year old white male with a recent history of urinary frequency q2-3h , stranguria , nocturia x 3-4 per night .","problem":["nocturia","urinary frequency","stranguria"],"test":[],"treatment":[],"problem_indices_start":[65,91,104],"problem_indices_end":[82,101,112],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his urinalysis showed marked occult blood and positive white blood cell screen but was otherwise negative .","problem":["positive white blood cell screen","marked occult blood"],"test":["his urinalysis"],"treatment":[],"problem_indices_start":[22,46],"problem_indices_end":[41,78],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his postoperative course was remarkable for a low grade temperature to 101.7 .","problem":["a low grade temperature"],"test":[],"treatment":[],"problem_indices_start":[44],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt 9.4\/10.3 , ptt 27 .","problem":[],"test":["pt","ptt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,14],"test_indices_end":[2,17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no costovertebral angle tenderness .","problem":["costovertebral angle tenderness"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a biopsy showed moderately to poorly differentiated grade iii-iv adenocarcinoma on the left .","problem":["moderately to poorly differentiated grade iii-iv adenocarcinoma on the left"],"test":["a biopsy"],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[91],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his white blood count was 7100 , hematocrit 35.9 , platelet count 258,000 .","problem":[],"test":["platelet count","his white blood count","hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,33,51],"test_indices_end":[21,43,65],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his jackson-pratt drained about 35-40 cc per day and was discontinued on postoperative day # 3 .","problem":[],"test":[],"treatment":["his jackson-pratt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[17]}
{"text":"significant for non-insulin diabetes mellitus , for which he takes diabeta , one qd ; right eye cataract , operated on three years ago .","problem":["non-insulin diabetes mellitus","right eye cataract"],"test":[],"treatment":["diabeta"],"problem_indices_start":[16,86],"problem_indices_end":[45,104],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[67],"treatment_indices_end":[74]}
{"text":"he was afebrile postoperatively with vital signs stable .","problem":["afebrile"],"test":["vital signs"],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[15],"test_indices_start":[37],"test_indices_end":[48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his genitourinary exam showed an uncircumcised male with normal scrotal contents .","problem":[],"test":["his genitourinary exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a radical retropubic prostatectomy with bilateral lymph node dissection was done .","problem":[],"test":[],"treatment":["bilateral lymph node dissection","a radical retropubic prostatectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,40],"treatment_indices_end":[34,71]}
{"text":"he is allergic to motrin .","problem":["allergic"],"test":[],"treatment":["motrin"],"problem_indices_start":[6],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[24]}
{"text":"pulses 2+ .","problem":[],"test":["pulses"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he also had a 3-4 year history of impotence .","problem":["impotence"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"prostate cancer .","problem":["prostate cancer"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the remaining unit of autologous packed red blood cells was transfused .","problem":[],"test":[],"treatment":["autologous packed red blood cells"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[55]}
{"text":"regular rate and rhythm with normal s1 and s2 , no murmurs .","problem":["murmurs ."],"test":[],"treatment":[],"problem_indices_start":[51],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no clubbing , cyanosis or edema .","problem":["clubbing ,","cyanosis","edema"],"test":[],"treatment":[],"problem_indices_start":[3,14,26],"problem_indices_end":[13,22,31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"prostate cancer .","problem":["prostate cancer"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"diabeta , one qd .","problem":[],"test":[],"treatment":["diabeta"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"he subsequently did well , with a repeat hematocrit of 34.3 after the transfusion .","problem":[],"test":["the transfusion","a repeat hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[32,66],"test_indices_end":[51,81],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on that day he was slightly diaphoretic with some tachycardia to 100 .","problem":["slightly diaphoretic","some tachycardia"],"test":[],"treatment":[],"problem_indices_start":[19,45],"problem_indices_end":[39,61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ekg :","problem":[],"test":["ekg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his creatinine was 1.2 on postoperative day # 5 .","problem":[],"test":["his creatinine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his hematocrit on 07\/03 was 28.1 .","problem":[],"test":["his hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his vital signs were stable .","problem":[],"test":["his vital signs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was managed with vasotec , nifedipine and clonidine with blood pressure under good control at the time of discharge , average 125 systolic , 70 diastolic , heart rate of 72 .","problem":[],"test":["blood pressure","systolic","heart rate","diastolic"],"treatment":["nifedipine","clonidine","vasotec"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[69,142,156,168],"test_indices_end":[83,150,165,178],"treatment_indices_start":[29,39,54],"treatment_indices_end":[36,49,63]}
{"text":"cardiovascular exam :","problem":[],"test":["cardiovascular exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"electrolytes were within normal limits , glucose 192 , bun and creatinine 9\/0.7 , hematocrit 49.5 , white blood count 7.9 , platelet count 166,000 , 65% polys , 3 bands , 24% lymphs .","problem":[],"test":["electrolytes","glucose","platelet count","hematocrit","polys","lymphs","white blood count","bun","creatinine","bands"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,41,55,63,82,100,124,153,163,175],"test_indices_end":[12,48,58,73,92,117,138,158,168,181],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the electrocardiogram showed normal sinus rhythm with old q wave inferior myocardial infarction .","problem":["old q wave inferior myocardial infarction"],"test":["the electrocardiogram"],"treatment":[],"problem_indices_start":[54],"problem_indices_end":[95],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right thalamic hemorrhage , hypertension , diabetes mellitus .","problem":["hypertension","right thalamic hemorrhage","diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[0,28,43],"problem_indices_end":[25,40,60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the cranial nerves showed full visual fields without extinction , pupils 5 to 3 bilaterally and equal , disks flat , lower left facial decreased sensation to temperature , pin prick on the left v1 through v3 , tongue deviates to the left , good gag , decreased shrug on the left .","problem":["decreased shrug on the left","extinction","lower left facial decreased sensation to temperature"],"test":["pin prick"],"treatment":[],"problem_indices_start":[53,117,251],"problem_indices_end":[63,169,278],"test_indices_start":[172],"test_indices_end":[181],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was unable to move the left side of his body and felt numb on that side .","problem":["numb on that side"],"test":[],"treatment":[],"problem_indices_start":[57],"problem_indices_end":[74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the abdomen was soft and non-tender , obese , with normal bowel sounds .","problem":["non-tender","obese"],"test":[],"treatment":[],"problem_indices_start":[25,38],"problem_indices_end":[35,43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his voice became slurred and he had a mild central dull headache .","problem":["a mild central dull headache","slurred"],"test":[],"treatment":[],"problem_indices_start":[17,36],"problem_indices_end":[24,64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vasotec 40 mg q.day , soma 1 tablet q.day , demerolprn , clonidine .","problem":[],"test":[],"treatment":["soma","clonidine","vasotec","demerolprn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,22,44,57],"treatment_indices_end":[7,26,54,66]}
{"text":"vasotec 20 mg po b.i.d. , clonidine 0.2 mg po b.i.d. , nifedipine 20 mg po t.i.d. , flexeril 10 mg po t.i.d. , valium 5 mg po t.i.d. , micronase 1.25 mg q.day .","problem":[],"test":[],"treatment":["valium","vasotec","clonidine","micronase","flexeril","nifedipine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,26,55,84,111,135],"treatment_indices_end":[7,35,65,92,117,144]}
{"text":"the neurological examination on discharge was no movement in the hand on the left or arm .","problem":["movement in the hand"],"test":["the neurological examination"],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[69],"test_indices_start":[0],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on sensory examination , had decreased pin prick , temperature , vibration in the left side of the body .","problem":[],"test":["sensory examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on physical examination , patient is in no acute distress , afebrile , blood pressure 134\/80 , heart rate 80 and regular , no bruits .","problem":["acute distress","bruits","afebrile"],"test":["on physical examination","blood pressure","heart rate"],"treatment":[],"problem_indices_start":[43,60,126],"problem_indices_end":[57,68,132],"test_indices_start":[0,71,95],"test_indices_end":[23,85,105],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has a history of adult onset diabetes mellitus , ankylosing spondylitis , status post myocardial infarction in '96 ( ? ) now with acute onset of left face and arm greater than leg hemiplegia and primary hemisensory loss on the left .","problem":["primary hemisensory loss on the left","myocardial infarction","left face and arm greater than leg hemiplegia","ankylosing spondylitis","adult onset diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[29,61,98,162,212],"problem_indices_end":[58,83,119,207,248],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was started on 2.5 of micronase with resulting sugars as low as 63 , decreased to 1.25 mg q.day .","problem":[],"test":["resulting sugars"],"treatment":["micronase"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[49],"test_indices_end":[65],"treatment_indices_start":[34],"treatment_indices_end":[43]}
{"text":"on the lower extremity , could wiggle toes , flexor and plantar , 3+\/5 , quadriceps 4\/5 on the left .","problem":[],"test":["plantar","flexor","wiggle toes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[31,45,56],"test_indices_end":[42,51,63],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he denies any visual symptoms or cortical-type symptoms .","problem":["visual symptoms","cortical-type symptoms"],"test":[],"treatment":[],"problem_indices_start":[14,33],"problem_indices_end":[29,55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was taken to wayskemedcalltown talmi and transferred to heaonboburg linpack grant medical center with a computerized tomography scan showing a 1x2 thalamic capsular hemorrhage without superficial mass effect .","problem":["superficial mass effect","a 1x2 thalamic capsular hemorrhage"],"test":["a computerized tomography scan"],"treatment":[],"problem_indices_start":[144,187],"problem_indices_end":[178,210],"test_indices_start":[105],"test_indices_end":[135],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the chest x-ray was clear .","problem":[],"test":["the chest x-ray"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. diabetes mellitus .","problem":["diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"back and neck were stiff and sore , without localizing tenderness .","problem":["stiff","sore","localizing tenderness"],"test":[],"treatment":[],"problem_indices_start":[19,29,44],"problem_indices_end":[24,33,65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"muscle spasms were managed with flexeril 10 po t.i.d.","problem":["muscle spasms"],"test":[],"treatment":["flexeril"],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32],"treatment_indices_end":[40]}
{"text":"the patient has no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the family history is positive for diabetes mellitus , positive for cancer .","problem":["cancer","diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[35,68],"problem_indices_end":[52,74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 58 year old right hand dominant white male with a long history of hypertension , changed his medications from aldomet to clonidine six weeks ago .","problem":["hypertension"],"test":[],"treatment":["clonidine","aldomet","his medications"],"problem_indices_start":[83],"problem_indices_end":[95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[106,127,138],"treatment_indices_end":[121,134,147]}
{"text":"three on the left knee , 4 on the left ankle with upgoing toe and clonus on the left .","problem":["clonus"],"test":[],"treatment":[],"problem_indices_start":[66],"problem_indices_end":[72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"also managed with valium 5 mg po t.i.d.","problem":[],"test":[],"treatment":["valium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[24]}
{"text":"motor examination showed full power on the right arm and leg , could barely flex fingers of the left hand , pulls left arm medially only .","problem":[],"test":["motor examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"regular rate and rhythm with a i\/vi systolic ejection murmur .","problem":["a i\/vi systolic ejection murmur"],"test":[],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head computerized tomography scan showed 1.5 to 2 centimeter bleed in the right thalamus extending to the internal capsule with mild distortion only , no shift .","problem":["shift","mild distortion","1.5 to 2 centimeter bleed in the right thalamus"],"test":["head computerized tomography scan"],"treatment":[],"problem_indices_start":[41,128,154],"problem_indices_end":[88,143,159],"test_indices_start":[0],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on reflex examination , 2 on the right upper extremity , 2+ on the left upper extremity , 2 on the right knee , 0 on the right ankle , with down going toe on the right .","problem":[],"test":["reflex examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on neurological examination , mental status alert and oriented x three , good memory , fluent speech , good repetition and naming .","problem":[],"test":["neurological examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his lungs were clear to auscultation and percussion .","problem":[],"test":["percussion","auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24,41],"test_indices_end":[36,51],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his blood pressure was 220\/110 there .","problem":[],"test":["his blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was found to be allergic to percocet and percodan during his hospital course .","problem":["allergic"],"test":[],"treatment":["percodan","percocet"],"problem_indices_start":[28],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40,53],"treatment_indices_end":[48,61]}
{"text":"the finger-to-nose was okay on the right .","problem":[],"test":["the finger-to-nose"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this will be followed by a trial of coumadin , and then by mitral commissurotomy or replacement and probable tricuspid annuloplasty by dr. riemund c. wave .","problem":[],"test":[],"treatment":["tricuspid annuloplasty","mitral commissurotomy","coumadin","replacement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36,59,84,109],"treatment_indices_end":[44,80,95,131]}
{"text":"digoxin 0.125 mg q.d. , lasix 80 mg q.a.m. and 40 mg q.p.m. aspirin 1 q.d. , and vanceril three puffs b.i.d.","problem":[],"test":[],"treatment":["lasix","aspirin","vanceril","digoxin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,24,60,81],"treatment_indices_end":[7,29,67,89]}
{"text":"superficial varicose veins .","problem":["superficial varicose veins"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coumadin has caused bleeding from the mouth and nose on two occasions , on one occasion with prothrombin time 13 , and has been replaced by anti-platelet agents .","problem":["bleeding from the mouth and nose"],"test":["prothrombin time"],"treatment":["anti-platelet agents","coumadin"],"problem_indices_start":[20],"problem_indices_end":[52],"test_indices_start":[93],"test_indices_end":[109],"treatment_indices_start":[0,140],"treatment_indices_end":[8,160]}
{"text":"she has had one gram per day proteinuria with normal creatinine .","problem":[],"test":[],"treatment":["proteinuria"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[40]}
{"text":"she has been treated with vanceril for chronic obstructive pulmonary disease .","problem":["chronic obstructive pulmonary disease"],"test":[],"treatment":["vanceril"],"problem_indices_start":[39],"problem_indices_end":[76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[34]}
{"text":"she has had an appendectomy and cholecystectomy .","problem":[],"test":[],"treatment":["cholecystectomy","an appendectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12,32],"treatment_indices_end":[27,47]}
{"text":"hematocrit 44 , potassium 4.0 , bun 23 , creatinine 1.2 , blood sugar 115 , digoxin 1.4 .","problem":[],"test":["hematocrit","creatinine","potassium","bun","digoxin","blood sugar"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,32,41,58,76],"test_indices_end":[10,25,35,51,69,83],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right ventricular heave .","problem":["right ventricular heave"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"because it would be ideal to place a mechanical valve if valve replacement rather that commissurotomy is needed , she was seen by dr. ca shuff of ent for her history of epistaxis .","problem":["epistaxis"],"test":[],"treatment":["commissurotomy","valve replacement","a mechanical valve"],"problem_indices_start":[169],"problem_indices_end":[178],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[35,57,87],"treatment_indices_end":[53,74,101]}
{"text":"chest x-ray showed left atrial , right ventricular and pulmonary arterial enlargement and interstitial edema with small , bilateral effusions .","problem":["left atrial , right ventricular and pulmonary arterial enlargement","small , bilateral effusions","interstitial edema"],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[19,90,114],"problem_indices_end":[85,108,141],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no s3 or opening snap .","problem":["opening snap","s3"],"test":[],"treatment":[],"problem_indices_start":[3,9],"problem_indices_end":[5,21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tricuspid regurgitation , heart failure , chronic atrial fibrillation , chronic ventricular ectopy , chronic obstructive lung disease .","problem":["tricuspid regurgitation","chronic ventricular ectopy","heart failure","chronic obstructive lung disease","chronic atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[0,26,42,72,101],"problem_indices_end":[23,39,69,98,133],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has now had progressive heart failure .","problem":["progressive heart failure"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"s2 narrowly physiologically split with accentuation of p2 .","problem":["accentuation","narrowly physiologically split"],"test":[],"treatment":[],"problem_indices_start":[3,39],"problem_indices_end":[33,51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the procedure could not be scheduled during this admission .","problem":[],"test":[],"treatment":["the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"apical impulse not palpable .","problem":[],"test":["apical impulse"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"electrocardiogram showed atrial fibrillation , moderate ventricular response , incomplete right bundle branch block , right axis deviation , right ventricular hypertrophy and possible apical infarction .","problem":["atrial fibrillation","moderate ventricular response","right axis deviation","right ventricular hypertrophy","incomplete right bundle branch block","apical infarction"],"test":["electrocardiogram"],"treatment":[],"problem_indices_start":[25,47,79,118,141,184],"problem_indices_end":[44,76,115,138,170,201],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was minimal aortic valve calcification , mild ______________ thickening , normal open , and mild aortic regurgitation .","problem":["minimal aortic valve calcification","mild ______________ thickening","mild aortic regurgitation"],"test":[],"treatment":[],"problem_indices_start":[10,47,98],"problem_indices_end":[44,77,123],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"liver slightly pulsatile but no enlarged .","problem":["liver slightly pulsatile","enlarged"],"test":[],"treatment":[],"problem_indices_start":[0,32],"problem_indices_end":[24,40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has had recurrent syncope since age 6 .","problem":["recurrent syncope"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"transdermal nitroglycerin caused headache .","problem":["headache"],"test":[],"treatment":["transdermal nitroglycerin"],"problem_indices_start":[33],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[25]}
{"text":"fvc was 1.6 or 58 percent of predicted and fev1 0.95 or 45 percent of predicted .","problem":[],"test":["fev1","fvc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,43],"test_indices_end":[3,47],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a holter showed atrial fibrillation with period of ventricular bigemini .","problem":["atrial fibrillation","ventricular bigemini"],"test":["a holter"],"treatment":[],"problem_indices_start":[16,51],"problem_indices_end":[35,71],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right atrial pressure was 12 with a wave form consistent with tricuspid regurgitation .","problem":["tricuspid regurgitation"],"test":["right atrial pressure"],"treatment":[],"problem_indices_start":[62],"problem_indices_end":[85],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"potassium replacement has caused , according to the patient , marked hyperkalemia in the past .","problem":["marked hyperkalemia"],"test":[],"treatment":["potassium replacement"],"problem_indices_start":[62],"problem_indices_end":[81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[21]}
{"text":"the patient is , therefore , discharged after a three day hospitalization , with plans for re-admission for the neuroradiology procedure .","problem":[],"test":[],"treatment":["the neuroradiology procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[108],"treatment_indices_end":[136]}
{"text":"pulmonary capillary wedge pressure was markedly elevated at 38 , with a very large mitral valve gradient .","problem":["markedly elevated","a very large mitral valve gradient"],"test":["pulmonary capillary wedge pressure"],"treatment":[],"problem_indices_start":[39,70],"problem_indices_end":[56,104],"test_indices_start":[0],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has not had hypertension or diabetes , and says he has lowered her cholesterol from 333 to 197 by changing her diet .","problem":["diabetes","hypertension"],"test":["her cholesterol"],"treatment":[],"problem_indices_start":[16,32],"problem_indices_end":[28,40],"test_indices_start":[67],"test_indices_end":[82],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was little or no aortic valve gradient .","problem":["aortic valve gradient"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"epistaxis to coumadin in the past .","problem":["epistaxis"],"test":[],"treatment":["coumadin"],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[21]}
{"text":"pulses normal to the femorals with weak dorsalis pedis pulses .","problem":["weak dorsalis pedis pulses"],"test":["pulses"],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[61],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no tricuspid valve gradient .","problem":["tricuspid valve gradient"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"arterial oxygen saturation was 85 percent .","problem":[],"test":["arterial oxygen saturation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had a partial gastrectomy in 1972 for a " tumor " .","problem":["a " tumor ""],"test":[],"treatment":["a partial gastrectomy"],"problem_indices_start":[42],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[8],"treatment_indices_end":[29]}
{"text":"he identified no bleeding source , but felt that the risk of nasal hemorrhage on coumadin could be minimized interventional neuroradiology occlusion of the arteries to the nose bilaterally .","problem":["nasal hemorrhage","bleeding source"],"test":[],"treatment":["coumadin","interventional neuroradiology occlusion"],"problem_indices_start":[17,61],"problem_indices_end":[32,77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[81,109],"treatment_indices_end":[89,148]}
{"text":"there was minimal mitral valve calcification , normal left ventricular contraction , and 2+ mitral regurgitation into a large left atrium .","problem":["minimal mitral valve calcification","2+ mitral regurgitation into a large left atrium"],"test":[],"treatment":[],"problem_indices_start":[10,89],"problem_indices_end":[44,137],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the meantime , lasix dosage is increased .","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[23]}
{"text":"cardiac catheterization 11\/03 .","problem":[],"test":["cardiac catheterization"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac catheterization was performed without complication from the right neck and right groin on the day of admission .","problem":["complication"],"test":[],"treatment":["cardiac catheterization"],"problem_indices_start":[46],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[23]}
{"text":"heart rate 86 , irregularly irregular , blood pressure 142\/86 .","problem":[],"test":["blood pressure","heart rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,40],"test_indices_end":[10,54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no family history of heart disease .","problem":["heart disease"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"grade ii decrescendo diastolic murmur at the left lower sternal border .","problem":["grade ii decrescendo diastolic murmur at the left lower sternal border"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"room air arterial blood gas was 56\/40\/7.45 .","problem":[],"test":["room air arterial blood gas"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"digoxin 0.125 mg po q.d. , lasix 40 mg b.i.d. , aspirin held , and vanceril three puffs b.i.d.","problem":[],"test":[],"treatment":["vanceril","lasix","aspirin","digoxin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,27,48,67],"treatment_indices_end":[7,32,55,75]}
{"text":"mitral stenosis","problem":["mitral stenosis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neck veins distended .","problem":["neck veins distended"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this 68-year-old patient of dr. naka jesc had two episodes of rheumatic fever as a teenager .","problem":["rheumatic fever"],"test":[],"treatment":[],"problem_indices_start":[62],"problem_indices_end":[77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"grade ii systolic murmur at the left lower sternal border .","problem":["grade ii systolic murmur at the left lower sternal border"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"fich cardiac output was 3.0 and indexed 2.0 .","problem":[],"test":["fich cardiac output"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mitral stenosis","problem":["mitral stenosis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pulmonary artery pressure was markedly elevated at 120\/60 .","problem":["markedly elevated"],"test":["pulmonary artery pressure"],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[47],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was mild atherosclerosis of the mid left anterior descending .","problem":["mild atherosclerosis of the mid left anterior descending"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"diastolic rumble at the apex .","problem":["diastolic rumble at the apex"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has had chronic atrial fibrillation .","problem":["chronic atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no edema .","problem":["edema"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pulmonary function test 11\/04 .","problem":[],"test":["pulmonary function test"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"flank pain uri ?","problem":["uri","flank pain"],"test":[],"treatment":[],"problem_indices_start":[0,11],"problem_indices_end":[10,14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"return to the er for high fevers , vomiting , uncontrolled pains or other concerns as needed .","problem":["uncontrolled pains","high fevers","other concerns","vomiting"],"test":[],"treatment":[],"problem_indices_start":[21,35,46,68],"problem_indices_end":[32,43,64,82],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"exam , urinalysis , medication","problem":[],"test":["exam","urinalysis"],"treatment":["medication"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,7],"test_indices_end":[4,17],"treatment_indices_start":[20],"treatment_indices_end":[30]}
{"text":"levofloxacin 500 mg every day for 7 days","problem":[],"test":[],"treatment":["levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"urinary tract infection","problem":["urinary tract infection"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given printed instructions for urinary tract infection ( portugese ) .","problem":["urinary tract infection"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was admitted on 06\/07\/00 for a matched , unrelated donor bone marrow transplant .","problem":[],"test":[],"treatment":["a matched , unrelated donor bone marrow transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32],"treatment_indices_end":[82]}
{"text":"on 06\/26\/00 due to agitation , change in mental status and increased respiratory distress , the patient was intubated .","problem":["agitation","increased respiratory distress","change in mental status"],"test":[],"treatment":["intubated"],"problem_indices_start":[19,31,59],"problem_indices_end":[28,54,89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[108],"treatment_indices_end":[117]}
{"text":"although the patient 's pain and sedation meds were adjusted he continued to be agitated and there was difficulty weaning him off the vent .","problem":["agitated"],"test":[],"treatment":["the patient 's pain and sedation meds","the vent"],"problem_indices_start":[85],"problem_indices_end":[93],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9,135],"treatment_indices_end":[51,143]}
{"text":"1. status post bone marrow transplant .","problem":[],"test":[],"treatment":["bone marrow transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[37]}
{"text":"neurosurgery was consulted but due to the severity of the bleed surgery was not considered an option .","problem":["the severity of the bleed"],"test":[],"treatment":["surgery"],"problem_indices_start":[38],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[64],"treatment_indices_end":[71]}
{"text":"mr. larsen was a 50-year-old salesman who in 12\/26 was noted to have an elevated platelet count of 778,000 .","problem":["an elevated platelet count"],"test":[],"treatment":[],"problem_indices_start":[69],"problem_indices_end":[95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white blood cell count of 24.409 and platelets of 956,000 .","problem":[],"test":["platelets","white blood cell count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,37],"test_indices_end":[22,46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was felt at that time that the changing mental status and respiratory distress might be due to a combination of medication and worsening mucositis .","problem":["respiratory distress","the changing mental status","worsening mucositis"],"test":[],"treatment":["medication"],"problem_indices_start":[30,61,130],"problem_indices_end":[56,81,149],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[115],"treatment_indices_end":[125]}
{"text":"chronic myelogenous leukemia","problem":["chronic myelogenous leukemia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his course was then complicated by fevers and neutropenia which were treated with antibiotics and a diffuse erythroderm felt to be a drug reaction .","problem":["a drug reaction","fevers","neutropenia","a diffuse erythroderm"],"test":[],"treatment":["antibiotics"],"problem_indices_start":[35,46,98,131],"problem_indices_end":[41,57,119,146],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[82],"treatment_indices_end":[93]}
{"text":"because of this continued agitation , a head ct was performed on 07\/01\/00 and it revealed an intraparenchymal hemorrhage .","problem":["this continued agitation","an intraparenchymal hemorrhage"],"test":["a head ct"],"treatment":[],"problem_indices_start":[11,90],"problem_indices_end":[35,120],"test_indices_start":[38],"test_indices_end":[47],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient received his bone marrow transplant on 06\/12\/00 .","problem":[],"test":[],"treatment":["his bone marrow transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[47]}
{"text":"cml .","problem":["cml"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a bronchoscopy was done and there was blood found in the upper airways but no evidence of blood in alveoli so it was not felt to be dah .","problem":["blood","blood in alveoli","dah"],"test":["a bronchoscopy"],"treatment":[],"problem_indices_start":[38,90,132],"problem_indices_end":[43,106,135],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 06\/24\/00 the patient was found to have pulmonary infiltrates and some hemoptysis .","problem":["pulmonary infiltrates","some hemoptysis"],"test":[],"treatment":[],"problem_indices_start":[42,68],"problem_indices_end":[63,83],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient gradually lost brain systolic ejection murmur function and was pronounced dead on 07\/02\/00 .","problem":["dead"],"test":[],"treatment":[],"problem_indices_start":[86],"problem_indices_end":[90],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. intraparenchymal bleed .","problem":["intraparenchymal bleed"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was found to have cml .","problem":["cml"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"uric acid 4.7 , cholesterol 150 , triglycerides 74 , hdl 44 , ldl 91 .","problem":[],"test":["cholesterol","triglycerides","ldl","uric acid","hdl"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,34,53,62],"test_indices_end":[9,27,47,56,65],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her speech was fluent with no phasic or praxic problems , dysarthric .","problem":["dysarthric","phasic or praxic problems"],"test":[],"treatment":[],"problem_indices_start":[30,58],"problem_indices_end":[55,68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"father and brother died of pe .","problem":["pe"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she did not complain of headache , diplopia , or any other neurological symptoms .","problem":["diplopia","headache","any other neurological symptoms"],"test":[],"treatment":[],"problem_indices_start":[24,35,49],"problem_indices_end":[32,43,80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"given the localization of the hematoma and the history of hypertension , the most likely cause for mrs. dua 's cerebellar hemorrhage is hypertension .","problem":["the hematoma","hypertension","hypertension","cerebellar hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[26,58,116,141],"problem_indices_end":[38,70,137,153],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"twenty-four urine for catecholamine , metanephrines , and vma pending at the time of discharge .","problem":[],"test":["twenty-four urine","vma","catecholamine","metanephrines"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,22,38,58],"test_indices_end":[17,35,51,61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a magnetic resonance imaging study will be scheduled as an outpatient in three months to rule out a small vascular malformation if responsible for the hemorrhage .","problem":["a small vascular malformation","the hemorrhage"],"test":["a magnetic resonance imaging study"],"treatment":[],"problem_indices_start":[98,147],"problem_indices_end":[127,161],"test_indices_start":[0],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"so far no secondary causes of hypertension were identified but causes like lymphocytic ? chromocytoma or renal artery stenosis have not been ruled out yet .","problem":["renal artery stenosis","lymphocytic ? chromocytoma","secondary causes","hypertension"],"test":[],"treatment":[],"problem_indices_start":[10,30,75,105],"problem_indices_end":[26,42,101,126],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"protein c , protein s and plasminogen level within normal limits .","problem":[],"test":["protein s","plasminogen level","protein c"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,12,26],"test_indices_end":[9,21,43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"normocephalic , atraumatic , anicteric .","problem":["anicteric","atraumatic"],"test":[],"treatment":[],"problem_indices_start":[16,29],"problem_indices_end":[26,38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hydrochlorothiazide 25 mg. po q.day , captopril 75 mg. po three times a day , nifedipine 40 mg. po three times a day .","problem":[],"test":[],"treatment":["hydrochlorothiazide","nifedipine","captopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,38,78],"treatment_indices_end":[19,47,88]}
{"text":"her hypertension was difficult to manage initially and required three days of intensive care unit with a-line and nipride intravenously .","problem":["her hypertension"],"test":[],"treatment":["a-line","nipride intravenously"],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[103,114],"treatment_indices_end":[109,135]}
{"text":"regular rhythm with no murmur , rub or gallop .","problem":["rub","gallop","murmur"],"test":[],"treatment":[],"problem_indices_start":[23,32,39],"problem_indices_end":[29,35,45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no evidence of pulmonary emboli .","problem":["pulmonary emboli"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bowel sounds present , soft , nontender , nondistended , guaiac negative , no hepatosplenomegaly .","problem":["hepatosplenomegaly","nontender","nondistended"],"test":[],"treatment":[],"problem_indices_start":[30,42,78],"problem_indices_end":[39,54,96],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urine culture negative .","problem":[],"test":["urine culture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the deep tendon reflexes were 2+ on the left side , 1+ on the right side .","problem":[],"test":["the deep tendon reflexes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was then transferred to ro woodma healthcare for further management .","problem":[],"test":[],"treatment":["further management"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[53],"treatment_indices_end":[71]}
{"text":"sodium 140 , potassium 4 , chloride 107 , co2 25.4 , bun 9 , creatinine .8 , blood sugar 130 .","problem":[],"test":["sodium","potassium","blood sugar","creatinine","chloride","co2","bun"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,27,42,53,61,77],"test_indices_end":[6,22,35,45,56,71,88],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sinus rhythm at 116 , axis of 23 , intervals of .14\/ .07\/ .42 , no st-segment abnormalities .","problem":["st-segment abnormalities"],"test":["axis","sinus rhythm","intervals"],"treatment":[],"problem_indices_start":[67],"problem_indices_end":[91],"test_indices_start":[0,22,35],"test_indices_end":[12,26,44],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"supple , no bruits .","problem":["bruits"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white blood cell count 9.8 , hematocrit 44.1 , platelets 262 , prothrombin time 10.4\/ 10.3 , partial thromboplastin time 25.9 .","problem":[],"test":["platelets","prothrombin time","hematocrit","white blood cell count","partial thromboplastin time"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,29,47,63,93],"test_indices_end":[22,39,56,79,120],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her speech became slurred , this was followed a few seconds after by weakness and numbness of her arm and leg .","problem":["slurred","weakness and numbness of her arm and leg"],"test":[],"treatment":[],"problem_indices_start":[18,69],"problem_indices_end":[25,109],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"specific gravity 125 , ph 6 .","problem":[],"test":["specific gravity"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no clubbing , cyanosis or edema .","problem":["edema","clubbing ,","cyanosis"],"test":[],"treatment":[],"problem_indices_start":[3,14,26],"problem_indices_end":[13,22,31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head computerized tomography scan on 10\/19 : 3 centimeter hyperdensity within the right putamenal area in the right external capsusle consistent with intra-parenchymal hematoma with mild local mass effect and surrounding edema .","problem":["intra-parenchymal hematoma","mild local mass effect","3 centimeter hyperdensity","surrounding edema"],"test":["head computerized tomography scan"],"treatment":[],"problem_indices_start":[45,150,182,209],"problem_indices_end":[70,176,204,226],"test_indices_start":[0],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the exam is remarkable for a mild leftsided face , arm and leg weakness and sensory deficit that should further improve with physical therapy and occupational therapy help .","problem":["arm and leg weakness","sensory deficit","a mild leftsided face"],"test":["the exam"],"treatment":["occupational therapy","physical therapy"],"problem_indices_start":[27,51,76],"problem_indices_end":[48,71,91],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[125,146],"treatment_indices_end":[141,166]}
{"text":"the fine motor movements of the left hand were diminished , there was a mild dysmetria on the left side to finger \/ nose and heel \/ shin .","problem":["a mild dysmetria on the left side","diminished"],"test":["heel \/ shin","finger \/ nose"],"treatment":[],"problem_indices_start":[47,70],"problem_indices_end":[57,103],"test_indices_start":[107,125],"test_indices_end":[120,136],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urinalysis :","problem":[],"test":["urinalysis"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was finally under control with high doses of captopril , nifedipine , and hydrochlorothiazide .","problem":[],"test":[],"treatment":["hydrochlorothiazide","captopril","nifedipine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48,60,77],"treatment_indices_end":[57,70,96]}
{"text":"the workup to rule out secondary cause of hypertension given the patient 's young age and the difficulty controlling the blood pressure was started as an inpatient and will be completed by dr. ______________as an outpatient .","problem":["hypertension","secondary cause"],"test":["the workup"],"treatment":[],"problem_indices_start":[23,42],"problem_indices_end":[38,54],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on sensory exam there was a mild diminution of light touch , pinprick , position , and vibration sense in the left side .","problem":["a mild diminution of light touch , pinprick , position , and vibration sense in the left side"],"test":["sensory exam"],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[119],"test_indices_start":[3],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she is now able to walk fitfully and use her left hand with no problem .","problem":["problem"],"test":[],"treatment":[],"problem_indices_start":[63],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the area of hemorrhage the same , slightly more edema and mass effect .","problem":["hemorrhage","slightly more edema and mass effect"],"test":[],"treatment":[],"problem_indices_start":[12,34],"problem_indices_end":[22,69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sedimentation rate 2 , antithrombin 3 .","problem":[],"test":["sedimentation rate","antithrombin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,23],"test_indices_end":[18,35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"will be reassessed after a month of intensive physical therapy and occupational therapy .","problem":[],"test":[],"treatment":["occupational therapy","intensive physical therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36,67],"treatment_indices_end":[62,87]}
{"text":"thyroid stimulation hormone 1.9 .","problem":[],"test":["thyroid stimulation hormone"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a 34 year old white female lying in bed , anxious ; blood pressure of 220\/120 , afebrile .","problem":["afebrile","anxious"],"test":["blood pressure"],"treatment":[],"problem_indices_start":[42,80],"problem_indices_end":[49,88],"test_indices_start":[52],"test_indices_end":[66],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mrs. dua is a 34 year old white female with an unclear history of hypertension for at least five years .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[66],"problem_indices_end":[78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pulmonary angiogram :","problem":[],"test":["pulmonary angiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was a left central facial paresis .","problem":["a left central facial paresis"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was in her usual state of health until around 12:40 on october 19 , when while on the phone , started to have difficulty in talking .","problem":["difficulty in talking"],"test":[],"treatment":[],"problem_indices_start":[114],"problem_indices_end":[135],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pupils were 2 millimeters down to 1 millimeter by direct and consensual stimuli .","problem":[],"test":["direct and consensual stimuli"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[50],"test_indices_end":[79],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no lesions .","problem":["lesions"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head computerized tomography scan of 10\/23 :","problem":[],"test":["head computerized tomography scan"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was a left arm pronator .","problem":["a left arm pronator"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"electrocardiogram :","problem":[],"test":["electrocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest x-ray negative .","problem":[],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right capsular putamenal hemorrhage .","problem":["right capsular putamenal hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she does not smoke , does not use birth control pills , does not use drugs .","problem":[],"test":[],"treatment":["birth control pills"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[53]}
{"text":"clear to auscultation .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[9],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dexamethasone suppression test negative with a cortisol level at 8 a.m. of 1.7 .","problem":[],"test":["a cortisol level","dexamethasone suppression test"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,45],"test_indices_end":[30,61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"v1 through v3 , diminished light touch and pinprick in the left side .","problem":[],"test":["light touch","pinprick"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[27,43],"test_indices_end":[38,51],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"visual fields were full to confrontation .","problem":[],"test":["confrontation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[27],"test_indices_end":[40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was seen at a memorial hospital where her blood pressure was measured at 240\/120 and was found to have a mild left hemiparesis .","problem":["a mild left hemiparesis"],"test":["her blood pressure"],"treatment":[],"problem_indices_start":[107],"problem_indices_end":[130],"test_indices_start":[42],"test_indices_end":[60],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urine and serum toxicology screen negative .","problem":[],"test":["urine and serum toxicology screen"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no other areas of hemorrhage identified .","problem":["hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[18],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the walk was paretic in the left side .","problem":["the walk was paretic in the left side"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gag was symmetric .","problem":[],"test":["gag"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right capsular putamenal hemorrhage .","problem":["right capsular putamenal hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vaginal delivery with second degree laceration","problem":["second degree laceration"],"test":[],"treatment":["vaginal delivery"],"problem_indices_start":[22],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"efw = 7# .","problem":[],"test":["efw"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ctx q 6 ' .","problem":[],"test":["ctx"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"height 63 heent normal mouth normal neck normal breasts normal no masses nipples normal chest normal cta bilat , neg wheezing cor normal nsr , no murmur abdomen gravid , vtx .","problem":["murmur","masses","gravid","wheezing"],"test":["cta","heent"],"treatment":[],"problem_indices_start":[66,117,146,161],"problem_indices_end":[72,125,152,167],"test_indices_start":[10,101],"test_indices_end":[15,104],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abnormal laboratory result ; abnormal pap test ; monilial vaginitis","problem":["abnormal laboratory result","abnormal pap test","monilial vaginitis"],"test":[],"treatment":[],"problem_indices_start":[0,29,49],"problem_indices_end":[26,46,67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extrem normal skin normal nodes normal vulva normal vagina leaking copious amounts clear fluid .","problem":["copious amounts clear fluid"],"test":["extrem"],"treatment":[],"problem_indices_start":[67],"problem_indices_end":[94],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she delivered a 3235 gram male infant on 11\/01\/2004 at 09:31 am with apgar scores of 9 and 9 at one and five minutes respectively at 39.0 weeks gestation via spontaneous vertex vaginal delivery .","problem":[],"test":["apgar scores"],"treatment":["spontaneous vertex vaginal delivery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[69],"test_indices_end":[81],"treatment_indices_start":[158],"treatment_indices_end":[193]}
{"text":"sse and digital exam deferred cervix digital exam deferred at time of admission os normal see above adnexae normal non-palp d \/ t advanced gest uterus gravid , vtx .","problem":["advanced gest uterus gravid"],"test":["digital exam","adnexae","cervix digital exam","os","sse"],"treatment":[],"problem_indices_start":[130],"problem_indices_end":[157],"test_indices_start":[0,8,30,80,100],"test_indices_end":[3,20,49,82,107],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"multivitamins and folate","problem":[],"test":[],"treatment":["folate","multivitamins"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,18],"treatment_indices_end":[13,24]}
{"text":"mild irreg. ctx .","problem":["mild irreg. ctx"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"premature rupture of membranes .","problem":["premature rupture of membranes"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"fhts 140s w\/ reactivity .","problem":[],"test":["fhts"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"efw = 7# .","problem":[],"test":["efw"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"spontaneous vertex vaginal delivery","problem":[],"test":[],"treatment":["spontaneous vertex vaginal delivery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[35]}
{"text":"fluid amnioswab and fern positive .","problem":["fern positive"],"test":["fluid amnioswab"],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[33],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"routine post partum care","problem":[],"test":[],"treatment":["routine post partum care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"premature rupture of membranes","problem":["premature rupture of membranes"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"uterine size in weeks 38","problem":[],"test":["uterine size"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"fhts 140s w\/ reactivity .","problem":[],"test":["fhts"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"your patient was admitted under the care of aner , aea m with a preliminary diagnosis of line sepsis .","problem":["line sepsis"],"test":[],"treatment":[],"problem_indices_start":[89],"problem_indices_end":[100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following evaluation and treatment , the patient 's disposition at the end of the visit was admitted as an inpatient to ph university of medical center .","problem":[],"test":["evaluation"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[20],"treatment_indices_start":[25],"treatment_indices_end":[34]}
{"text":"the patient presented with a chief complaint of fever .","problem":["fever"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a left breast lumpectomy was reportedly benign .","problem":[],"test":["benign"],"treatment":["a left breast lumpectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[40],"test_indices_end":[46],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"seventh nerve weakness on the right in a central pattern is present .","problem":["seventh nerve weakness"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"metamucil 1 teaspoon q.d. , with first bolus of juice , juice 250 cc. down nasogastric tube t.i.d. , tube feeds as above , lactinex as above , tagamet 800 mg. nasogastric tube qhs , nystatin swish and spit 10 cc. five times a day , cardizem slow release 90 mg. po q.d. , folic acid 1 mg. po q.d. , ciprofloxacin 500 mg. po b.i.d. , discontinue on 12\/10\/92 kayciel 30 meq. down nasogastric tube q.d. , peridex 10 cc. swish and spit q.i.d. , coumadin 4 mg. nasogastric tube on odd days , alternating with 5 mg. nasogastric tube on even days , once daily , tylenol 650 mg. po and pr q6hours prn pain , nystatin powder to axilla and groin as needed .","problem":["pain"],"test":[],"treatment":["nasogastric tube","juice","nasogastric tube","cardizem slow release","coumadin","folic acid","peridex","lactinex","tylenol","tagamet","nasogastric tube","kayciel","kayciel","ciprofloxacin","juice","nystatin swish and spit","metamucil","nystatin powder","tube feeds"],"problem_indices_start":[592],"problem_indices_end":[596],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,48,56,75,101,123,143,159,182,232,271,298,356,377,401,440,554,599],"treatment_indices_end":[9,53,61,91,111,131,150,175,205,253,281,311,363,393,408,448,561,614]}
{"text":"she has been afebrile for greater than 10 days , including several days on oral antibiotics .","problem":["afebrile"],"test":[],"treatment":["oral antibiotics"],"problem_indices_start":[13],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[75],"treatment_indices_end":[91]}
{"text":"for a short time , she seemed " locked in " .","problem":["" locked in ""],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"regular rate and rhythm , without ectopy .","problem":["ectopy"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mevicor 60 mg. po q.d. , cardizem 90 mg. w release po q.d. , questran one pack q.i.d. , niacin 500 mg. po b.i.d.","problem":[],"test":[],"treatment":["niacin","cardizem","questran","mevicor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,25,61,88],"treatment_indices_end":[7,33,69,94]}
{"text":"she has severe memory deficits , but nevertheless , is able to engage in conversation , answers questions , names things well , does calculations and recognizes family members and states preferences .","problem":["severe memory deficits"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this did not normalize with administration of isordil and the patient denied chest pain at this time .","problem":["chest pain"],"test":[],"treatment":["isordil"],"problem_indices_start":[77],"problem_indices_end":[87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[46],"treatment_indices_end":[53]}
{"text":"iron studies are all entirely normal , her anemia is attributed to anemia or chronic disease with hypoproliferation as well as multiple phlebotomies .","problem":["hypoproliferation","anemia","chronic disease","her anemia"],"test":["multiple phlebotomies","iron studies"],"treatment":[],"problem_indices_start":[39,67,77,98],"problem_indices_end":[49,73,92,115],"test_indices_start":[0,127],"test_indices_end":[12,148],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has developed bad thrush in this setting , she is not yet able to swallow and so she is on nystatin swish and spit five times a day .","problem":["bad thrush"],"test":[],"treatment":["nystatin swish and spit"],"problem_indices_start":[18],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[95],"treatment_indices_end":[118]}
{"text":"the plan is to give her folic acid , but not iron .","problem":[],"test":[],"treatment":["iron","folic acid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24,45],"treatment_indices_end":[34,49]}
{"text":"the patient needs prothrombin time checked daily , patient needs potassium checked daily , patient needs sodium checked at least every other day .","problem":[],"test":["sodium","prothrombin time","potassium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[18,65,105],"test_indices_end":[34,74,111],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the cranial nerve exam :","problem":[],"test":["the cranial nerve exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"follow up computerized tomography scans and magnetic resonance imaging studies have shown infarction in bilateral basis pontis , mid brain , the superior cerebellar areas , left thalamus , bilateral temporal lobes medially and inferiorly and left posterior communicating artery .","problem":["infarction in bilateral basis pontis , mid brain , the superior cerebellar areas , left thalamus , bilateral temporal lobes medially and inferiorly and left posterior communicating artery"],"test":["magnetic resonance imaging studies","computerized tomography scans"],"treatment":[],"problem_indices_start":[90],"problem_indices_end":[277],"test_indices_start":[10,44],"test_indices_end":[39,78],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she did have brief chest pain twice during this admission that did not correlate with electrocardiogram changes .","problem":["brief chest pain"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sensory limb of the right eye corneal reflex is slowed , otherwise normal .","problem":[],"test":["corneal reflex"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[30],"test_indices_end":[44],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the first week of november , her electrocardiogram showed t wave inversions in the lateral leads , correlating with an increase in the ldh , but not ck .","problem":["t wave inversions in the lateral leads","an increase"],"test":["her electrocardiogram","ck","the ldh"],"treatment":[],"problem_indices_start":[61,119],"problem_indices_end":[99,130],"test_indices_start":[32,134,152],"test_indices_end":[53,141,154],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has been working with speech therapy , occupational therapy and physical therapy closely and should continue to show improvement .","problem":[],"test":[],"treatment":["occupational therapy","physical therapy","speech therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,43,68],"treatment_indices_end":[40,63,84]}
{"text":"anemia , discharge hematocrit 28 , not iron deficient .","problem":["iron deficient","anemia"],"test":["discharge hematocrit"],"treatment":[],"problem_indices_start":[0,39],"problem_indices_end":[6,53],"test_indices_start":[9],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"includes recent infarct to pons , mid brain , left thalamus , bilateral temporal lobes and left visual cortex , on coumadin .","problem":["recent infarct to pons , mid brain , left thalamus , bilateral temporal lobes and left visual cortex"],"test":[],"treatment":["coumadin"],"problem_indices_start":[9],"problem_indices_end":[109],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[115],"treatment_indices_end":[123]}
{"text":"normal pulses , no clubbing , cyanosis or edema .","problem":["edema","clubbing","cyanosis"],"test":[],"treatment":[],"problem_indices_start":[19,30,42],"problem_indices_end":[27,38,47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"once her liver enzymes are completely normal , a seven day course of fluconazol may be helpful if the thrush is not spontaneously resolving off of antibiotics .","problem":["the thrush"],"test":["her liver enzymes"],"treatment":["fluconazol","antibiotics"],"problem_indices_start":[98],"problem_indices_end":[108],"test_indices_start":[5],"test_indices_end":[22],"treatment_indices_start":[69,147],"treatment_indices_end":[79,158]}
{"text":"the day of discharge is day #3 of 7 , after which antibiotics should be totally discontinued .","problem":[],"test":[],"treatment":["antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[50],"treatment_indices_end":[61]}
{"text":"sputum grew out klebsiella pneumoniae , and she was treated with gentamicin and ancef for 14 days intravenous ( bug being sensitive to these two drugs ) .","problem":["klebsiella pneumoniae","bug"],"test":["sputum"],"treatment":["gentamicin","ancef","these two drugs"],"problem_indices_start":[16,112],"problem_indices_end":[37,115],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[65,80,135],"treatment_indices_end":[75,85,150]}
{"text":"the patient is a 68 year old , right handed caucasian female , former r.n. who complained of several days of vertigo , one day of double vision , dysarthria and worsening of vertigo .","problem":["vertigo","vertigo","double vision","dysarthria"],"test":[],"treatment":[],"problem_indices_start":[109,130,146,174],"problem_indices_end":[116,143,156,181],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hypertension for 20 years , high cholesterol , coronary artery disease with episodes of angina , no history of myocardial infarction , exercise treadmill or evaluation .","problem":["high cholesterol","angina","coronary artery disease","myocardial infarction","hypertension"],"test":["evaluation","exercise treadmill"],"treatment":[],"problem_indices_start":[0,28,47,88,111],"problem_indices_end":[12,44,70,94,132],"test_indices_start":[135,157],"test_indices_end":[153,167],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this may due to her central nervous system process or her pulmonary process , with fluids administered as described , she should not have any problems from this .","problem":["any problems","her pulmonary process","her central nervous system process"],"test":[],"treatment":["fluids administered"],"problem_indices_start":[16,54,138],"problem_indices_end":[50,75,150],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[83],"treatment_indices_end":[102]}
{"text":"the patient had fevers sporadically during this hospitalization with rising white blood counts .","problem":["rising white blood counts","fevers"],"test":[],"treatment":[],"problem_indices_start":[16,69],"problem_indices_end":[22,94],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sensory exam was not remarkable , cerebellar exam was not possible .","problem":[],"test":["cerebellar exam","sensory exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,34],"test_indices_end":[12,49],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she also gets lactinex granules three packages in each bottle of tube feeds .","problem":[],"test":[],"treatment":["lactinex granules","tube feeds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14,65],"treatment_indices_end":[31,75]}
{"text":"note that the liver enzymes were normal on admission , at which time she was taking all of the above cholesterol medicines .","problem":[],"test":["the liver enzymes"],"treatment":["the above cholesterol medicines"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[27],"treatment_indices_start":[91],"treatment_indices_end":[122]}
{"text":"a left pleural effusion developed and this was tapped with ultrasound guidance , and found to be sterile , and without evidence of empyema .","problem":["a left pleural effusion","empyema"],"test":["ultrasound guidance"],"treatment":[],"problem_indices_start":[0,131],"problem_indices_end":[23,138],"test_indices_start":[59],"test_indices_end":[78],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a small intimal tear in the arch of the aorta during the angiogram , was without sequelae .","problem":["a small intimal tear","sequelae"],"test":["the angiogram"],"treatment":[],"problem_indices_start":[0,81],"problem_indices_end":[20,89],"test_indices_start":[53],"test_indices_end":[66],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pupils reactive to light , extra ocular movements show good upgaze up to 3 mm. , good down gaze .","problem":[],"test":["extra ocular movements"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[27],"test_indices_end":[49],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"soft , without hepatosplenomegaly .","problem":["hepatosplenomegaly"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"admitting creatinine was .7 , glucose 131 , white blood count was 10,000 , hematocrit was 40 , liver enzymes normal range .","problem":[],"test":["admitting creatinine","hematocrit","liver enzymes","glucose","white blood count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,30,44,75,95],"test_indices_end":[20,37,61,85,108],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right lateral gaze , the right eye had 2 mm. of sclera showing , the left eye was normal , and there are a few beats of right beading nystagmus .","problem":["right beading nystagmus"],"test":["right lateral gaze"],"treatment":[],"problem_indices_start":[120],"problem_indices_end":[143],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she is anticoagulated on coumadin and this has been stable .","problem":[],"test":[],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25],"treatment_indices_end":[33]}
{"text":"she has had an inguinal hernia repair .","problem":[],"test":[],"treatment":["an inguinal hernia repair"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[37]}
{"text":"initially this improved on clindamycin and cefotetan , but fevers recurred on this antibiotic regimen .","problem":["fevers"],"test":[],"treatment":["cefotetan","this antibiotic regimen","clindamycin"],"problem_indices_start":[59],"problem_indices_end":[65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,43,78],"treatment_indices_end":[38,52,101]}
{"text":"the patient was taken to the intensive care unit after her angiogram .","problem":[],"test":["her angiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[55],"test_indices_end":[68],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an magnetic resonance imaging study showed basilar artery disease , questionable aneurysm .","problem":["aneurysm","basilar artery disease"],"test":["an magnetic resonance imaging study"],"treatment":[],"problem_indices_start":[43,81],"problem_indices_end":[65,89],"test_indices_start":[0],"test_indices_end":[35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's liver enzymes were noted to be elevated mid way through her hospital course , to about three times normal , especially the sgot and sgpt .","problem":[],"test":["the patient 's liver enzymes","sgpt","sgot"],"treatment":["her hospital course"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,143,152],"test_indices_end":[33,147,156],"treatment_indices_start":[76],"treatment_indices_end":[95]}
{"text":"she also gets peridex to clean out her mouth .","problem":[],"test":[],"treatment":["peridex"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[21]}
{"text":"a chest x-ray showed some left lower lobe atelectasis .","problem":["some left lower lobe atelectasis"],"test":["a chest x-ray"],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[53],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"full strength replete with fiber at 70 cc. per hour .","problem":[],"test":[],"treatment":["fiber"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[32]}
{"text":"low sodium , responsive to fluid restriction .","problem":["low sodium"],"test":[],"treatment":["fluid restriction"],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[44]}
{"text":"she also gets metamucil one teaspoon with the first bolus of juice each day .","problem":[],"test":[],"treatment":["metamucil","juice"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14,61],"treatment_indices_end":[23,66]}
{"text":"tibialis 3 on the left , 5+ on the right .","problem":[],"test":["tibialis"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a chest x-ray documented a progressing left lower lobe infiltrate .","problem":["a progressing left lower lobe infiltrate"],"test":["a chest x-ray"],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[65],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her tube feeds orders are as follow :","problem":[],"test":[],"treatment":["her tube feeds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[14]}
{"text":"these can be restarted when it is deemed reasonable , in view of her acute disease and recently elevated liver enzymes .","problem":["recently elevated liver enzymes","her acute disease"],"test":[],"treatment":[],"problem_indices_start":[65,87],"problem_indices_end":[82,118],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gastroc. 3 on the left and 4+ on the right .","problem":[],"test":["gastroc."],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"low potassium , thought due to gentamicin .","problem":["low potassium"],"test":[],"treatment":["gentamicin"],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31],"treatment_indices_end":[41]}
{"text":"a right upper quadrant ultrasound documented gallstones , without evidence of common bile duct dilatation or active cholecystitis .","problem":["common bile duct dilatation","active cholecystitis","gallstones"],"test":["a right upper quadrant ultrasound"],"treatment":[],"problem_indices_start":[45,78,109],"problem_indices_end":[55,105,129],"test_indices_start":[0],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her blood pressure was 190\/90 when i first saw her on her second hospital day .","problem":[],"test":["her blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"as of 4\/7 , her electrocardiogram had reverted back to normal and there is no evidence of congestive heart failure or continued electrocardiogram changes , and chest pain is absent .","problem":["congestive heart failure","chest pain"],"test":["her electrocardiogram"],"treatment":[],"problem_indices_start":[90,160],"problem_indices_end":[114,170],"test_indices_start":[12],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her sodiums were never below 130 .","problem":[],"test":["her sodiums"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an angiogram on 11\/3 was consistent with thrombosis at the mid basilar artery .","problem":["thrombosis at the mid basilar artery"],"test":["an angiogram"],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[77],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left lower lobe pneumonia , resolving now on oral antibiotics .","problem":["left lower lobe pneumonia"],"test":[],"treatment":["oral antibiotics"],"problem_indices_start":[0],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[45],"treatment_indices_end":[61]}
{"text":"she was doing well with at least 4+ strength in all of her extremities , when on 11\/13 , she had an acute drop in her systolic blood pressure to 70 for unclear reasons and without evidence of acute sepsis .","problem":["acute sepsis","an acute drop"],"test":["her systolic blood pressure"],"treatment":[],"problem_indices_start":[97,192],"problem_indices_end":[110,204],"test_indices_start":[114],"test_indices_end":[141],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was aggressively anticoagulated with heparin .","problem":[],"test":[],"treatment":["heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[41],"treatment_indices_end":[48]}
{"text":"she was afebrile , in sinus rhythm , pulse 60 .","problem":["afebrile"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"quadraceps 2+ on the left and 3+ on the right .","problem":[],"test":["quadraceps"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has had low sodiums during this hospitalization .","problem":["low sodiums"],"test":[],"treatment":["this hospitalization"],"problem_indices_start":[20],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39],"treatment_indices_end":[59]}
{"text":"basilar artery stenosis with basilar thrombosis and " top of the basilar " syndrome .","problem":["" top of the basilar " syndrome","basilar thrombosis","basilar artery stenosis"],"test":[],"treatment":[],"problem_indices_start":[0,29,52],"problem_indices_end":[23,47,93],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gallstones , thought to be inactive .","problem":["gallstones"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she is drowsy at times , but generally alert , responsive , interactive , able to talk in two to three word sentences when she wants to .","problem":["drowsy"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition , the patient gets 250 cc. of juice ( not water ) three times a day .","problem":[],"test":[],"treatment":["juice"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[42],"treatment_indices_end":[47]}
{"text":"the patient had a steady decline in her hematocrit during this hospitalization .","problem":["a steady decline"],"test":["her hematocrit"],"treatment":["this hospitalization"],"problem_indices_start":[16],"problem_indices_end":[32],"test_indices_start":[36],"test_indices_end":[50],"treatment_indices_start":[58],"treatment_indices_end":[78]}
{"text":"she was seen at the outside hospital and put on aspirin for two days .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48],"treatment_indices_end":[55]}
{"text":"please note that evaluation by the swallowing therapist , showed that the patient is aspirating at this time , but there is great hope from the nature of her deficit and the good movements of her tongue that normal swallowing should return soon .","problem":["her deficit"],"test":["evaluation by the swallowing therapist"],"treatment":[],"problem_indices_start":[154],"problem_indices_end":[165],"test_indices_start":[17],"test_indices_end":[55],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was accompanied by substantial decrement in neurologic function .","problem":["substantial decrement in neurologic function"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"high cholesterol .","problem":["high cholesterol"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's potassiums have been repeatedly low and require daily checks and repletion .","problem":[],"test":["the patient 's potassiums","daily checks"],"treatment":["repletion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,68],"test_indices_end":[30,80],"treatment_indices_start":[85],"treatment_indices_end":[94]}
{"text":"reflexes were diffuse 3+ , toes upgoing bilaterally .","problem":[],"test":["reflexes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the left lateral gaze , the left eye had 1 mm. of lateral sclera showing .","problem":[],"test":["the left lateral gaze"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ck 's were mildly elevated but the mb fractions were not remarkable .","problem":["mildly elevated"],"test":["the mb fractions","ck 's"],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[31],"test_indices_start":[0,36],"test_indices_end":[10,52],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it is for this reason that she is discharged with an nasogastric tube and that no plans for g tube placement are made at this time .","problem":[],"test":[],"treatment":["g tube placement","an nasogastric tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[50,92],"treatment_indices_end":[69,108]}
{"text":"motor exam showed greater than 4+ strength bilateral upper extremities and psoas unable to lift off bed .","problem":[],"test":["motor exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her cholesterol was 350 here .","problem":[],"test":["her cholesterol"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the exact cause of her liver enzyme elevation is unclear , but we are being careful about administering drugs , which might irritate the liver .","problem":["her liver enzyme elevation"],"test":[],"treatment":["drugs"],"problem_indices_start":[19],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[104],"treatment_indices_end":[109]}
{"text":"she does well with tube feeds .","problem":[],"test":[],"treatment":["tube feeds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[29]}
{"text":"the patient is on ciprofloxacin .","problem":[],"test":[],"treatment":["ciprofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[31]}
{"text":"this must be carefully checked despite the standing order for potassium .","problem":[],"test":[],"treatment":["potassium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[62],"treatment_indices_end":[71]}
{"text":"she has a history of of angina without myocardial infarction that has not been worked up .","problem":["angina","myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[24,39],"problem_indices_end":[30,60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a ii \/ vi systolic ejection murmur is at the base , minimal radiation to the carotids .","problem":["minimal radiation to the carotids","a ii \/ vi systolic ejection murmur"],"test":[],"treatment":[],"problem_indices_start":[0,52],"problem_indices_end":[34,85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"post angiogram her eyes were closed .","problem":[],"test":["angiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[5],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"history of coronary artery disease .","problem":["coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is thought due to the extensive course of gentamicin which she received .","problem":[],"test":[],"treatment":["gentamicin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47],"treatment_indices_end":[57]}
{"text":"she has been off of her hypercholesterol medicines .","problem":[],"test":[],"treatment":["her hypercholesterol medicines"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[50]}
{"text":"improving liver enzyme elevation .","problem":["liver enzyme elevation"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on admission , electrocardiogram showed less than 1 mm. of st depression in v4 to v6 , which is likely the patient 's baseline .","problem":["st depression in v4 to v6"],"test":["electrocardiogram"],"treatment":[],"problem_indices_start":[59],"problem_indices_end":[84],"test_indices_start":[15],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was put on heparin and was stable since .","problem":[],"test":[],"treatment":["heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[30]}
{"text":"thrush .","problem":["thrush"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was very responsive , somewhat sleepy , she complained of chest pain , which was diffuse , non-localizing without electrocardiogram changes and persisted for several days and then went away completely .","problem":["chest pain"],"test":[],"treatment":[],"problem_indices_start":[62],"problem_indices_end":[72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the neurological examination :","problem":[],"test":["the neurological examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"likely recently passed kidney stone","problem":["recently passed kidney stone"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"also please follow up with urology regarding management of your kidney stones .","problem":["your kidney stones"],"test":[],"treatment":["management"],"problem_indices_start":[59],"problem_indices_end":[77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[45],"treatment_indices_end":[55]}
{"text":"the patient was given printed instructions for kidney stones ( english ) .","problem":["kidney stones"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"history , physical , lab , abdominal ct scan","problem":[],"test":["abdominal ct scan","physical","lab"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10,21,27],"test_indices_end":[18,24,44],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"motrin as needed","problem":[],"test":[],"treatment":["motrin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"please return if your symptoms return , you develop a fever .","problem":["your symptoms","a fever"],"test":[],"treatment":[],"problem_indices_start":[17,52],"problem_indices_end":[30,59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rlq pain","problem":["rlq pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient presented with a chief complaint of iv fluids .","problem":[],"test":[],"treatment":["iv fluids"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48],"treatment_indices_end":[57]}
{"text":"following triage , the patient left without treatment .","problem":[],"test":["triage"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[16],"treatment_indices_start":[44],"treatment_indices_end":[53]}
{"text":"she had no lachmann or anterior drawer , she did have a mild effusion .","problem":["a mild effusion"],"test":[],"treatment":[],"problem_indices_start":[54],"problem_indices_end":[69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"anxiety neurosis for which she has received shock therapy in the past .","problem":["anxiety neurosis"],"test":[],"treatment":["shock therapy"],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[44],"treatment_indices_end":[57]}
{"text":"the foley catheter was removed on 6\/29 and she had no difficulties voiding .","problem":["difficulties voiding"],"test":[],"treatment":["the foley catheter"],"problem_indices_start":[54],"problem_indices_end":[74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[18]}
{"text":"left total knee arthroplasty on 6\/26\/90 .","problem":[],"test":[],"treatment":["left total knee arthroplasty"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[28]}
{"text":"doxepin causes itching .","problem":["itching"],"test":[],"treatment":["doxepin"],"problem_indices_start":[15],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"her hematocrit was 31.4 on 6\/29 with a pt of 18.2","problem":[],"test":["her hematocrit","a pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,37],"test_indices_end":[14,41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her pt drifted down to a level of 12.9 by 7\/3 and therefore she will be discharged with 4 mg of coumadin per day to be followed by the coumadin clinic at cowerin tonli medical center .","problem":[],"test":["her pt"],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[96],"treatment_indices_end":[104]}
{"text":"psychiatry service saw her on 6\/28 and recommended avoiding benzodiazepines and haldol for agitation .","problem":["agitation"],"test":[],"treatment":["haldol","benzodiazepines"],"problem_indices_start":[91],"problem_indices_end":[100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[60,80],"treatment_indices_end":[75,86]}
{"text":"potassium 4.4 .","problem":[],"test":["potassium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was therefore taken to the operating room on 6\/26 and underwent a left total knee arthroplasty losing 200 cc of blood in the procedure with two drains left in which were removed on the first postoperative day .","problem":[],"test":[],"treatment":["the procedure","two drains","a left total knee arthroplasty"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[68,125,144],"treatment_indices_end":[98,138,154]}
{"text":"mri demonstrated a left femoral condyle osteonecrotic defect and degenerative meniscus .","problem":["a left femoral condyle osteonecrotic defect","degenerative meniscus"],"test":["mri"],"treatment":[],"problem_indices_start":[17,65],"problem_indices_end":[60,86],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her ekg was normal .","problem":[],"test":["her ekg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"since that time , she has used a cane and she was referred to dr. koors .","problem":[],"test":[],"treatment":["a cane"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31],"treatment_indices_end":[37]}
{"text":"she developed no problems with edema or with her wound during her hospital stay .","problem":["edema","her wound"],"test":[],"treatment":[],"problem_indices_start":[31,45],"problem_indices_end":[36,54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was discharged with a prescription for tylenol #3 with physical therapy .","problem":[],"test":[],"treatment":["physical therapy","tylenol #3"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[43,59],"treatment_indices_end":[53,75]}
{"text":"her left knee had 5 degrees of valgus , 120 degrees of flexion , full extension and slight valgus instability .","problem":["slight valgus instability","valgus"],"test":[],"treatment":[],"problem_indices_start":[31,84],"problem_indices_end":[37,109],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was slightly agitated on the first postoperative day but this resolved by the second postoperative day .","problem":["slightly agitated"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 78-year-old female who has had osteoarthritis and noted the sudden onset of left knee pain in 09\/89 .","problem":["left knee pain","osteoarthritis"],"test":[],"treatment":[],"problem_indices_start":[48,93],"problem_indices_end":[62,107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her epidural catheter was removed on 6\/29 .","problem":[],"test":[],"treatment":["her epidural catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[21]}
{"text":"hepatitis 35 years ago .","problem":["hepatitis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she presented for an elective left total knee arthroplasty .","problem":[],"test":[],"treatment":["an elective left total knee arthroplasty"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[58]}
{"text":"she was prophylaxed with kefzol perioperatively and with coumadin postoperatively .","problem":[],"test":[],"treatment":["kefzol","coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25,57],"treatment_indices_end":[31,65]}
{"text":"on admission included a hematocrit of 34.2 .","problem":[],"test":["a hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she did quite well with physical therapy and was ambulating with a walker and crutches by 7\/3\/90 .","problem":[],"test":[],"treatment":["physical therapy","a walker","crutches"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24,65,78],"treatment_indices_end":[40,73,86]}
{"text":"pneumonia one and a half years ago .","problem":["pneumonia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on admission included tylenol .","problem":[],"test":[],"treatment":["tylenol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[29]}
{"text":"she can one walk without difficulties .","problem":["difficulties"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was also given whiskey spirits because of the fact that she drank one to two drinks of scotch per day .","problem":[],"test":[],"treatment":["whiskey spirits"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[34]}
{"text":"the patient was cleared for surgery by dr. lupevickette ca .","problem":[],"test":[],"treatment":["surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28],"treatment_indices_end":[35]}
{"text":"she climbs stairs one at a time and denied rest pain .","problem":["rest pain"],"test":[],"treatment":[],"problem_indices_start":[43],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left knee osteoarthritis .","problem":["left knee osteoarthritis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"total abdominal hysterectomy .","problem":[],"test":[],"treatment":["total abdominal hysterectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[28]}
{"text":"on admission was only significant for her orthopaedic exam .","problem":[],"test":["her orthopaedic exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[38],"test_indices_end":[58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was given lasix 40 mg iv x 1 and also had nitro paste around the time of his surgery and beta blocker .","problem":[],"test":[],"treatment":["lasix","nitro paste","beta blocker","his surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,45,76,92],"treatment_indices_end":[18,56,87,104]}
{"text":"left proximal humerus fracture .","problem":["left proximal humerus fracture"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"colace 100 mg. p.o. t.i.d. senokot 1 p.o. q. h.s. nystatin powder to affected area t.i.d. lopressor 25 mg. p.o. b.i.d. atrovent 0.8\/2.5 c.c. normal saline nebulizers q. 8 h. albuterol 2.5\/5 c.c. normal saline nebulizers q. 4 h. with q. 2 h. p.r.n. percocet 1-2 p.o. q. 4 h. p.r.n. pain .","problem":["affected area","pain"],"test":[],"treatment":["colace","senokot","atrovent","normal saline nebulizers","lopressor","albuterol","nystatin","percocet","normal saline nebulizers"],"problem_indices_start":[69,281],"problem_indices_end":[82,285],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,27,50,90,119,141,174,195,248],"treatment_indices_end":[6,34,58,99,127,165,183,219,256]}
{"text":"adult-onset diabetes mellitus x 40 years , history of silent myocardial infarction , coronary artery bypass graft ( three vessels in 1987 ) , history of chronic , stable angina pectoris , fournier 's gangrene versus necrotizing fasciitis , congestive heart failure in 03\/97 while in the hospital for a rib fracture , glaucoma , diabetic retinopathy with blindness in the right eye , history of gastric stapling , left rib fracture , right femur surgery .","problem":["congestive heart failure","blindness in the right eye","diabetic retinopathy","chronic , stable angina pectoris","fournier 's gangrene","glaucoma","silent myocardial infarction","necrotizing fasciitis","adult-onset diabetes mellitus","left rib fracture","a rib fracture"],"test":[],"treatment":["coronary artery bypass graft","gastric stapling","right femur surgery"],"problem_indices_start":[0,54,153,188,221,245,305,322,333,359,418],"problem_indices_end":[29,82,185,213,242,269,319,330,353,385,435],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[85,399,438],"treatment_indices_end":[113,415,457]}
{"text":"prilosec 20 mg. p.o. b.i.d. vexol 1% 1 gtt od b.i.d. lasix 40 mg. p.o. q.d. kcl 20 meq p.o. q.d. tylenol 650 mg. p.o. q. 12 h. p.r.n. ativan 1 mg. p.o. q. h.s. p.r.n.","problem":[],"test":[],"treatment":["prilosec","ativan","tylenol","vexol","lasix","kcl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,28,53,76,97,134],"treatment_indices_end":[8,33,58,79,104,140]}
{"text":"the patient transfused 2 units on 10\/15\/97 for a hematocrit of 27.6 .","problem":[],"test":["a hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[47],"test_indices_end":[59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient also had a shoulder film done on 10\/10\/97 that showed a severely comminuted fracture of the proximal left humerus with proximal distraction .","problem":["a severely comminuted fracture of the proximal left humerus","proximal distraction"],"test":["a shoulder film"],"treatment":[],"problem_indices_start":[66,131],"problem_indices_end":[125,151],"test_indices_start":[21],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this ct scan , done also on 10\/10\/97 , again showed the severely comminuted fracture of the proximal left humerus .","problem":["the severely comminuted fracture of the proximal left humerus"],"test":["this ct scan"],"treatment":[],"problem_indices_start":[52],"problem_indices_end":[113],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an echocardiogram was performed on columbus day which showed an ejection fraction of 50% , left atrial enlargement , thickening of the aortic wall consistent with atherosclerotic changes , left ventricle size , and systolic function within normal limits .","problem":["thickening of the aortic wall","atherosclerotic changes","left atrial enlargement"],"test":["an echocardiogram","an ejection fraction"],"treatment":[],"problem_indices_start":[91,117,163],"problem_indices_end":[114,146,186],"test_indices_start":[0,61],"test_indices_end":[17,81],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cholecystectomy .","problem":[],"test":[],"treatment":["cholecystectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"sodium 135 , potassium 4.1 , chloride 101 , c02 28.4 , bun 17 , creatinine 1.0 , glucose 302 , calcium 8.6 , phosphorus 2.5 , magnesium 1.6 , total protein 6.7 , albumin 3.3 , globulin 3.4 , uric acid 6.3 , totalbilirubin .7 , alkaline phosphatase 93 , sgot 20 , ldh 258 , cpk 95 , whiteblood count 15.3 , hematocrit 49.7 , platelet count 159 , mcv 98 .","problem":[],"test":["whiteblood count","bun","globulin","c02","glucose","albumin","sodium","platelet count","calcium","chloride","hematocrit","ldh","magnesium","alkaline phosphatase","creatinine","totalbilirubin","sgot","potassium","mcv","phosphorus","uric acid","total protein","cpk"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,29,44,55,64,81,95,109,126,142,162,176,191,207,227,253,263,273,282,306,324,345],"test_indices_end":[6,22,37,47,58,74,88,102,119,135,155,169,184,200,221,247,257,266,276,298,316,338,348],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ocufen 0.03% 1 gtt od t.i.d. vasotec 20 mg. p.o.q. a.m. prozac 40 mg.p.o.q. a.m.","problem":[],"test":[],"treatment":["prozac","ocufen","vasotec"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,29,56],"treatment_indices_end":[6,36,62]}
{"text":"he does become slightly short of breath when lifting furniture .","problem":["slightly short of breath"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's admitting chest x-ray showed an elevated left hemidiaphragm consistent with atelectasis versus splinting on that side .","problem":["atelectasis","an elevated left hemidiaphragm","splinting on that side"],"test":["the patient 's admitting chest x-ray"],"treatment":[],"problem_indices_start":[49,96,115],"problem_indices_end":[79,107,137],"test_indices_start":[0],"test_indices_end":[41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"non-focal , except unable to assess left upper extremity secondary to the patient 's broken humeral fracture .","problem":["the patient 's broken humeral fracture"],"test":[],"treatment":[],"problem_indices_start":[70],"problem_indices_end":[113],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his bun\/ creatinine rose from 16\/1.2 on 10\/18\/97 to 25\/1.9 on 10\/18\/97 to 22\/9.1 to today 's labs , which are 15\/0.7 on 10\/23\/97 .","problem":[],"test":["his bun\/ creatinine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood pressure 120\/70 , temperature 97.8 f , pulse 68 , respirations 22 , sa02 on 2 l 94% .","problem":[],"test":["sa02","pulse","respirations","temperature","blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,24,45,56,74],"test_indices_end":[14,35,50,68,78],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen distended , mild tenderness on the left , bowel sounds present , nohepatosplenomegaly .","problem":["abdomen distended","mild tenderness on the left","nohepatosplenomegaly"],"test":["bowel sounds"],"treatment":[],"problem_indices_start":[0,20,73],"problem_indices_end":[17,47,93],"test_indices_start":[50],"test_indices_end":[62],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the stomach had evidence of prior surgery and old blood in the stomach .","problem":["old blood in the stomach"],"test":[],"treatment":["prior surgery"],"problem_indices_start":[46],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28],"treatment_indices_end":[41]}
{"text":"history of coronary artery disease status post silent myocardial infarction in the past and three-vessel coronary artery bypass graft in 1987 .","problem":["silent myocardial infarction","coronary artery disease"],"test":[],"treatment":["three-vessel coronary artery bypass graft"],"problem_indices_start":[11,47],"problem_indices_end":[34,75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[92],"treatment_indices_end":[133]}
{"text":"the patient was initially on cimetidine and carafate here at bri health , and then switched to prilosec 20 mg bid .","problem":[],"test":[],"treatment":["prilosec","cimetidine","carafate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29,44,95],"treatment_indices_end":[39,52,103]}
{"text":"no hemoptysis , hematemesis , abdominal pain , black or tarry stools , dysuria \/ frequency\/urgency .","problem":["hemoptysis","hematemesis","black or tarry stools","abdominal pain","frequency\/urgency","dysuria"],"test":[],"treatment":[],"problem_indices_start":[3,16,30,47,71,81],"problem_indices_end":[13,27,44,68,78,98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right femur surgery approximately two years ago .","problem":[],"test":[],"treatment":["right femur surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[19]}
{"text":"the patient urinalysis on 10\/19\/97 showed moderate occult blood , ph 5 , albumin 1+ , white blood cells present , 2-50 red blood cell , 10-20 white blood cells , few bacteria , and moderate bladder epithelial cells .","problem":["moderate occult blood","few bacteria","moderate bladder epithelial cells"],"test":["red blood cell","the patient urinalysis","white blood cells","albumin","white blood cells","ph"],"treatment":[],"problem_indices_start":[42,162,181],"problem_indices_end":[63,174,214],"test_indices_start":[0,66,73,86,119,142],"test_indices_end":[22,68,80,103,133,159],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"humulin 70\/30 with 30 units subq.q.a.m. and 20 units subq.q.p.m. vasotec 20 mg. q. a.m. prozac 40 mg. q.d. lasix 40 mg. q.d. k-dur approximately 28 ? meq q.d. atropine 1% 1 gtt od b.i.d. ocufen 0.03% 1 gtt od t.i.d. ventolin metered-dose inhaler .","problem":[],"test":[],"treatment":["humulin","ventolin","prozac","ocufen","atropine","k-dur","lasix","vasotec"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,65,88,107,125,159,187,216],"treatment_indices_end":[7,72,94,112,130,167,193,224]}
{"text":"elevated left hemidiaphragm of uncertain etiology or duration .","problem":["elevated left hemidiaphragm"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gi was consulted on 10\/15\/97 for melena , decreased hematocrit prior to his humeral fixation surgery .","problem":["decreased hematocrit","melena"],"test":[],"treatment":["his humeral fixation surgery"],"problem_indices_start":[33,42],"problem_indices_end":[39,62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[72],"treatment_indices_end":[100]}
{"text":"the patient presented with a comminuted fracture of the proximal left humerus when he slipped over the stairs , about to board an airplane back to jeglas blvd. , jolouisrowarlihis , alabama 86071 .","problem":["a comminuted fracture of the proximal left humerus"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coumadin was reportedly discontinued approximately six months ago secondary to planned surgery for diabetic retinopathy and glaucoma .","problem":["glaucoma","diabetic retinopathy"],"test":[],"treatment":["surgery","coumadin"],"problem_indices_start":[99,124],"problem_indices_end":[119,132],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,87],"treatment_indices_end":[8,94]}
{"text":"left shoulder hemiarthroplasty .","problem":[],"test":[],"treatment":["left shoulder hemiarthroplasty"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[30]}
{"text":"the patient received chest physical therapy bid .","problem":[],"test":[],"treatment":["chest physical therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[43]}
{"text":"during conscious sedation , the patient developed bigeminy ( the patient was sedated , did not feel chest pain or shortness of breath ) .","problem":["shortness of breath","bigeminy","chest pain"],"test":[],"treatment":["conscious sedation"],"problem_indices_start":[50,100,114],"problem_indices_end":[58,110,133],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[7],"treatment_indices_end":[25]}
{"text":"on the day of admission , when he fell , the patient was experiencing no chest pain , no shortness of breath , and had no loss of consciousness , no head trauma with fall .","problem":["chest pain","head trauma with fall","shortness of breath","loss of consciousness"],"test":[],"treatment":[],"problem_indices_start":[73,89,122,149],"problem_indices_end":[83,108,143,170],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a repeat urinalysis on 10\/22\/97 was negative .","problem":[],"test":["a repeat urinalysis"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"repleting potassium , magnesium , phosphorus as needed .","problem":[],"test":[],"treatment":["potassium","magnesium","phosphorus"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10,22,34],"treatment_indices_end":[19,31,44]}
{"text":"atropine sulfate 1 gtt 1% od b.i.d.","problem":[],"test":[],"treatment":["atropine sulfate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"fbs less than 200 = 0 units of czi fbs 201-250 = 2 units of czi fbs 251-300 = 4 units of czi fbs 301-350 = 6 units of czi fbs 351-400 = 8 units of czi fbs greater than 400 = 10 units of czi .","problem":[],"test":["fbs","fbs","fbs","fbs","fbs","fbs"],"treatment":["czi","czi","czi","czi","czi","czi"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,35,64,93,122,151],"test_indices_end":[3,38,67,96,125,154],"treatment_indices_start":[31,60,89,118,147,186],"treatment_indices_end":[34,63,92,121,150,189]}
{"text":"innumerable smaller fracture fragments were interposed between the fracture fragment and the distal humeral shaft .","problem":["the fracture fragment","innumerable smaller fracture fragments"],"test":[],"treatment":[],"problem_indices_start":[0,63],"problem_indices_end":[38,84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after his procedure on 10\/17\/97 , elevated cpks were noted on 10\/19\/97 to 10\/20\/97 , and the first level was 744 , cpk # 2 635 , and cpk # 3 461 .","problem":["elevated cpks"],"test":["cpk","cpk"],"treatment":["his procedure"],"problem_indices_start":[34],"problem_indices_end":[47],"test_indices_start":[115,133],"test_indices_end":[118,136],"treatment_indices_start":[6],"treatment_indices_end":[19]}
{"text":"the patient has right facial droop , right ptosis , stable and present for greater than one year .","problem":["right facial droop","right ptosis"],"test":[],"treatment":[],"problem_indices_start":[16,37],"problem_indices_end":[34,49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no chest pain , no shortness of breath , 1+ ankle edema .","problem":["chest pain","shortness of breath","1+ ankle edema"],"test":[],"treatment":[],"problem_indices_start":[3,19,41],"problem_indices_end":[13,38,55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiology was consulted and aspirin and beta blocker added to his regimen , as well as chest wall nitroglycerin around the time of surgery , which was subsequently discontinued .","problem":[],"test":[],"treatment":["chest wall nitroglycerin","beta blocker","his regimen","surgery","aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29,41,63,88,132],"treatment_indices_end":[36,53,74,112,139]}
{"text":"diabetic retinopathy with the patient blind in right eye .","problem":["diabetic retinopathy","blind in right eye"],"test":[],"treatment":[],"problem_indices_start":[0,38],"problem_indices_end":[20,56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"upper endoscopy x 2 .","problem":[],"test":[],"treatment":["upper endoscopy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"left proximal humerus fracture .","problem":["left proximal humerus fracture"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right-sided ptosis , right eye not reactive to light , cataract present , patient blind in that eye , left eye reactive to light , cataract also present in that eye .","problem":["blind in that eye","right-sided ptosis","cataract","cataract"],"test":[],"treatment":[],"problem_indices_start":[0,55,82,131],"problem_indices_end":[18,63,99,139],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mb fractionations of the cpks were all negative and were thought to be secondary to the patient 's beginning physical therapy on 10\/19\/97 , and all muscular in origin .","problem":["mb fractionations"],"test":["the cpks"],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[21],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a lucency and irregularity of the glenoid , possibly representing a fracture , was also seen , and a ct scan was therefore obtained in order to evaluate this area .","problem":["a fracture","a lucency and irregularity of the glenoid"],"test":["a ct scan"],"treatment":[],"problem_indices_start":[0,66],"problem_indices_end":[41,76],"test_indices_start":[99],"test_indices_end":[108],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the fracture fragments retained their proper site of articulation with the glenoid fossa .","problem":["the fracture fragments"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left rib fracture .","problem":["left rib fracture"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a bone density scan would be recommended as an outpatient , in order to evaluate this .","problem":[],"test":["a bone density scan"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"diabetes mellitus for approximately 40 years .","problem":["diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was reported to have had a myocardial infarction in the past ( ekg positive for ischemia , exercise tolerance test positive , cardiac catheterization positive , the patient is now status posta three-vessel coronary artery bypass graft in 1987 ) .","problem":["ischemia","a myocardial infarction"],"test":["cardiac catheterization","ekg","exercise tolerance test"],"treatment":["three-vessel coronary artery bypass graft"],"problem_indices_start":[28,83],"problem_indices_end":[51,91],"test_indices_start":[66,94,129],"test_indices_end":[69,117,152],"treatment_indices_start":[196],"treatment_indices_end":[237]}
{"text":"a small \/ moderate-sized , mild-intensity , reversible posterior lateral defect was also seen , indicative of mild \/ moderate ischemia .","problem":["mild \/ moderate ischemia","a small \/ moderate-sized , mild-intensity , reversible posterior lateral defect"],"test":[],"treatment":[],"problem_indices_start":[0,110],"problem_indices_end":[79,134],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was on coumadin recently , ? whether for the arrhythmia .","problem":["arrhythmia"],"test":[],"treatment":["coumadin"],"problem_indices_start":[57],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[27]}
{"text":"an adenosine sestamibi was performed on 10\/12\/97 , which showed a negative electrocardiogram for ischemia and cardiac perfusion scans , with a moderate-sized , dense , fixed inferior defect indicative of scar .","problem":["scar","ischemia","a moderate-sized , dense , fixed inferior defect"],"test":["an adenosine sestamibi","cardiac perfusion scans"],"treatment":[],"problem_indices_start":[97,141,204],"problem_indices_end":[105,189,208],"test_indices_start":[0,110],"test_indices_end":[22,133],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient also hada history of arrhythmia , found approximately ten years ago , unknown what type .","problem":["arrhythmia"],"test":[],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"incentive spirometry was started .","problem":[],"test":[],"treatment":["incentive spirometry"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[20]}
{"text":"the patient was ruled out for a myocardial infarction , given his fall at the airport and bigeminy seen on electrocardiogram that he developed during conscious sedation during reduction of the fracture .","problem":["bigeminy","his fall","a myocardial infarction"],"test":["electrocardiogram"],"treatment":["reduction of the fracture","conscious sedation"],"problem_indices_start":[30,62,90],"problem_indices_end":[53,70,98],"test_indices_start":[107],"test_indices_end":[124],"treatment_indices_start":[150,176],"treatment_indices_end":[168,201]}
{"text":"his nph was recently increased today ( 10\/23\/97 ) to 24 units in the a.m. and 14 units in the p.m. with czi sliding-scale coverage .","problem":[],"test":[],"treatment":["czi sliding-scale coverage","his nph"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,104],"treatment_indices_end":[7,130]}
{"text":"oxygen 2-4 l to keep sa02 greater than or equal to 94-95% and wean as tolerated .","problem":[],"test":["sa02"],"treatment":["oxygen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[21],"test_indices_end":[25],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"the patient is a 65-year-old male with a past medical history of diabetes mellitus , three-vessel coronary artery bypassgraft , congestive heart failure , who presents with a humeral fracture .","problem":["diabetes mellitus","congestive heart failure","a humeral fracture"],"test":[],"treatment":["three-vessel coronary artery bypassgraft"],"problem_indices_start":[65,128,173],"problem_indices_end":[82,152,191],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[85],"treatment_indices_end":[125]}
{"text":"the patient also needs a repeat endoscopy and a gi follow-up appointment inapproximately two months .","problem":[],"test":["a gi follow-up","a repeat endoscopy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[23,46],"test_indices_end":[41,60],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was noted to be slightly hyponatremic over the past few days , with sodiums in the 128-132 range , but this was secondary to elevated glucose fingerstick blood sugars .","problem":["slightly hyponatremic","elevated glucose fingerstick blood sugars"],"test":["sodiums"],"treatment":[],"problem_indices_start":[28,137],"problem_indices_end":[49,178],"test_indices_start":[80],"test_indices_end":[87],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a second endoscopy was also performed several days later , in order to rule out a gastric ulcer , and also because the patient had had another episode of melena .","problem":["a gastric ulcer","melena"],"test":["a second endoscopy"],"treatment":[],"problem_indices_start":[80,154],"problem_indices_end":[95,160],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"floxin 200 mg po bid was begun .","problem":[],"test":[],"treatment":["floxin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"ekg :","problem":[],"test":["ekg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"two major fracture fragments were seen at the humeral head , articulating with the glenoid fossa .","problem":["two major fracture fragments"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was thought that the blood in the esophagus was secondary to a possible mallory-weiss tear .","problem":["the blood in the esophagus","mallory-weiss tear"],"test":[],"treatment":[],"problem_indices_start":[20,75],"problem_indices_end":[46,93],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he can climb approximately three flights of stairs before becoming short of breath .","problem":["short of breath"],"test":[],"treatment":[],"problem_indices_start":[67],"problem_indices_end":[82],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is diffusely wheezy upon presentation .","problem":["diffusely wheezy"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"postoperative changes of the sternum and media stinum were seen and no acute pulmonary disease was visualized .","problem":["acute pulmonary disease","postoperative changes of the sternum and media stinum"],"test":[],"treatment":[],"problem_indices_start":[0,71],"problem_indices_end":[53,94],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"righteye surgery for glaucoma in 05\/97 .","problem":["glaucoma"],"test":[],"treatment":["righteye surgery"],"problem_indices_start":[21],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"the first was on 10\/15\/97 , which showed clotted blood in the esophagus .","problem":["clotted blood in the esophagus"],"test":[],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest x-ray 10\/10\/97 :","problem":[],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no slurred speech .","problem":["slurred speech"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has stable three-pillow orthopnea and occasional paroxysmal nocturnal dyspnea .","problem":["stable three-pillow orthopnea","occasional paroxysmal nocturnal dyspnea"],"test":[],"treatment":[],"problem_indices_start":[16,50],"problem_indices_end":[45,89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"guaiac negative .","problem":[],"test":["guaiac"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nph insulin 24 units subq. q. a.m. nph insulin 14 units subq. q. p.m. czi sliding scale on a q. a.c. and q. h.s. fingerstick basis with the following scale :","problem":[],"test":[],"treatment":["czi","nph insulin","nph insulin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,35,70],"treatment_indices_end":[11,46,73]}
{"text":"he has a chronic cough with clear sputum .","problem":["clear sputum","a chronic cough"],"test":[],"treatment":[],"problem_indices_start":[7,28],"problem_indices_end":[22,40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient did not have chest pain until approximately 1-1\/2 years ago , when he began to have chest tightness ( pressure ) approximately every three months with stress .","problem":["stress","chest tightness ( pressure )","chest pain"],"test":[],"treatment":[],"problem_indices_start":[25,96,163],"problem_indices_end":[35,124,169],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extraocular movements - conjugated eye movement intact .","problem":[],"test":["extraocular movements"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after the patient 's procedure , he was felt to be volume overloaded .","problem":["volume overloaded"],"test":[],"treatment":["the patient 's procedure"],"problem_indices_start":[56],"problem_indices_end":[73],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6],"treatment_indices_end":[35]}
{"text":"the fracture was seen by orthopedics and was reduced .","problem":["the fracture"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac monitor was placed on the patient , given the bigeminy , and he did rule out for myocardial infarction .","problem":["the bigeminy","myocardial infarction"],"test":["cardiac monitor"],"treatment":[],"problem_indices_start":[50,89],"problem_indices_end":[62,110],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"oropharynx moist , without lesions .","problem":["lesions"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"upper endoscopy x 2 were done .","problem":[],"test":["upper endoscopy x 2"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , his urine culture from the same day remained negative , and this was discontinued two days later .","problem":[],"test":["his urine culture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient transfused 2 units on 10\/20\/97 for a hematocrit of 28.2.10 .","problem":[],"test":["a hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[47],"test_indices_end":[59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiology recommended that in addition to the medications already stated above , his hematocrit be kept greater than 30 .","problem":[],"test":["his hematocrit"],"treatment":["the medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[82],"test_indices_end":[96],"treatment_indices_start":[43],"treatment_indices_end":[58]}
{"text":"the patient is retired , lives with his wife and one son , who is 47 years old and had multiple myeloma and renal failure .","problem":["renal failure","multiple myeloma"],"test":[],"treatment":[],"problem_indices_start":[87,108],"problem_indices_end":[103,121],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is alert and oriented and has a sling for his left humeral fracture .","problem":["his left humeral fracture"],"test":[],"treatment":["a sling"],"problem_indices_start":[54],"problem_indices_end":[79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[42],"treatment_indices_end":[49]}
{"text":"a gastric ulcer was found and this was biopsied and pathology is pending at this time .","problem":["a gastric ulcer"],"test":["pathology"],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[52],"test_indices_end":[61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no fevers or chills , no chest pain , no shortness of breath .","problem":["chills","fevers","shortness of breath","chest pain"],"test":[],"treatment":[],"problem_indices_start":[3,13,25,41],"problem_indices_end":[9,19,35,60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has a severely comminuted fracture of the proximal left humerus .","problem":["a severely comminuted fracture of the proximal left humerus"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"physical therapy has been seeing the patient and putting him through passive external rotation to the neutral position of the left shoulder and forward flexion with physical therapy assistance .","problem":[],"test":[],"treatment":["passive external rotation","physical therapy assistance"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[69,165],"treatment_indices_end":[94,192]}
{"text":"1+ edema of the ankles , pulses present bilaterally .","problem":["1+ edema of the ankles"],"test":["pulses"],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[22],"test_indices_start":[25],"test_indices_end":[31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mild right facial droop .","problem":["mild right facial droop"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"laser surgery for retinopathy .","problem":["retinopathy"],"test":[],"treatment":["laser surgery"],"problem_indices_start":[18],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"he is status post a hemiarthroplasty on 10\/17\/97 .","problem":[],"test":[],"treatment":["a hemiarthroplasty"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[36]}
{"text":"normal sinus rhythm at 72 beats \/ minute , intraventricular conduction delay , q - waves seen in ii , iii , and avf with probable old inferior myocardial infarction .","problem":["old inferior myocardial infarction","intraventricular conduction delay"],"test":["beats \/ minute"],"treatment":[],"problem_indices_start":[43,130],"problem_indices_end":[76,164],"test_indices_start":[26],"test_indices_end":[40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"history of congestive heart failure , diagnosed approximately eight years ago .","problem":["congestive heart failure"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient needs still better diabetes control .","problem":[],"test":[],"treatment":["diabetes control"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31],"treatment_indices_end":[47]}
{"text":"he received ancef preoperatively .","problem":[],"test":[],"treatment":["ancef"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[17]}
{"text":"the patient transfused 1 unit on 10\/18\/97 for a hematocrit of 29.4 .","problem":[],"test":["a hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[46],"test_indices_end":[58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient became slightly hypotensive on the night of 10\/18\/97 with systolic blood pressures in the 80s to 90s.","problem":["slightly hypotensive"],"test":["systolic blood pressures"],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[39],"test_indices_start":[70],"test_indices_end":[94],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has no chest pain when walking slowly and can walk approximately 1.5 miles .","problem":["chest pain"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has been experiencing chronic , stable angina pectoris over the past one to one and a half years approximately once every three months .","problem":["chronic , stable angina pectoris"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient transfused 2 units of 10\/16\/97 for a hematocrit of 30.03 .","problem":[],"test":["a hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[47],"test_indices_end":[59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient transfused 1 unit on 10\/19\/97 for a hematocrit of 27.9 .","problem":[],"test":["a hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[46],"test_indices_end":[58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"brittle bones were noted during the operation .","problem":["brittle bones"],"test":[],"treatment":["the operation"],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32],"treatment_indices_end":[45]}
{"text":"albuterol and atrovent nebulizers were done .","problem":[],"test":[],"treatment":["albuterol and atrovent nebulizers"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[33]}
{"text":"some type of cardiac arrhythmia , diagnosed approximately ten years ago .","problem":["cardiac arrhythmia"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no calf tenderness .","problem":["calf tenderness"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"fournier 's gangrene versus necrotizing fasciitis .","problem":["fournier 's gangrene","necrotizing fasciitis"],"test":[],"treatment":[],"problem_indices_start":[0,33],"problem_indices_end":[25,54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is admitted for preoperative and orthopedic evaluations .","problem":[],"test":["preoperative and orthopedic evaluations"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[28],"test_indices_end":[67],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient presented to bri health in order to be evaluated for preoperative clearance .","problem":[],"test":["preoperative clearance"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[65],"test_indices_end":[87],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no scapular fractures were present .","problem":["scapular fractures"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"status post gastric stapling .","problem":[],"test":[],"treatment":["gastric stapling"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[28]}
{"text":"ventricular bigeminy was also seen .","problem":["ventricular bigeminy"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"glaucoma .","problem":["glaucoma"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"regular rate and rhythm , no murmur appreciated , normal s1 and s2 .","problem":["murmur"],"test":[],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he also complained of occasional spells and jitteriness and some orthostatic dizziness and thus neurology was consulted and emg 's were performed which were normal .","problem":["occasional spells","some orthostatic dizziness","jitteriness"],"test":["emg 's"],"treatment":[],"problem_indices_start":[22,44,60],"problem_indices_end":[39,55,86],"test_indices_start":[124],"test_indices_end":[135],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen was obese with positive bowel sounds , nontender , nondistended .","problem":["obese","nontender","nondistended"],"test":[],"treatment":[],"problem_indices_start":[12,47,59],"problem_indices_end":[17,56,71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"occupational therapy became involved initially and he remained on patient controlled analgesia secondary to problems with left shoulder pain .","problem":["left shoulder pain"],"test":[],"treatment":["patient controlled analgesia"],"problem_indices_start":[122],"problem_indices_end":[140],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[66],"treatment_indices_end":[94]}
{"text":"on admission revealed a white male with no palpable adenopathy .","problem":["palpable adenopathy"],"test":[],"treatment":[],"problem_indices_start":[43],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 52-year-old right handed male with a many year history of bilateral shoulder pain , right greater than left .","problem":["bilateral shoulder pain"],"test":[],"treatment":[],"problem_indices_start":[75],"problem_indices_end":[98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his hemoglobin a1c levels actually came back within normal limits , however , the wide excursions of his sugars were consistent with possible diabetes .","problem":["diabetes","the wide excursions"],"test":["his hemoglobin a1c levels","his sugars"],"treatment":[],"problem_indices_start":[78,142],"problem_indices_end":[97,150],"test_indices_start":[0,101],"test_indices_end":[25,111],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , his course was otherwise complicated by discovery of persistently elevated blood sugars and endocrinology was consulted to rule out possible newly diagnosed diabetes .","problem":["persistently elevated blood sugars","newly diagnosed diabetes"],"test":[],"treatment":[],"problem_indices_start":[63,151],"problem_indices_end":[97,175],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his wound remained clean and dry and showed no signs of infection and healed well .","problem":["his wound","signs of infection"],"test":[],"treatment":[],"problem_indices_start":[0,47],"problem_indices_end":[9,65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"arthrogram in the distant past showed a right rotator cuff tear and he now has increased pain in his left shoulder .","problem":["increased pain in his left shoulder","a right rotator cuff tear"],"test":["arthrogram"],"treatment":[],"problem_indices_start":[38,79],"problem_indices_end":[63,114],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on admission included naprosyn .","problem":[],"test":[],"treatment":["naprosyn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[30]}
{"text":"the patient was admitted with the assessment of left rotator cuff repair and he was taken to the operating room on the day of admission where he underwent left rotator cuff repair under general endotracheal tube anesthesia .","problem":[],"test":["the assessment"],"treatment":["left rotator cuff repair","general endotracheal tube anesthesia","left rotator cuff repair"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[30],"test_indices_end":[44],"treatment_indices_start":[48,155,186],"treatment_indices_end":[72,179,222]}
{"text":"thus , he was discharged on postoperative day number eight in good condition with a well healed left shoulder wound and doing well with occupational therapy with plans for him to follow-up with dr. necessary .","problem":["a well healed left shoulder wound"],"test":[],"treatment":["occupational therapy"],"problem_indices_start":[82],"problem_indices_end":[115],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[136],"treatment_indices_end":[156]}
{"text":"further work-up of his neurologic conditions were planned as an outpatient .","problem":["his neurologic conditions"],"test":["further work-up"],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[44],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mri by report showed bilateral rotator cuff repairs and he was admitted for repair of the left rotator cuff .","problem":[],"test":["mri"],"treatment":["repair of the left rotator cuff","bilateral rotator cuff repairs"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[21,76],"treatment_indices_end":[51,107]}
{"text":"on discharge included valium , 2 mg po t.i.d.; naprosyn , 500 mg po b.i.d. ________________________________ zv061\/6138 ticena necessary , m.d. wo00","problem":[],"test":[],"treatment":["naprosyn","valium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,47],"treatment_indices_end":[28,55]}
{"text":"left rotator cuff tear .","problem":["left rotator cuff tear"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was placed on a diabetic diet and his sugars did show some improvement .","problem":[],"test":["his sugars"],"treatment":["a diabetic diet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[37],"test_indices_end":[47],"treatment_indices_start":[17],"treatment_indices_end":[32]}
{"text":"he has steroid injections in the right and in the left four times .","problem":[],"test":[],"treatment":["steroid injections"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[7],"treatment_indices_end":[25]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lungs revealed occasional wheezing bilaterally at both bases .","problem":["occasional wheezing bilaterally"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heart was regular with a i \/ vi systolic ejection murmur without jugular venous distention .","problem":["a i \/ vi systolic ejection murmur","jugular venous distention"],"test":[],"treatment":[],"problem_indices_start":[23,65],"problem_indices_end":[56,90],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ankle surgery times two on the right .","problem":[],"test":[],"treatment":["ankle surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"heent exam was within normal limits .","problem":[],"test":["heent exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"examination of his shoulder revealed the patient to be able to flex his right arm to 170 degrees , internally rotate to 10 degrees and externally rotate to 40 degrees with positive joint tenderness .","problem":["positive joint tenderness"],"test":["examination of his shoulder"],"treatment":[],"problem_indices_start":[172],"problem_indices_end":[197],"test_indices_start":[0],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was not necessary to start him on oral hypoglycemics or insulin .","problem":[],"test":[],"treatment":["insulin","oral hypoglycemics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37,59],"treatment_indices_end":[55,66]}
{"text":"his neurologist was contacted , dr. cap , and the exact of his problems was not demonstrated during this hospitalization , however , they felt that this could possibly be an autonomic type neuropathy maybe secondary to some underlying diabetic process .","problem":["some underlying diabetic process","an autonomic type neuropathy"],"test":[],"treatment":[],"problem_indices_start":[171,219],"problem_indices_end":[199,251],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pilonidal cyst removal .","problem":[],"test":[],"treatment":["pilonidal cyst removal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[22]}
{"text":"pulses were 2+ bilaterally .","problem":[],"test":["pulses"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there were no intraoperative complications .","problem":["intraoperative complications"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"back pain .","problem":["back pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 40 year old male with a history of prior anterior myocardial infarction and insulin dependent diabetes mellitus who was transferred from an outside hospital after an episode of acute shortness of breath and pulmonary edema .","problem":["acute shortness of breath","pulmonary edema","insulin dependent diabetes mellitus","prior anterior myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[52,93,194,224],"problem_indices_end":[88,128,219,239],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"temperature 100.3 , heart rate 76 , blood pressure 100\/78 , respiratory rate 16 , and an oxygen saturation of 96% on two liters .","problem":[],"test":["temperature","respiratory rate","an oxygen saturation","heart rate","blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,20,36,60,86],"test_indices_end":[11,30,50,76,106],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"given his high right-sided filling pressure , he was started on lasix for diuresis and his captopril was increased for greater afterload reduction .","problem":["his high right-sided filling pressure"],"test":[],"treatment":["lasix","his captopril","greater afterload reduction","diuresis"],"problem_indices_start":[6],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[64,74,87,119],"treatment_indices_end":[69,82,100,146]}
{"text":"the course had multiple complications requiring pressors .","problem":["multiple complications"],"test":[],"treatment":["pressors"],"problem_indices_start":[15],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48],"treatment_indices_end":[56]}
{"text":"he called the emt 's and was found to be in pulmonary edema by chest x-ray at centdick naco hospital medical center .","problem":["pulmonary edema"],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[64],"test_indices_start":[68],"test_indices_end":[79],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"clear to auscultation with no wheezes or rales .","problem":["wheezes","rales"],"test":["auscultation"],"treatment":[],"problem_indices_start":[30,41],"problem_indices_end":[37,46],"test_indices_start":[9],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was subsequently medically management after this hospitalization and has done very well .","problem":[],"test":[],"treatment":["this hospitalization"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[56],"treatment_indices_end":[76]}
{"text":"it was felt that the patient should have an augmented medical regimen and as an outpatient undergo an exercise tolerance test with viability evaluation to determine whether he would benefit from revascularization .","problem":[],"test":["viability evaluation","an exercise tolerance test"],"treatment":["an augmented medical regimen","revascularization"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[99,131],"test_indices_end":[125,151],"treatment_indices_start":[41,195],"treatment_indices_end":[69,212]}
{"text":"no jugular venous distention .","problem":["jugular venous distention"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt 14.1 with an inr of 1.4 , ptt 36.7 .","problem":[],"test":["ptt","an inr","pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,29],"test_indices_end":[2,19,32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. prior history of anterior myocardial infarction","problem":["anterior myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his coronary arteries revealed an 80% stenosis and a large om .","problem":["a large om","an 80% stenosis"],"test":[],"treatment":[],"problem_indices_start":[31,51],"problem_indices_end":[46,61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was restarted on coumadin for his low ejection fraction and started on diuresis with iv lasix for two days and then switched to an oral lasix regimen .","problem":["his low ejection fraction"],"test":[],"treatment":["coumadin","an oral lasix regimen","diuresis","iv lasix"],"problem_indices_start":[33],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20,74,88,131],"treatment_indices_end":[28,82,96,152]}
{"text":"at cardiac catheterization he had an ra pressure of 8 , an rv pressure of 52\/10 , pa pressure of 60\/25 , and wedge of 26 .","problem":[],"test":["cardiac catheterization","an ra pressure","wedge","pa pressure","an rv pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3,34,56,82,109],"test_indices_end":[26,48,70,93,114],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had a cardiac catheterization performed which revealed a three vessel coronary artery disease with an occluded rca , 70%-80% proximal lad , and a high grade left circumflex lesion after the om with distal left circumflex occlusion .","problem":["a high grade left circumflex lesion after the om","an occluded rca","a three vessel coronary artery disease","distal left circumflex occlusion","70%-80% proximal lad"],"test":["a cardiac catheterization"],"treatment":[],"problem_indices_start":[58,102,120,147,201],"problem_indices_end":[96,117,140,195,233],"test_indices_start":[7],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"aspirin 325 mg p.o. q. day , capoten 25 mg p.o. q.8h. , nph insulin 28 units q.a.m. and 10 units q.p.m. , regular insulin 4 units q.a.m. and 4 units q.p.m. , simvastatin 20 mg p.o. q. day , digoxin 0.25 mg.","problem":[],"test":[],"treatment":["nph insulin","digoxin","capoten","simvastatin","regular insulin","aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,29,56,106,158,190],"treatment_indices_end":[7,36,67,121,169,197]}
{"text":"he had no chest pain , palpitations , diaphoresis , or nausea .","problem":["chest pain","palpitations","nausea","diaphoresis"],"test":[],"treatment":[],"problem_indices_start":[10,23,38,55],"problem_indices_end":[20,35,49,61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest x-ray showed no infiltrates and no pulmonary edema .","problem":["pulmonary edema","infiltrates"],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[22,41],"problem_indices_end":[33,56],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"(3) in 1967 he had an orchiopexy for undescended testicle .","problem":["undescended testicle"],"test":[],"treatment":["an orchiopexy"],"problem_indices_start":[37],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[32]}
{"text":"1. insulin dependent diabetes mellitus","problem":["insulin dependent diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"insulin nph 10 units q.p.m. and 28 units q.a.m. , insulin regular 4 units q.a.m. and 4 units q.p.m. , aspirin 325 mg p.o. q. day , digoxin 0.25 mg p.o. q. day , simvastatin 20 mg p.o. q. day , captopril 37.5 mg p.o. t.i.d. , coumadin 5 mg p.o. q.h.s. , lasix 20 mg p.o. q. day .","problem":[],"test":[],"treatment":["coumadin","simvastatin","insulin nph","lasix","insulin regular","aspirin","captopril","digoxin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,50,102,131,161,193,225,253],"treatment_indices_end":[11,65,109,138,172,202,233,258]}
{"text":"the patient has a history four years ago of being admitted to the etearal etsystems\/ hospital after suffering an acute anterior myocardial infarction .","problem":["an acute anterior myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[110],"problem_indices_end":[149],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"(4) coronary artery disease as above .","problem":["coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. episode of pulmonary edema","problem":["pulmonary edema"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was felt that the patient possibly had a worsening of his coronary artery disease and therefore underwent cardiac catheterization on 01\/17\/96 .","problem":["his coronary artery disease"],"test":["cardiac catheterization"],"treatment":[],"problem_indices_start":[57],"problem_indices_end":[84],"test_indices_start":[109],"test_indices_end":[132],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had flat t waves in i and avl , which were unchanged from previous ecg .","problem":["flat t waves in i and avl"],"test":["previous ecg"],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[32],"test_indices_start":[61],"test_indices_end":[73],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient also had an electrocardiogram in april of 1996 which was negative following , however was at a low workload .","problem":[],"test":["an electrocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[21],"test_indices_end":[41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his ecg showed no ischemic changes .","problem":["ischemic changes"],"test":["his ecg"],"treatment":[],"problem_indices_start":[18],"problem_indices_end":[34],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he is to see dr. ench in two weeks to check his pt and inr , also to check for potassium .","problem":[],"test":["his pt","inr","potassium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[44,55,79],"test_indices_end":[50,58,88],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was diuresed and ruled out for myocardial infarction .","problem":["myocardial infarction"],"test":[],"treatment":["diuresed"],"problem_indices_start":[34],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[7],"treatment_indices_end":[15]}
{"text":"(1) insulin dependent diabetes mellitus x 15 years with no retinopathy or foot lesions .","problem":["retinopathy","foot lesions","insulin dependent diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[4,59,74],"problem_indices_end":[39,70,86],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bun 25 and creatinine 1.4 .","problem":[],"test":["creatinine","bun"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,11],"test_indices_end":[3,21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his most recent echocardiogram in april of 1996 showed an ejection fraction of 20% with a thin fibrotic septum with akinesis and moderately severe hypokinesis in all other regions except for the lateral wall .","problem":["a thin fibrotic septum","akinesis","moderately severe hypokinesis in all other regions"],"test":["an ejection fraction","his most recent echocardiogram"],"treatment":[],"problem_indices_start":[88,116,129],"problem_indices_end":[110,124,179],"test_indices_start":[0,55],"test_indices_end":[30,75],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"electrocardiogram showed normal sinus rhythm at 63 with normal intervals .","problem":[],"test":["electrocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white count 6 and hematocrit 41.5 .","problem":[],"test":["white count","hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,18],"test_indices_end":[11,28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was felt that this cardiac catheterization was not significantly changed from his previous catheterization .","problem":[],"test":["his previous catheterization","this cardiac catheterization"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17,81],"test_indices_end":[45,109],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urinalysis was negative .","problem":[],"test":["urinalysis"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. hypercholesterolemia","problem":["hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he also had a 50% lad stenosis , a 100% large dt stenosis and a nondominant rca with left rca collaterals .","problem":["a 50% lad stenosis","a 100% large dt stenosis"],"test":[],"treatment":[],"problem_indices_start":[12,33],"problem_indices_end":[30,57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no edema with 2+ pulses .","problem":["edema"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was admitted for further management of his pulmonary edema .","problem":["his pulmonary edema"],"test":[],"treatment":["further management"],"problem_indices_start":[51],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[47]}
{"text":"his mother and father both died secondary to myocardial infarction .","problem":["myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[45],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"one of his brothers has had a myocardial infarction .","problem":["a myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[28],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"(2) bilateral cataracts .","problem":["bilateral cataracts"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the dominant left circumflex was occluded with left-to-left filling .","problem":["left-to-left filling","occluded"],"test":[],"treatment":[],"problem_indices_start":[33,47],"problem_indices_end":[41,67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"regular rate and rhythm with no extra heart sounds and no murmurs .","problem":["extra heart sounds","murmurs"],"test":[],"treatment":[],"problem_indices_start":[32,58],"problem_indices_end":[50,65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was then transferred to the retelk county medical center for further management .","problem":[],"test":[],"treatment":["further management"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[64],"treatment_indices_end":[82]}
{"text":"the patient 's was most recently admitted to centdick naco hospital medical center on martin luther king day after becoming acutely short of breath after a five minute walk .","problem":["acutely short of breath"],"test":[],"treatment":[],"problem_indices_start":[129],"problem_indices_end":[152],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"having failed conservative management , the patient presented for elective right total hip replacement .","problem":[],"test":[],"treatment":["conservative management","elective right total hip replacement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14,66],"treatment_indices_end":[37,102]}
{"text":"there was no leg length discrepancy .","problem":["leg length discrepancy"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's pain has not been relieved by darvocet and advil .","problem":["the patient 's pain"],"test":[],"treatment":["advil","darvocet"],"problem_indices_start":[0],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[50,63],"treatment_indices_end":[58,68]}
{"text":"it was his impression that the patient 's hypertension was controlled on hydrochlorothiazide .","problem":["the patient 's hypertension"],"test":[],"treatment":["hydrochlorothiazide"],"problem_indices_start":[27],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[78],"treatment_indices_end":[97]}
{"text":"the sodium was 140 , potassium 3.7 , chloride 96 , bicarbonate 30 , bun and creatinine 14\/0.9 , glucose 105 , hematocrit 42 , white blood count 8.6 , platelet count 644,000 , prothrombin time 10.4 , partial thromboplastin time 28.7 , urinalysis trace white blood cells , slight occult red blood cells .","problem":["trace white blood cells","slight occult red blood cells"],"test":["platelet count","prothrombin time","bicarbonate","bun","potassium","glucose","the sodium","creatinine","chloride","partial thromboplastin time","hematocrit","urinalysis","white blood count"],"treatment":[],"problem_indices_start":[245,271],"problem_indices_end":[268,300],"test_indices_start":[0,21,37,51,68,76,96,110,126,150,175,199,234],"test_indices_end":[10,30,45,62,71,86,103,120,143,164,191,226,244],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there she should received physical therapy to consist of a routine post total hip replacement rehabilitation protocol , with emphasis on gait training , partial weight bearing on the right lower extremity , using a walker or crutches .","problem":[],"test":[],"treatment":["physical therapy","gait training","walker","a routine post total hip replacement rehabilitation protocol","crutches"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,57,137,215,225],"treatment_indices_end":[42,117,150,221,233]}
{"text":"the patient was an elderly woman in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[39],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient used the cane in her left hand .","problem":[],"test":[],"treatment":["the cane"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17],"treatment_indices_end":[25]}
{"text":"hypertension , possible peptic ulcer disease 1959 , history of left ankle and knee fractures , 1980 .","problem":["left ankle and knee fractures","hypertension","peptic ulcer disease"],"test":[],"treatment":[],"problem_indices_start":[0,24,63],"problem_indices_end":[12,44,92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her hematocrit remained stable in the low to mid 30 's and she did not require a transfusion .","problem":[],"test":["her hematocrit"],"treatment":["a transfusion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[84],"treatment_indices_end":[97]}
{"text":"recent urinary tract infection , e. coli 03\/93 .","problem":["e. coli","recent urinary tract infection"],"test":[],"treatment":[],"problem_indices_start":[0,33],"problem_indices_end":[30,40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hydrochlorothiazide 50 mg. po qday , kayciel 40 meq. b.i.d. , ecotrin 1 tablet qday , ferrous sulfate 325 mg. po b.i.d. , folate 1 mg. po qday , multivitamins one tablet qday , tylenol # 3 1 to 2 po q3hours prn .","problem":[],"test":[],"treatment":["tylenol # 3","hydrochlorothiazide","ecotrin","ferrous sulfate","multivitamins","folate","kayciel"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,37,62,86,122,145,177],"treatment_indices_end":[19,44,69,101,128,158,188]}
{"text":"right hip osteoarthritis , status post right total hip replacement on 4\/17\/93 .","problem":["right hip osteoarthritis"],"test":[],"treatment":["right total hip replacement"],"problem_indices_start":[0],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39],"treatment_indices_end":[66]}
{"text":"hydrochlorothiazide 50 mg. po qday , kayciel .","problem":[],"test":[],"treatment":["hydrochlorothiazide","kayciel"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,37],"treatment_indices_end":[19,44]}
{"text":"the patient was seen in consultation with the physical therapy service initially for routine rehabilitation after a total hip replacement .","problem":[],"test":[],"treatment":["routine rehabilitation","a total hip replacement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[85,114],"treatment_indices_end":[107,137]}
{"text":"right hip 90 degrees of flexion , minus 30 degrees of extension , 20 degrees of abduction , 30 degrees of adduction , less than 5 degrees of internal rotation and flexion and less than 5 degrees of external rotation and flexion .","problem":[],"test":["abduction","external rotation and flexion","extension","flexion","internal rotation and flexion","adduction"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24,54,80,106,141,198],"test_indices_end":[31,63,89,115,170,227],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a generally healthy 85 year old female , who has had a five year history of right hip pain , worsening over the past several months .","problem":["right hip pain"],"test":[],"treatment":[],"problem_indices_start":[91],"problem_indices_end":[105],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"recent herpes zoster .","problem":["recent herpes zoster"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"radiographs demonstrate right hip osteoarthritis .","problem":["right hip osteoarthritis"],"test":["radiographs"],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[48],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there were no acute ischemic changes .","problem":["acute ischemic changes"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's neurovascular examination was intact .","problem":[],"test":["the patient 's neurovascular examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[45],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's coumadin was thus stopped and she was switched to bufferin .","problem":[],"test":[],"treatment":["the patient 's coumadin","bufferin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,70],"treatment_indices_end":[28,78]}
{"text":"cholecystectomy , total abdominal hysterectomy , cataract excision .","problem":[],"test":[],"treatment":["total abdominal hysterectomy","cataract excision","cholecystectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,18,49],"treatment_indices_end":[15,46,66]}
{"text":"the chest x-ray showed borderline cardiomegaly but no acute cardiac or pulmonary disease .","problem":["acute cardiac or pulmonary disease","borderline cardiomegaly"],"test":["the chest x-ray"],"treatment":[],"problem_indices_start":[23,54],"problem_indices_end":[46,88],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her pain is located in the groin and thigh .","problem":["her pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left hip 110 degrees of flexion , 0 degrees of extension , 30 degrees of abduction , 45 degrees of adduction , 10 degrees of internal rotation and flexion , 45 degrees of external rotation and flexion .","problem":[],"test":["extension","external rotation and flexion","internal rotation and flexion","abduction","flexion","adduction"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24,47,73,99,125,171],"test_indices_end":[31,56,82,108,154,200],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"postoperative hypokalemia , resolved .","problem":["postoperative hypokalemia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the electrocardiogram showed normal sinus rhythm at a rate of 80 with intraventricular conduction delay and poor r wave progression .","problem":["intraventricular conduction delay","poor r wave progression"],"test":["the electrocardiogram","a rate"],"treatment":[],"problem_indices_start":[70,108],"problem_indices_end":[103,131],"test_indices_start":[0,52],"test_indices_end":[21,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her hemovac drains were removed on postoperative day # 2 as was her foley catheter .","problem":[],"test":[],"treatment":["her foley catheter","her hemovac drains"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,64],"treatment_indices_end":[18,82]}
{"text":"the patient did have postoperatively hypokalemia to a level of 2.7 and subsequently was corrected with oral and intravenous potassium on 4\/22\/93 , the patient underwent a duplex ultrasound examination , which showed no evidence of of deep venous thrombosis .","problem":["deep venous thrombosis","postoperatively hypokalemia"],"test":["a duplex ultrasound examination"],"treatment":["oral and intravenous potassium"],"problem_indices_start":[21,234],"problem_indices_end":[48,256],"test_indices_start":[169],"test_indices_end":[200],"treatment_indices_start":[103],"treatment_indices_end":[133]}
{"text":"medications on admission :","problem":[],"test":[],"treatment":["medications on admission"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"she uses a cane or walker for ambulation , and is limited to one to two blocks .","problem":[],"test":[],"treatment":["a cane","walker"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9,19],"treatment_indices_end":[15,25]}
{"text":"the head and neck exam was within normal limits .","problem":[],"test":["the head and neck exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"regular rate and rhythm without murmur .","problem":["murmur"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on the following morning 4\/17\/93 , the patient was taken to the operating room where she underwent a right total hip replacement , using a hybrid s-rom system .","problem":[],"test":[],"treatment":["a hybrid s-rom system","a right total hip replacement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[99,137],"treatment_indices_end":[128,158]}
{"text":"given the patient 's low potassium level of 2.4 on the day of admission , he suggested supplementation with potassium .","problem":["the patient 's low potassium level"],"test":[],"treatment":["potassium"],"problem_indices_start":[6],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[113],"treatment_indices_end":[122]}
{"text":"right hip , osteoarthritis .","problem":["right hip , osteoarthritis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"postoperative confusion , transient and resolved spontaneously .","problem":["postoperative confusion"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the lungs were clear to auscultation .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it is associated with rest pain as well .","problem":["rest pain"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient should also have her potassium levels checked two times per week to insure that she is not becoming hypokalemic .","problem":["hypokalemic"],"test":["her potassium levels"],"treatment":[],"problem_indices_start":[112],"problem_indices_end":[123],"test_indices_start":[29],"test_indices_end":[49],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has difficulty with shoes and socks and foot care .","problem":["difficulty with shoes and socks and foot care"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right hip , osteoarthritis .","problem":["right hip , osteoarthritis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"otherwise you need to see a gynecologist to evaluate this bleeding .","problem":["this bleeding"],"test":[],"treatment":[],"problem_indices_start":[53],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pelvic ultrasound - normal ovaries , thickened endometrium hematocrit - 33","problem":["thickened endometrium"],"test":["pelvic ultrasound","hematocrit"],"treatment":[],"problem_indices_start":[37],"problem_indices_end":[58],"test_indices_start":[0,59],"test_indices_end":[17,69],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"percocet as directed for pain","problem":["pain"],"test":[],"treatment":["percocet"],"problem_indices_start":[25],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"please return to the ed if you develop any worsening pain , vomiting or fevers > 101 .","problem":["any worsening pain","vomiting","fevers"],"test":[],"treatment":[],"problem_indices_start":[39,60,72],"problem_indices_end":[57,68,78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dysfunctional uterine bleeding","problem":["dysfunctional uterine bleeding"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vag bleeding","problem":["vag bleeding"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please follow up with gynecology - you will need to have your uterine bleeding evaluted","problem":["your uterine bleeding"],"test":[],"treatment":[],"problem_indices_start":[57],"problem_indices_end":[78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if you are unable to keep down liquids or have any fainting episodes we should see you again as well .","problem":["any fainting episodes"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tylenol ( acetaminophen ) 650 mg po q4h prn pain colace ( docusate sodium ) 100 mg po bid prn constipation ibuprofen 600 mg po q4-6h prn pain milk of magnesia ( magnesium hydroxide ) 30 milliliters po qd prn constipation percocet 1-2 tab po q4h prn pain","problem":["pain","pain","pain","constipation","constipation"],"test":[],"treatment":["percocet","ibuprofen","colace ( docusate sodium )","milk of magnesia ( magnesium hydroxide )","tylenol ( acetaminophen )"],"problem_indices_start":[44,94,137,208,249],"problem_indices_end":[48,106,141,220,253],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,49,107,142,221],"treatment_indices_end":[25,75,116,182,229]}
{"text":"houghtbreun 6 weeks , no known allergies","problem":["known allergies"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"insulin dependent gestational diabetic , prior c \/ s , rsap","problem":["insulin dependent gestational diabetic","prior c \/ s","rsap"],"test":[],"treatment":[],"problem_indices_start":[0,41,55],"problem_indices_end":[38,52,59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"attending evaluation","problem":[],"test":["attending evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"conditions , infections , complications , affecting treatment \/ stay iup at 36 weeks .","problem":["iup"],"test":[],"treatment":[],"problem_indices_start":[69],"problem_indices_end":[72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"apgars 9,9","problem":[],"test":["apgars"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"repeat c \/ s pps","problem":["repeat c \/ s pps"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"responsible after study for causing admission ) iup at 36 weeks , delivered","problem":["iup"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"weight :","problem":[],"test":["weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. anemia .","problem":["anemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he is also to have ah for his home stent care .","problem":[],"test":[],"treatment":["ah","his home stent care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,26],"treatment_indices_end":[21,45]}
{"text":"this is a 70 year old gentleman with metastatic rectal cancer who presented with biliary obstruction .","problem":["biliary obstruction","metastatic rectal cancer"],"test":[],"treatment":[],"problem_indices_start":[37,81],"problem_indices_end":[61,100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"total bilirubin was 12 and direct bilirubin 8 .","problem":[],"test":["total bilirubin","direct bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,27],"test_indices_end":[15,43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had two drains placed after a prolonged course and difficult procedure .","problem":[],"test":[],"treatment":["difficult procedure","a prolonged course","two drains"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16,40,63],"treatment_indices_end":[26,58,82]}
{"text":"exam within normal limits .","problem":[],"test":["exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white count was 8.2 , hematocrit 35 .","problem":[],"test":["white count","hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,22],"test_indices_end":[11,32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ast was 175 , alt 76 , ldh 454 .","problem":[],"test":["ldh","ast","alt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,14,23],"test_indices_end":[3,17,26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the day prior , the patient had endoscopic retrograde cholangiopancreatography done with dilated ducts times two and eventually had interventional radiology attempt to place percutaneous drains to decompress his biliary tree .","problem":["dilated ducts","his biliary tree"],"test":["endoscopic retrograde cholangiopancreatography"],"treatment":["percutaneous drains","interventional radiology"],"problem_indices_start":[89,208],"problem_indices_end":[102,224],"test_indices_start":[32],"test_indices_end":[78],"treatment_indices_start":[132,174],"treatment_indices_end":[156,193]}
{"text":"temperature was 99.1 , blood pressure 132\/74 , heart rate 80 , respirations 18 , 02 sat 99% on room air .","problem":[],"test":["02 sat","heart rate","temperature","blood pressure","respirations"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,23,47,63,81],"test_indices_end":[11,37,57,75,87],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was taken back to surgery by the interventional radiology team and had a second drain placed without any difficulty and was transferred back to the short stay unit .","problem":[],"test":[],"treatment":["a second drain"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[83],"treatment_indices_end":[97]}
{"text":"he was admitted to the short stay unit , given ancef and gentamicin per the team for antibiotic prophylaxis and observed overnight .","problem":[],"test":[],"treatment":["antibiotic prophylaxis","ancef","gentamicin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47,57,85],"treatment_indices_end":[52,67,107]}
{"text":"5. urinary tract infection .","problem":["urinary tract infection"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was admitted to the short stay unit for further evaluation .","problem":[],"test":["further evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[52],"test_indices_end":[70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was an alert , jaundiced gentleman in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[53],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was doing well with minimal to no belly pain and no nausea or vomiting .","problem":["nausea","vomiting","belly pain"],"test":[],"treatment":[],"problem_indices_start":[46,64,74],"problem_indices_end":[56,70,82],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cipro 500 mg p.o. b.i.d. , vasotec 10 mg q.d.","problem":[],"test":[],"treatment":["cipro","vasotec"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,27],"treatment_indices_end":[5,34]}
{"text":"he will continue cipro p.o. for prophylaxis .","problem":[],"test":[],"treatment":["prophylaxis","cipro p.o."],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17,32],"treatment_indices_end":[27,43]}
{"text":"significant for colon carcinoma .","problem":["colon carcinoma"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"biliary obstruction","problem":["biliary obstruction"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was admitted to the short stay unit and continued to receive antibiotics overnight .","problem":[],"test":[],"treatment":["antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[73],"treatment_indices_end":[84]}
{"text":"3. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"had a regular rate and rhythm with a ii \/ vi systolic murmur at the right sternal border .","problem":["a ii \/ vi systolic murmur at the right sternal border"],"test":[],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"were clear to auscultation .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. metastatic colon carcinoma .","problem":["metastatic colon carcinoma"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"alkaline phosphatase was 372 .","problem":[],"test":["alkaline phosphatase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"was soft , nontender , with good bowel sounds .","problem":["nontender"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the next morning , he was doing well with the intact drain draining bilious material without any difficulty .","problem":["bilious material"],"test":[],"treatment":["the intact drain"],"problem_indices_start":[68],"problem_indices_end":[84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[42],"treatment_indices_end":[58]}
{"text":"were without edema .","problem":["edema"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. cholangitis .","problem":["cholangitis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. aortic stenosis with porcine valve .","problem":["aortic stenosis"],"test":[],"treatment":["porcine valve"],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[37]}
{"text":"he had midline catheter that was still in place and was draining bile .","problem":[],"test":[],"treatment":["midline catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[7],"treatment_indices_end":[23]}
{"text":"in the past , he had biliary stents placed which clotted off .","problem":[],"test":[],"treatment":["biliary stents"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[35]}
{"text":"the patient was observed overnight without any problems .","problem":["any problems"],"test":[],"treatment":[],"problem_indices_start":[43],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. rectal carcinoma , status post partial colectomy .","problem":["rectal carcinoma"],"test":[],"treatment":["partial colectomy"],"problem_indices_start":[3],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[51]}
{"text":"after being transferred from the interventional radiology table to the stretcher , one of his lateral percutaneous drains had been pulled out inadvertently .","problem":[],"test":[],"treatment":["his lateral percutaneous drains"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[90],"treatment_indices_end":[121]}
{"text":"serum sodium 141 , potassium 4.0 , chloride 106 , c02 29.6 , calcium 9.2 , phosphorus 3.6 .","problem":[],"test":["calcium","phosphorus","chloride","serum sodium","c02","potassium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,19,35,50,61,75],"test_indices_end":[12,28,43,53,68,85],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a quantitative vq scan of the lung showed 42% ventilation to the left , 57% ventilation to the right , 42% perfusion to the left , 57% perfusion to the right .","problem":[],"test":["perfusion to the right","ventilation to the right","ventilation to the left","perfusion to the left","a quantitative vq scan"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,46,76,107,135],"test_indices_end":[22,69,100,128,157],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"history of gastrointestinal intolerance to tetracycline , erythromycin , declomycin associated with edema and rash , talwin associated with disorientation and gastrointestinal symptoms , dilantin has caused rash and edema , morphine associated with itching and gastrointestinal symptoms , demerol unclear .","problem":["disorientation","gastrointestinal intolerance","gastrointestinal symptoms","edema","rash","rash","edema","itching","gastrointestinal symptoms"],"test":[],"treatment":["demerol","tetracycline","erythromycin","morphine","declomycin","dilantin","talwin"],"problem_indices_start":[11,100,110,140,159,207,216,249,261],"problem_indices_end":[39,105,114,154,184,211,221,256,286],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[43,58,73,117,187,224,289],"treatment_indices_end":[55,70,83,123,195,232,296]}
{"text":"white blood count 9.6 , hematocrit 38.8 , platelet 348,000 , mean corpuscular volume 85 and 86 , mch 29 , mchc 34 .","problem":[],"test":["mch","hematocrit","mchc","mean corpuscular volume","platelet","white blood count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,24,42,61,97,106],"test_indices_end":[17,34,50,84,100,110],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"notable for her diffuse expiratory wheezes and scattered expiratory crackles .","problem":["scattered expiratory crackles","her diffuse expiratory wheezes"],"test":[],"treatment":[],"problem_indices_start":[12,47],"problem_indices_end":[42,76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no acute pathology was noted and no treatment was necessary at this time .","problem":["acute pathology","treatment"],"test":[],"treatment":[],"problem_indices_start":[3,36],"problem_indices_end":[18,45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the electrocardiogram showed a short pr interval with no delta wave , clockwise rotation present .","problem":["clockwise rotation present","a short pr interval","delta wave"],"test":["the electrocardiogram"],"treatment":[],"problem_indices_start":[29,57,70],"problem_indices_end":[48,67,96],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urinalysis was normal .","problem":[],"test":["urinalysis"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"notable for a history of trigeminal neuralgia , left shoulder surgery , fibrocystic breast disease , endometriosis and status post total abdominal hysterectomy .","problem":["trigeminal neuralgia","total abdominal hysterectomy","fibrocystic breast disease","endometriosis"],"test":[],"treatment":["left shoulder surgery"],"problem_indices_start":[25,72,101,131],"problem_indices_end":[45,98,114,159],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48],"treatment_indices_end":[69]}
{"text":"a left and right heart catheterization and coronary angiogram revealed aortic 120\/70 , mean 95 , pa 26\/10 , mean 17 , pc 7 , rv 26\/6 , ra 4 , cardiac output 5.7 , index 3.8 .","problem":[],"test":["a left and right heart catheterization","mean","cardiac output","index","pc","ra","coronary angiogram","pa","rv","aortic","mean"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,43,71,87,97,108,118,125,135,142,163],"test_indices_end":[38,61,77,91,99,112,120,127,137,156,168],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urine cotenine level none detected .","problem":[],"test":["urine cotenine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the lh was 4.9 , fsh 3.3 .","problem":[],"test":["the lh","fsh"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,17],"test_indices_end":[6,20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bun 12 , creatinine 0.6 , glucose 92 , uric acid 3.3. cholesterol 236 , triglycerides 115 , hdl 99 , ldl 114 , total protein 6.2 , globulin 2.6 , direct bilirubin 0 , total bilirubin 0.2 , alkaline phosphatase 59 , amylase 64 , sgot 16 , ldh 141 , cpk 57 .","problem":[],"test":["uric acid","cholesterol","creatinine","alkaline phosphatase","cpk","direct bilirubin","triglycerides","glucose","bun","total protein","total bilirubin","amylase","hdl","ldl","sgot 16","globulin","ldh 141"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,9,26,39,54,72,92,101,111,131,146,167,189,215,228,238,248],"test_indices_end":[3,19,33,48,65,85,95,104,124,139,162,182,209,222,235,245,251],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was noted to have mild cataracts , possibly due to chronic steroids , as well as a subtle temporal disc pallor od , possibly due to previous episode of optic neuritis .","problem":["mild cataracts","a subtle temporal disc pallor od","optic neuritis"],"test":[],"treatment":["chronic steroids"],"problem_indices_start":[22,85,156],"problem_indices_end":[36,117,170],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[55],"treatment_indices_end":[71]}
{"text":"estradialol pending .","problem":[],"test":["estradialol"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has no history of asbestos exposure or tuberculosis exposure .","problem":["asbestos exposure","tuberculosis exposure"],"test":[],"treatment":[],"problem_indices_start":[22,43],"problem_indices_end":[39,64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tsh was 124 , cortisol 2.1 , 25 hydroxy vitamin d , and 125 dihydroxy vitamin d levels were pending .","problem":[],"test":["25 hydroxy vitamin d , and 125 dihydroxy vitamin d levels","tsh","cortisol"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,14,29],"test_indices_end":[3,22,86],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mrs. cast is a 50 year old white female with a history of chronic obstructive pulmonary disease and evidence of severe lobular emphysema , who has progressive shortness of breath and inability to carry on with activities of daily living without assistance .","problem":["severe lobular emphysema","chronic obstructive pulmonary disease","progressive shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[58,112,147],"problem_indices_end":[95,136,178],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"varicella antibody positive , cmv antibody positive , toxo negative , rpr non reactive .","problem":[],"test":["cmv antibody","varicella antibody","toxo","rpr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,30,54,70],"test_indices_end":[18,42,58,73],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sed rate 6 .","problem":[],"test":["sed rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt 9.5\/10.0 , ptt 23.9 .","problem":[],"test":["pt","ptt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,14],"test_indices_end":[2,17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hiv testing results pending .","problem":[],"test":["hiv testing"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"systemic arterial resistance 12\/81 .","problem":[],"test":["systemic arterial resistance"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dr. koteelks indicated that the patient did not have sinus problems currently but thought that the trigeminal pain might be investigated further and that the sphenoid might account for some of the patient 's discomfort .","problem":["the trigeminal pain","the patient 's discomfort","sinus problems","the sphenoid"],"test":[],"treatment":[],"problem_indices_start":[53,95,154,193],"problem_indices_end":[67,114,166,223],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dr. tikkerth felt that the patient had mild adjustment related anxiety under good control with a history of tobacco abuse in the past .","problem":["mild adjustment related anxiety"],"test":[],"treatment":[],"problem_indices_start":[39],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"fev1 0.78 liters , vital capacity 2.12 liters , total lung capacity 5.51 liters , single breath dlco 5.3 ( 25% predicted ) .","problem":[],"test":["vital capacity","fev1","total lung capacity","single breath dlco"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,19,48,82],"test_indices_end":[4,33,67,100],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chronic obstructive pulmonary disease","problem":["chronic obstructive pulmonary disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she knows to return to her local physician for her routine care with her condition unchanged at the time of discharge .","problem":["her condition"],"test":[],"treatment":["her routine care"],"problem_indices_start":[69],"problem_indices_end":[82],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47],"treatment_indices_end":[63]}
{"text":"hepatitis serologies pending .","problem":[],"test":["hepatitis serologies"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdominal ultrasound was unremarkable .","problem":[],"test":["abdominal ultrasound"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient completed the studies and to be informed of the results as an outpatient .","problem":[],"test":["the studies"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has been steroid dependent for two years and has been intubated in the past only once for a surgical repair of trigeminal neuralgia .","problem":["steroid dependent"],"test":[],"treatment":["a surgical repair of trigeminal neuralgia","intubated"],"problem_indices_start":[21],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[66,102],"treatment_indices_end":[75,143]}
{"text":"magnesium 1.7 .","problem":[],"test":["magnesium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"steroid complications , including cataract , osteoporosis , diffuse fibrocystic breast disease , trigeminal neuralgia .","problem":["cataract","diffuse fibrocystic breast disease","trigeminal neuralgia","osteoporosis","steroid complications"],"test":[],"treatment":[],"problem_indices_start":[0,34,45,60,97],"problem_indices_end":[21,42,57,94,117],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the breasts were notable for fibrocystic changes .","problem":["fibrocystic changes"],"test":[],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cranial nerves were intact except for paresthesias on the left in the vii and viii distribution .","problem":["paresthesias"],"test":[],"treatment":[],"problem_indices_start":[38],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"echocardiogram showed normal right ventricular and left ventricular size and systolic function .","problem":[],"test":["echocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chronic obstructive pulmonary disease","problem":["chronic obstructive pulmonary disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiopulmonary exercise study results are pending .","problem":[],"test":["cardiopulmonary exercise study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was admitted to the hospital for a pre lung transplant evaluation .","problem":[],"test":["a pre lung transplant evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[37],"test_indices_end":[69],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest pain \/ sob","problem":["chest pain","sob"],"test":[],"treatment":[],"problem_indices_start":[0,13],"problem_indices_end":[10,16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"r lung mass , likely cancer","problem":["r lung mass","cancer"],"test":[],"treatment":[],"problem_indices_start":[0,21],"problem_indices_end":[11,27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vicodin 1-2 tabs po q6h prn pain , # 50 , no refills","problem":["pain"],"test":[],"treatment":["vicodin"],"problem_indices_start":[28],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"physical examination , laboratory evaluation , cxr , chest ct","problem":[],"test":["laboratory evaluation","chest ct","cxr","physical examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,23,47,53],"test_indices_end":[20,44,50,61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"we are scheduling you for a needle biopsy by interventional radiology for some time in the next week .","problem":[],"test":["a needle biopsy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26],"test_indices_end":[41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"significant for left tm scarring without acute inflammation or drainage .","problem":["left tm scarring","drainage","acute inflammation"],"test":[],"treatment":[],"problem_indices_start":[16,41,63],"problem_indices_end":[32,59,71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has had no fevers , chills , respiratory symptoms , diarrhea , bright red blood per rectum or melena .","problem":["chills","melena","bright red blood per rectum","fevers","respiratory symptoms","diarrhea"],"test":[],"treatment":[],"problem_indices_start":[15,24,33,56,67,98],"problem_indices_end":[21,30,53,64,94,104],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no anorexia .","problem":["anorexia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has had no symptoms until approximately two years ago when she began having classic biliary colic pain with right upper quadrant epigastric pain radiating to midback with nausea , but without vomiting .","problem":["nausea","symptoms","right upper quadrant epigastric pain","classic biliary colic pain","vomiting"],"test":[],"treatment":[],"problem_indices_start":[23,88,120,183,204],"problem_indices_end":[31,114,156,189,212],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"significant for a left ear operation approximately 30 years ago with left tm reconstruction in december 1999 at hitch hospital .","problem":[],"test":[],"treatment":["left tm reconstruction","a left ear operation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16,69],"treatment_indices_end":[36,91]}
{"text":"only multivitamins .","problem":[],"test":[],"treatment":["multivitamins"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[5],"treatment_indices_end":[18]}
{"text":"no lymphadenopathy is noted .","problem":["lymphadenopathy"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen is soft and nontender without hepatosplenomegaly or mass .","problem":["hepatosplenomegaly","nontender","mass"],"test":[],"treatment":[],"problem_indices_start":[20,38,60],"problem_indices_end":[29,56,64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"episodes have been increasing in frequency over the last few months .","problem":["episodes"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was admitted to the hospital on july 12th for a chole with a principle diagnosis of recurrent biliary colic .","problem":["recurrent biliary colic"],"test":[],"treatment":["a chole"],"problem_indices_start":[96],"problem_indices_end":[119],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[58],"treatment_indices_end":[65]}
{"text":"the patient was admitted for the lap coli with an intraoperative cholangiogram by dr. sterp under general anesthesia .","problem":[],"test":["an intraoperative cholangiogram"],"treatment":["general anesthesia","the lap coli"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[47],"test_indices_end":[78],"treatment_indices_start":[29,98],"treatment_indices_end":[41,116]}
{"text":"she has no family history of gallbladder or pancreatic disease .","problem":["gallbladder","pancreatic disease"],"test":[],"treatment":[],"problem_indices_start":[29,44],"problem_indices_end":[40,62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac exam ; she has positive s1 , s2 without murmur , rub or gallop .","problem":["rub","gallop","murmur"],"test":["cardiac exam"],"treatment":[],"problem_indices_start":[48,57,64],"problem_indices_end":[54,60,70],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rate was 75 .","problem":[],"test":["rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has had no significant weight loss .","problem":["weight loss"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has had ultrasound proven gallstones for ten years , seen on an earlier obstetric ultrasound .","problem":["ultrasound proven gallstones"],"test":["an earlier obstetric ultrasound"],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[40],"test_indices_start":[65],"test_indices_end":[96],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a healthy appearing female looking her stated age in no apparent distress .","problem":["apparent distress"],"test":[],"treatment":[],"problem_indices_start":[71],"problem_indices_end":[88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has not found any relieve with any over the counter medications .","problem":[],"test":[],"treatment":["over the counter medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39],"treatment_indices_end":[67]}
{"text":"the patient is a 42 year old with recurrent biliary colic .","problem":["recurrent biliary colic"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she is anicteric without rash or heent .","problem":["rash","anicteric"],"test":[],"treatment":[],"problem_indices_start":[7,25],"problem_indices_end":[16,29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her rectal exam is guaiac negative .","problem":[],"test":["her rectal exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has no history of liver disease , hepatitis .","problem":["liver disease","hepatitis"],"test":[],"treatment":[],"problem_indices_start":[22,38],"problem_indices_end":[35,47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has no rebound or guarding .","problem":["guarding","rebound"],"test":[],"treatment":[],"problem_indices_start":[11,22],"problem_indices_end":[18,30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an ultrasound on 1\/25\/00 showed six gallstones without cholecystitis .","problem":["cholecystitis","six gallstones"],"test":["an ultrasound"],"treatment":[],"problem_indices_start":[32,55],"problem_indices_end":[46,68],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was afebrile , vital signs were stable .","problem":["afebrile"],"test":["vital signs"],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[24],"test_indices_start":[27],"test_indices_end":[38],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she is without bruits or jvd .","problem":["bruits","jvd"],"test":[],"treatment":[],"problem_indices_start":[15,25],"problem_indices_end":[21,28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"percocet 5 mg in 325 mg one to two tabs po q4 to 6 prn pain .","problem":["pain"],"test":[],"treatment":["percocet"],"problem_indices_start":[55],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"no known drug allergies","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lungs are bilaterally clear to auscultation .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[31],"test_indices_end":[43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"operative course and recovery were without complication .","problem":["complication"],"test":[],"treatment":[],"problem_indices_start":[43],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dermoplast topical tp q12h prn pain docusate sodium 100 mg po bid prn constipation ibuprofen 400-600 mg po q6h prn pain","problem":["pain","pain","constipation"],"test":[],"treatment":["dermoplast topical","ibuprofen","docusate sodium"],"problem_indices_start":[31,70,115],"problem_indices_end":[35,82,119],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,36,83],"treatment_indices_end":[18,51,92]}
{"text":"nka","problem":["nka"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"take with food prenatal multivitamins ( stuartnatal 1+1 ) 1 tab po qd tucks ( witch hazel ) topical tp q4h prn pain","problem":["pain"],"test":[],"treatment":["tucks ( witch hazel )","prenatal multivitamins ( stuartnatal 1+1 )"],"problem_indices_start":[111],"problem_indices_end":[115],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15,70],"treatment_indices_end":[57,91]}
{"text":"labor at term","problem":["labor at term"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no observed abnormalities","problem":["observed abnormalities"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"initial newborn exam :","problem":[],"test":["initial newborn exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen obese , no scars .","problem":["scars","abdomen obese"],"test":[],"treatment":[],"problem_indices_start":[0,19],"problem_indices_end":[13,24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"total abdominal hysterectomy , bilateral salpingo oophorectomy 2-19-91 by dr. lako coma .","problem":[],"test":[],"treatment":["bilateral salpingo oophorectomy","total abdominal hysterectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,31],"treatment_indices_end":[28,62]}
{"text":"accordingly she presents for operative therapy at this time .","problem":[],"test":[],"treatment":["operative therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[46]}
{"text":"she had a normal abdominal exploration of a small uterus with superficial invasion on gross examination , normal ovaries .","problem":["superficial invasion"],"test":["a normal abdominal exploration","gross examination"],"treatment":[],"problem_indices_start":[62],"problem_indices_end":[82],"test_indices_start":[8,86],"test_indices_end":[38,103],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"endometrial cancer .","problem":["endometrial cancer"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pelvic exam showed a small mobile uterus .","problem":[],"test":["pelvic exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a subfascial j-p was left .","problem":[],"test":[],"treatment":["a subfascial j-p"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"the patient 's postoperative hct was 34 .","problem":[],"test":["postoperative hct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[37],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was brought to the operating room on 2-19-91 where she had an exploratory laparotomy , tah \/ bso , and omental biopsy .","problem":[],"test":["omental biopsy","an exploratory laparotomy"],"treatment":["tah \/ bso"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[71,115],"test_indices_end":[96,129],"treatment_indices_start":[99],"treatment_indices_end":[108]}
{"text":"this is an 81-year-old who presented with postmenopausal spotting and had an endometrial biopsy which was read at the etearal etsystems\/ hospital as showing grade i adenocarcinoma .","problem":["grade i adenocarcinoma","postmenopausal spotting"],"test":["an endometrial biopsy"],"treatment":[],"problem_indices_start":[42,157],"problem_indices_end":[65,179],"test_indices_start":[74],"test_indices_end":[95],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extremities show no edema .","problem":["edema"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"washings were sent .","problem":[],"test":["washings"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"subfascia drain was discontinued .","problem":[],"test":[],"treatment":["subfascia drain"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"on standing , she tended to fall to the front , back or sides without trying to stop her fall initially , and extensive gait testing was deferred due to concerns for safety .","problem":[],"test":["extensive gait testing"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[110],"test_indices_end":[132],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coordination - toe tap was slow bilaterally , although difficult to reproduce , and at best , was essentially within normal limits .","problem":["slow bilaterally"],"test":["toe tap"],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[43],"test_indices_start":[15],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her lungs were clear to auscultation bilaterally .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was admitted for her gait disorder with other notable findings on examination including anisocoria , which , by the patient 's report , had been noted several months earlier .","problem":["her gait disorder","anisocoria","notable findings"],"test":["examination"],"treatment":[],"problem_indices_start":[29,58,100],"problem_indices_end":[46,74,110],"test_indices_start":[78],"test_indices_end":[89],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on the second hospital day , her gait continued to be markedly unstable , although with no consistent pattern in terms of weakness or directionality of falling , and she continued to have no reproducible upper extremity or lower extremity ataxia or dysmetria .","problem":["markedly unstable","her gait","weakness","dysmetria","reproducible upper extremity or lower extremity ataxia"],"test":[],"treatment":[],"problem_indices_start":[29,54,122,191,249],"problem_indices_end":[37,71,130,245,258],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had been placed on heparin initially , but this was discontinued after the magnetic resonance imaging results were obtained .","problem":[],"test":["the magnetic resonance imaging"],"treatment":["heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[75],"test_indices_end":[105],"treatment_indices_start":[23],"treatment_indices_end":[30]}
{"text":"the psychiatrist also noted the indifference the patient evinced regarding her own symptomatology .","problem":["her own symptomatology"],"test":[],"treatment":[],"problem_indices_start":[75],"problem_indices_end":[97],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the subsequent two days , she had several small spells of " imbalance " , particularly towards the right , and other symptoms included diffuse and mainly frontal headaches and mild neck soreness .","problem":["other symptoms","diffuse and mainly frontal headaches","mild neck soreness","small spells of " imbalance"],"test":[],"treatment":[],"problem_indices_start":[45,124,148,189],"problem_indices_end":[77,138,184,207],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her doxepin has recently been increased .","problem":[],"test":[],"treatment":["her doxepin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"a magnetic resonance imaging and magnetic resonance angiogram study was obtained , which showed no clear evidence of arterial dissections or infarction or other pathologic processes .","problem":["infarction","other pathologic processes","arterial dissections"],"test":["magnetic resonance angiogram study","a magnetic resonance imaging"],"treatment":[],"problem_indices_start":[117,141,155],"problem_indices_end":[137,151,181],"test_indices_start":[0,33],"test_indices_end":[28,67],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her extremities were without clubbing , cyanosis , edema , or rash ; there were some older hematomas in the bilaterally shins .","problem":["hematomas in the bilaterally shins","clubbing","cyanosis","edema","rash"],"test":[],"treatment":[],"problem_indices_start":[29,40,51,62,91],"problem_indices_end":[37,48,56,66,125],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no diplopia , visual loss , speech abnormality or sensory change in her history .","problem":["diplopia","speech abnormality","sensory change","visual loss"],"test":[],"treatment":[],"problem_indices_start":[13,24,38,60],"problem_indices_end":[21,35,56,74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her erythrocyte sedimentation rate was 12 .","problem":[],"test":["her erythrocyte sedimentation rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her heel-to-shin and finger-to-nose testing was fully intact bilaterally without ataxia or tremor .","problem":["ataxia","tremor"],"test":["her heel-to-shin and finger-to-nose testing"],"treatment":[],"problem_indices_start":[81,91],"problem_indices_end":[87,97],"test_indices_start":[0],"test_indices_end":[43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had slightly slow fine finger motility approximately equal bilaterally , although this was extremely difficult to reproduce .","problem":["slightly slow fine finger motility"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was not felt to be acutely suicidal or otherwise in need of acute psychiatric treatment .","problem":["acutely suicidal"],"test":[],"treatment":["acute psychiatric treatment"],"problem_indices_start":[23],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[64],"treatment_indices_end":[91]}
{"text":"motor examination revealed 5\/5 power in all groups in the proximal and distal upper and lower extremities .","problem":[],"test":["motor examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was in her usual state of health until 3\/20\/97 when she experienced the fairly sudden onset of predominantly right-sided arm and leg weakness and ataxia .","problem":["right-sided arm and leg weakness","ataxia"],"test":[],"treatment":[],"problem_indices_start":[113,150],"problem_indices_end":[145,156],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her coagulation parameters were normal .","problem":[],"test":["her coagulation parameters"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there were no carotid or cervical bruits .","problem":["carotid or cervical bruits"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was evaluated in one of the neurology conferences for several hours , and during this time , showed significant improvement while receiving gait training as well as evaluation ; in particular , she became more stable with counter-balancing methods .","problem":[],"test":["evaluation"],"treatment":["gait training","counter-balancing methods"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[177],"test_indices_end":[187],"treatment_indices_start":[152,234],"treatment_indices_end":[165,259]}
{"text":"there was no nystagmus and no ptosis .","problem":["nystagmus","ptosis"],"test":[],"treatment":[],"problem_indices_start":[13,30],"problem_indices_end":[22,36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was pleasant , in no acute distress ; blood pressure 130\/60 ; heart rate 66 ; respirations 18 ; temperature 98 .","problem":["acute distress"],"test":["temperature","blood pressure","respirations","heart rate"],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[39],"test_indices_start":[42,66,82,100],"test_indices_end":[56,76,94,111],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 31-year-old right-handed female with right-sided greater than left-sided weakness and difficulty walking for several days .","problem":["difficulty walking","right-sided greater than left-sided weakness"],"test":[],"treatment":[],"problem_indices_start":[54,103],"problem_indices_end":[98,121],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"is notable for depression , and she has been followed regularly by dr. freiermchird of nash health for several months with pharmacologic treatment , which is apparently working well .","problem":["depression"],"test":[],"treatment":["pharmacologic treatment"],"problem_indices_start":[15],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[123],"treatment_indices_end":[146]}
{"text":"gait disorder .","problem":["gait disorder"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"were unremarkable with normal electrolytes and complete blood count parameters .","problem":[],"test":["complete blood count parameters","electrolytes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[30,47],"test_indices_end":[42,78],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"reflexes were 2+ throughout in the upper and lower extremities , and toes were downgoing .","problem":[],"test":["reflexes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her affect was slightly inappropriate at times ; for example , singing or humming along while performing some of the motor tasks and giving the impression of indifference to the deficits that were demonstrated on the examination .","problem":["singing or humming along","slightly inappropriate","the deficits","indifference"],"test":["the examination","the motor tasks"],"treatment":[],"problem_indices_start":[15,63,158,174],"problem_indices_end":[37,87,170,186],"test_indices_start":[113,213],"test_indices_end":[128,228],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was seen by the psychiatry service .","problem":[],"test":[],"treatment":["psychiatry service"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[38]}
{"text":"head ct scan without contrast showed normal brain parenchyma and no intracranial process .","problem":["intracranial process"],"test":["head ct scan without contrast"],"treatment":[],"problem_indices_start":[68],"problem_indices_end":[88],"test_indices_start":[0],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"posterior transcranial doppler studies showed normal studies of both vertebral arteries , and carotid non-invasive studies showed normal right and left carotid bifurcations .","problem":[],"test":["carotid non-invasive studies","posterior transcranial doppler studies"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,94],"test_indices_end":[38,122],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she evidently recovered from the episode after a number of minutes .","problem":["the episode"],"test":[],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"quinine gives her a rash .","problem":["a rash"],"test":[],"treatment":["quinine"],"problem_indices_start":[18],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"there was no drift .","problem":["drift"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no jaw jerk and no hoffman 's sign .","problem":["jaw jerk"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she will continue on her previous outpatient medical regimen .","problem":[],"test":[],"treatment":["her previous outpatient medical regimen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[60]}
{"text":"the only medications she is on are paxil 30 mg p.o. q.day , doxepin 25 mg p.o. q.day , and klonopin 2 mg p.o. q.h.s.","problem":[],"test":[],"treatment":["medications","doxepin","klonopin","paxil"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9,35,60,91],"treatment_indices_end":[20,40,67,99]}
{"text":"gait disorder .","problem":["gait disorder"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had a normal s1 and s2 and regular rate and rhythm with no murmurs .","problem":["murmurs"],"test":[],"treatment":[],"problem_indices_start":[63],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she is status post appendectomy and otherwise has no remarkable past medical history .","problem":[],"test":[],"treatment":["appendectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[31]}
{"text":"the following day , she remained in bed through essentially all of the day due to malaise with no specific deficits being noted .","problem":["malaise","specific deficits"],"test":[],"treatment":[],"problem_indices_start":[82,98],"problem_indices_end":[89,115],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct scan shows ovarian cyst","problem":["ovarian cyst"],"test":["ct scan"],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[26],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vicodin","problem":[],"test":[],"treatment":["vicodin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"abd pain\/ pelvic pain","problem":["pelvic pain","abd pain\/"],"test":[],"treatment":[],"problem_indices_start":[0,10],"problem_indices_end":[9,21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if you have continued fevers , worsening abdominal pain , discharge or other worrisome symptoms , please return to the emergency department .","problem":["worsening abdominal pain","other worrisome symptoms","discharge","fevers"],"test":[],"treatment":[],"problem_indices_start":[22,31,58,71],"problem_indices_end":[28,55,67,95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdominal pain treatment rendered :","problem":["abdominal pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given printed instructions for abdominal pain ( english ) .","problem":["abdominal pain"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following evaluation and treatment , the patient 's disposition at the end of the visit was admitted as an inpatient to fairm of ijordcompmac hospital .","problem":[],"test":["evaluation"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[20],"treatment_indices_start":[25],"treatment_indices_end":[34]}
{"text":"the patient presented with a chief complaint of sdh .","problem":["sdh"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's preliminary admitting physician is glyncred , nabeth n and the preliminary diagnosis is sdh .","problem":["sdh"],"test":[],"treatment":[],"problem_indices_start":[108],"problem_indices_end":[111],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"iv abx","problem":[],"test":[],"treatment":["iv abx"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"colace ( docusate sodium ) 100 mg po bid ibuprofen 600 mg po q6h prn pain aldomet ( methyldopa ) 250 mg po bid percocet 1-2 tab po q4h prn pain","problem":["pain"],"test":[],"treatment":["colace ( docusate sodium )","ibuprofen","aldomet ( methyldopa )","percocet"],"problem_indices_start":[139],"problem_indices_end":[143],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,41,74,111],"treatment_indices_end":[26,50,96,119]}
{"text":"no heavy lifting ; nothing in the vagina for 6 weeks -- no intercourse , no douching , no tampons ; call for fever above 100.5 , worsening abdominal pain , heavy bleeding , or any other concern ; no driving while taking percocet","problem":["heavy bleeding","worsening abdominal pain","any other concern","fever above 100.5"],"test":[],"treatment":["percocet"],"problem_indices_start":[109,129,156,176],"problem_indices_end":[126,153,170,193],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[220],"treatment_indices_end":[228]}
{"text":"12\/02\/03 03:20 pm apgars 7,8","problem":[],"test":["apgars"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[18],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"your obstetrician 6 weeks , no known allergies","problem":["known allergies"],"test":[],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"attending evaluation","problem":[],"test":["attending evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"principal discharge diagnosis ; responsible after study for causing admission ) s \/ p cesarean","problem":[],"test":[],"treatment":["cesarean"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[86],"treatment_indices_end":[94]}
{"text":"epidural vaginal delivery :","problem":[],"test":[],"treatment":["epidural"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"no observed abnormalities","problem":["observed abnormalities"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"s \/ p cesarean","problem":[],"test":[],"treatment":["cesarean"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6],"treatment_indices_end":[14]}
{"text":"other diagnosis ; conditions , infections , complications , affecting treatment \/ stay s \/ p cesarean","problem":[],"test":[],"treatment":["cesarean"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[93],"treatment_indices_end":[101]}
{"text":"non-reassuring fetal status , uterine","problem":["non-reassuring fetal status"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"s \/ p cesarean","problem":[],"test":[],"treatment":["cesarean"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6],"treatment_indices_end":[14]}
{"text":", other - bradycardia","problem":["bradycardia"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"weight :","problem":[],"test":["weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"post dates","problem":["post dates"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please use ice to sore areas for the next few days .","problem":["sore areas"],"test":[],"treatment":["ice"],"problem_indices_start":[18],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[11],"treatment_indices_end":[14]}
{"text":"xray - no evidence of fracture","problem":["fracture"],"test":["xray"],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[30],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"motrin 600 mg every 8 hours for pain - please take with food in your stomach","problem":["pain"],"test":[],"treatment":["motrin"],"problem_indices_start":[32],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"s \/ p motor vehicle accident , muscle contusions","problem":["muscle contusions"],"test":[],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given printed instructions for sprains , fractures and bruises ( english ) .","problem":["bruises","fractures","sprains"],"test":[],"treatment":[],"problem_indices_start":[47,57,71],"problem_indices_end":[54,66,78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given printed instructions for motor vehicle accident - trauma ( english ) .","problem":["trauma"],"test":[],"treatment":[],"problem_indices_start":[72],"problem_indices_end":[78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if you develop trouble breathing , worsening pain , vomiting or any other concerns please return to the ed for further evaluation .","problem":["worsening pain","any other concerns","trouble breathing","vomiting"],"test":["further evaluation"],"treatment":[],"problem_indices_start":[15,35,52,64],"problem_indices_end":[32,49,60,82],"test_indices_start":[111],"test_indices_end":[129],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient walked with her feet externally rotated with a wide based gait with shuffling short steps with a tendency to fall back and she was unable to walk without assist .","problem":["a tendency to fall back","a wide based gait","shuffling short steps","her feet externally rotated"],"test":[],"treatment":[],"problem_indices_start":[24,57,80,107],"problem_indices_end":[51,74,101,130],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"csf tube labeled # 4 was notable for csf color pink , csf turbidity slight , csf xanthochromia yes , csf rbcs 3,900 , csf white blood cells 3 , csf neutrophils 61 , csf bands 3 , csf lymphs 31 , csf monos 1 , csf eos 3 , csf basos 1 .","problem":[],"test":["csf monos","csf neutrophils","csf eos","csf basos","csf white blood cells","csf bands","csf turbidity","csf rbcs","csf xanthochromia","csf lymphs","csf color","csf tube labeled # 4"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,37,54,77,101,118,144,165,179,195,209,221],"test_indices_end":[20,46,67,94,109,139,159,174,189,204,216,230],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is a 44 year-old right handed woman with down 's syndrome who presents with increased falling and gait unsteadiness and an increased inability to perform her activities of daily living over the past three years .","problem":["increased falling","down 's syndrome","gait unsteadiness","an increased inability"],"test":[],"treatment":[],"problem_indices_start":[46,86,108,130],"problem_indices_end":[67,103,125,152],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tube and requisition of the csf labeled tube # 1 was notable for color pink , turbidity slight , xanthochromia yes , red blood cells 3,800 , white blood cells 3 , neutrophils 58 , bands 4 , lymphs 29 , monos 6 , eos 2 and basos 1 .","problem":[],"test":["neutrophils","white blood cells","eos","red blood cells","bands","color","turbidity","lymphs","xanthochromia","csf labeled tube # 1","monos","basos"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[28,65,78,97,117,141,163,180,190,202,212,222],"test_indices_end":[48,70,87,110,132,158,174,185,196,207,215,227],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdominal examination was soft , non-tender , positive bowel sounds .","problem":["non-tender"],"test":["abdominal examination"],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[43],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her mental status remained similarly to her admission examination .","problem":[],"test":["her admission examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[40],"test_indices_end":[65],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"notable for decreased ability to do her activities of daily living , a decrease in her language , some urinary accidents , increased falls and a poor gait .","problem":["some urinary accidents","a decrease in her language","a poor gait","increased falls","decreased ability"],"test":[],"treatment":[],"problem_indices_start":[12,69,98,123,143],"problem_indices_end":[29,95,120,138,154],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"notable for down 's syndrome , altzheimer 's disease secondary to down 's syndrome diagnosed in 1998 , status post multiple falls , no heart disease , ankle surgery and an abnormal eeg .","problem":["heart disease","altzheimer 's disease","down 's syndrome","down 's syndrome","an abnormal eeg","multiple falls"],"test":[],"treatment":["ankle surgery"],"problem_indices_start":[12,36,76,130,150,184],"problem_indices_end":[33,62,97,144,163,199],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[166],"treatment_indices_end":[179]}
{"text":"opening pressure was 17 and approximately 20-25 cc of csf was removed .","problem":[],"test":["opening pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"reflexes were 2+ bilaterally with down going toes .","problem":[],"test":["reflexes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"because of poor compliance with the gait examination it was very difficult to assess changing gait post lumbar puncture .","problem":["changing gait"],"test":["the gait examination","lumbar puncture"],"treatment":[],"problem_indices_start":[85],"problem_indices_end":[98],"test_indices_start":[32,104],"test_indices_end":[52,119],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on hospital day the patient underwent conscious sedation in the operating room where lumbar puncture was performed .","problem":[],"test":["lumbar puncture"],"treatment":["conscious sedation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[85],"test_indices_end":[100],"treatment_indices_start":[38],"treatment_indices_end":[56]}
{"text":"the fluid culture was no growth to date .","problem":[],"test":["the fluid culture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"include lamictal 50 mgs bid , aricept 10 mgs qhs , buspar 15 mgs bid , trazodone 100 mgs qhs .","problem":[],"test":[],"treatment":["lamictal","aricept","trazodone","buspar"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[8,30,51,71],"treatment_indices_end":[16,37,57,80]}
{"text":"the patient had back folliculitis .","problem":["back folliculitis"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's neuro examination was largely unchanged from the admission neuro examination .","problem":[],"test":["the patient 's neuro examination","the admission neuro examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,65],"test_indices_end":[37,96],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on the night of admission lumbar puncture was attempted on the floor , but we were unable to get cerebral spinal fluid due to difficulty with compliance with the patient who was severely agitated and would not comply with the examination .","problem":["severely agitated"],"test":["the examination","lumbar puncture"],"treatment":[],"problem_indices_start":[178],"problem_indices_end":[195],"test_indices_start":[26,222],"test_indices_end":[41,237],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent examination is notable for bilateral esotropia .","problem":["bilateral esotropia"],"test":["heent examination"],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[52],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest was clear to auscultation .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"csf gram stain was notable for no polys and no organisms seen .","problem":["organisms","polys"],"test":["csf gram stain"],"treatment":[],"problem_indices_start":[34,47],"problem_indices_end":[39,56],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"noted for friendly , jovial 44 year-old woman with down 's .","problem":["down 's"],"test":[],"treatment":[],"problem_indices_start":[51],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"csf was notable for sugar level of 65 and total protein level of 56 .","problem":[],"test":["total protein level","csf","sugar level"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,20,42],"test_indices_end":[3,31,61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac examination was regular rate and rhythm .","problem":[],"test":["cardiac examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there are no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"one day prior to lumbar puncture , an aerobic culture was similarly pending .","problem":[],"test":["an aerobic culture","lumbar puncture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17,35],"test_indices_end":[32,53],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lyme capture was pending and at the time of discharge .","problem":[],"test":["lyme capture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had an mri at an outside hospital which showed enlarged lateral ventricles and the possible diagnosis of normal pressure hydrocephalus was entertained and the patient was admitted for diagnostic lumbar puncture .","problem":["enlarged lateral ventricles","normal pressure hydrocephalus"],"test":["an mri","diagnostic lumbar puncture"],"treatment":[],"problem_indices_start":[59,117],"problem_indices_end":[86,146],"test_indices_start":[16,196],"test_indices_end":[22,222],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the diagnosis of alzheimer 's was made in 1998 .","problem":["alzheimer 's"],"test":[],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cranial nerves notable for bilateral esotropia .","problem":["bilateral esotropia"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood pressure 150\/82 , heart rate 88 , respiratory rate 18 .","problem":[],"test":["blood pressure","respiratory rate","heart rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,24,40],"test_indices_end":[14,34,56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is a 44 year-old right handed woman with down 's syndrome who presents with falling and a decrease in her activities of daily living .","problem":["down 's syndrome","falling","a decrease in her activities"],"test":[],"treatment":[],"problem_indices_start":[46,86,98],"problem_indices_end":[67,93,126],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vitamin b12 of 855 , folic acid of 15.4 .","problem":[],"test":["folic acid","vitamin b12"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,21],"test_indices_end":[11,31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rpr card test was negative .","problem":[],"test":["rpr card test"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mri , as discussed , was done at outside hospital and demonstrated large ventricles .","problem":["large ventricles"],"test":["mri"],"treatment":[],"problem_indices_start":[67],"problem_indices_end":[83],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left ankle was notable for swelling secondary to status post left ankle surgery .","problem":["swelling"],"test":[],"treatment":["left ankle surgery"],"problem_indices_start":[27],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61],"treatment_indices_end":[79]}
{"text":"the patient was admitted to the arkzie- memorial for lumbar puncture .","problem":[],"test":["lumbar puncture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[53],"test_indices_end":[68],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chem-7 was within normal limits .","problem":[],"test":["chem-7"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neuro examination was notable for a patient who was alert and oriented x 1 .","problem":[],"test":["neuro examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"alzheimer 's disease secondary to down 's syndrome .","problem":["down 's syndrome","alzheimer 's disease"],"test":[],"treatment":[],"problem_indices_start":[0,39],"problem_indices_end":[25,60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pregnancy , term","problem":["pregnancy , term"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"docusate sodium 100 mg po bid prn constipation ibuprofen 400-600 mg po q6h prn pain","problem":["constipation","pain"],"test":[],"treatment":["docusate sodium","ibuprofen"],"problem_indices_start":[34,79],"problem_indices_end":[46,83],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,47],"treatment_indices_end":[15,56]}
{"text":"perineal , 1st degree","problem":["perineal , 1st degree"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"take with food prenatal multivitamins ( stuartnatal ) 1 tab po qd maalox-tablets quick dissolve \/ chewable 1-2 tab po q6h prn upset stomach","problem":["upset stomach"],"test":[],"treatment":["maalox-tablets quick dissolve \/ chewable","prenatal multivitamins ( stuartnatal )"],"problem_indices_start":[126],"problem_indices_end":[139],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15,66],"treatment_indices_end":[53,106]}
{"text":"cnm evaluation","problem":[],"test":["cnm evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no observed abnormalities","problem":["observed abnormalities"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"repair of first degree perineal laceration","problem":["first degree perineal laceration"],"test":[],"treatment":["repair"],"problem_indices_start":[10],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"weight :","problem":[],"test":["weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"laceration :","problem":["laceration"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"apgars 9,9","problem":[],"test":["apgars"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was flaccid bilaterally .","problem":["flaccid bilaterally"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"consent for autopsy was denied .","problem":[],"test":["autopsy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. residual of previous right middle cerebral artery stroke .","problem":["previous right middle cerebral artery stroke"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he remained unresponsive with poor airway protection .","problem":["poor airway protection","unresponsive"],"test":[],"treatment":[],"problem_indices_start":[12,30],"problem_indices_end":[24,52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was at orlak on the day of admission and was found unresponsive with left tonic-clonic movements , greater in the arms than in the legs .","problem":["unresponsive","left tonic-clonic movements"],"test":[],"treatment":[],"problem_indices_start":[54,72],"problem_indices_end":[66,99],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the right upper extremity was flaccid and paresthetic .","problem":["paresthetic","flaccid"],"test":[],"treatment":[],"problem_indices_start":[30,42],"problem_indices_end":[37,53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had stertorous breathing , positional tremors of the left upper extremity , a spastic left hemiparesis in flexion .","problem":["positional tremors of the left upper extremity","stertorous breathing","a spastic left hemiparesis in flexion"],"test":[],"treatment":[],"problem_indices_start":[7,30,79],"problem_indices_end":[27,76,116],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at 1:15 pm on 10\/06\/94 , the patient was found unresponsive with no heart sounds , carotid pulse , respiratory excursions , or pupillary reactions .","problem":["carotid pulse","unresponsive","heart sounds","respiratory excursions","pupillary reactions"],"test":[],"treatment":[],"problem_indices_start":[47,68,83,99,127],"problem_indices_end":[59,80,96,121,146],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was transferred to fairm of ijordcompmac hospital , where seizures were stopped with 2 mg of ativan .","problem":["seizures"],"test":[],"treatment":["ativan"],"problem_indices_start":[61],"problem_indices_end":[69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[96],"treatment_indices_end":[102]}
{"text":"he had no carotid bruits .","problem":["carotid bruits"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was loaded with iv dilantin .","problem":[],"test":[],"treatment":["iv dilantin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[30]}
{"text":"he had no oculocephalic reflexes .","problem":["oculocephalic reflexes"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this 85 year old man was admitted because of the new onset of focal left-sided seizure and unresponsiveness .","problem":["unresponsiveness","focal left-sided seizure"],"test":[],"treatment":[],"problem_indices_start":[62,91],"problem_indices_end":[86,107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had a past history of ischemic cardiomyopathy with an ejection fraction of 10 , mild aortic stenosis and a right middle cerebral artery territory stroke in 07\/94 .","problem":["mild aortic stenosis","ischemic cardiomyopathy","a right middle cerebral artery territory stroke"],"test":["an ejection fraction"],"treatment":[],"problem_indices_start":[25,83,108],"problem_indices_end":[48,103,155],"test_indices_start":[54],"test_indices_end":[74],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after one hour his eyes were midline and he remained unresponsive .","problem":["unresponsive"],"test":[],"treatment":[],"problem_indices_start":[53],"problem_indices_end":[65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he withdrew both legs to painful stimuli .","problem":[],"test":["painful stimuli"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[25],"test_indices_end":[40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an electroencephalogram revealed generalized slowing without ictal events .","problem":["generalized slowing without ictal events"],"test":["an electroencephalogram"],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[73],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. left middle cerebral artery territory cerebral infarction .","problem":["left middle cerebral artery territory cerebral infarction"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. cardiomyopathy .","problem":["cardiomyopathy"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"routine post partum care","problem":[],"test":[],"treatment":["routine post partum care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"active labor","problem":["active labor"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"height 49 heent normal mouth normal neck normal breasts normal nipples normal chest normal cor normal abdomen normal gravid , + fhr , nt extrem normal skin normal nodes normal vulva normal vagina normal cervix normal 4-5\/100% os normal closed , firm , -cmt adnexae normal uterus normal term 7-7.5 # vtx uterine size in weeks normal term","problem":[],"test":["heent","height"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10],"test_indices_end":[6,15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vacuum extraction","problem":[],"test":[],"treatment":["vacuum extraction"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[17]}
{"text":"active labor .","problem":["active labor"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abnormal pap test , history of","problem":["abnormal pap test"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she delivered a 3263 gram female infant at 06\/14\/2001 at 06:40 pm with apgar scores of 8 and 8 at one and five minutes respectively at 40.3 weeks gestation via vacuum extraction .","problem":[],"test":["apgar scores"],"treatment":["vacuum extraction"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[71],"test_indices_end":[83],"treatment_indices_start":[160],"treatment_indices_end":[177]}
{"text":"abnormal fetal heart rate \/ rhythm - delivered","problem":["abnormal fetal heart rate \/ rhythm"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"fetal bradycardia .","problem":["fetal bradycardia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nuchal cord , times two .","problem":["nuchal cord"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient presents now for right modified radical mastectomy with impant .","problem":[],"test":[],"treatment":["impant","right modified radical mastectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29,68],"treatment_indices_end":[62,74]}
{"text":"this is an 81 year old female with a right breast mass with a discharge .","problem":["a right breast mass","a discharge"],"test":[],"treatment":[],"problem_indices_start":[35,60],"problem_indices_end":[54,71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the fall of 1991 , nipple changes and discomfort was again noted .","problem":["nipple changes","discomfort"],"test":[],"treatment":[],"problem_indices_start":[22,41],"problem_indices_end":[36,51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on the left , there was a new shawdown but the biopsy was negative .","problem":["a new shawdown"],"test":["the biopsy"],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[38],"test_indices_start":[43],"test_indices_end":[53],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"two drains were used .","problem":[],"test":[],"treatment":["two drains"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"discharge medications include percocet and colace .","problem":[],"test":[],"treatment":["discharge medications","percocet","colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,30,43],"treatment_indices_end":[21,38,49]}
{"text":"clear lungs , normal heart , pagett 's type changes on the right breast and left breast without apparent masses with scarring supra-areolar and infra-areolar .","problem":["apparent masses","scarring supra-areolar and infra-areolar"],"test":["pagett 's"],"treatment":[],"problem_indices_start":[101,122],"problem_indices_end":[116,162],"test_indices_start":[29],"test_indices_end":[43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"one drain was removed on postoperative day number two , and the second drain she will be discharged to home with .","problem":[],"test":[],"treatment":["one drain","the second drain"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,60],"treatment_indices_end":[9,76]}
{"text":"a mammogram of the right breast with shadow biopsy was negative .","problem":[],"test":["a mammogram of the right breast","shadow biopsy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,37],"test_indices_end":[31,50],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a biopsy scar on the right breast from 1990 .","problem":["a biopsy scar on the right breast"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"subsequently a saline-filled right breast implant was performed .","problem":[],"test":[],"treatment":["a saline-filled right breast implant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[49]}
{"text":"the patient was taken to the operting room on 8\/7\/92 , where a right modified radical mastectomy was performed .","problem":[],"test":[],"treatment":["a right modified radical mastectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61],"treatment_indices_end":[96]}
{"text":"a mmamogram showed no change on right , but new biopsy was positive .","problem":[],"test":["a mmamogram","new biopsy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,44],"test_indices_end":[11,54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient tolerated the procedure extremely well .","problem":[],"test":[],"treatment":["the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[35]}
{"text":"the patient will be followed at rehabilitation by her primary care physician , dr. both .","problem":[],"test":[],"treatment":["rehabilitation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32],"treatment_indices_end":[46]}
{"text":"the patient was evaluated by the surgical service who felt that the wound was clean with some erythema but without evidence of true cellulitis .","problem":["the wound","some erythema","true cellulitis"],"test":[],"treatment":[],"problem_indices_start":[64,89,127],"problem_indices_end":[73,102,142],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a neurological examination was performed which revealed no abnormality and imaging included a head scan which revealed no bleed and a cervical spine series which revealed degenerative joint disease but no obvious fracture .","problem":["abnormality","degenerative joint disease","obvious fracture","bleed"],"test":["a neurological examination","a cervical spine series","imaging","a head scan"],"treatment":[],"problem_indices_start":[59,122,171,205],"problem_indices_end":[70,127,197,221],"test_indices_start":[0,75,92,132],"test_indices_end":[26,82,103,155],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"11) axid 150 mg p.o. b.i.d.","problem":[],"test":[],"treatment":["axid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[8]}
{"text":"7) history of colitis .","problem":["colitis"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1) aortic stenosis , severe , echocardiogram in july of 1998 with a peak gradient of 6-8 mm of mercury , aortic valve area calculated to be 0.5 cm squared by the continuity equation .","problem":["aortic stenosis , severe"],"test":["aortic valve area","echocardiogram","continuity equation","a peak gradient"],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[27],"test_indices_start":[30,66,105,162],"test_indices_end":[44,81,122,181],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no s3 appreciated .","problem":["s3"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sodium was 142 , potassium 3.3 , chloride 99 , bun 23 , creatinine 1.1 .","problem":[],"test":["creatinine","bun","sodium","chloride","potassium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,17,33,47,56],"test_indices_end":[6,26,41,50,66],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's coumadin was continued .","problem":[],"test":[],"treatment":["the patient 's coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[28]}
{"text":"the patient has a history of severe aortic stenosis and was recently admitted to the retelk county medical center for a nafcillin sensitive staphylococcus aureus cellulitis of the right leg treated with a course of nafcillin and levofloxacin .","problem":["nafcillin sensitive staphylococcus aureus cellulitis of the right leg","severe aortic stenosis"],"test":[],"treatment":["levofloxacin","a course of nafcillin"],"problem_indices_start":[29,120],"problem_indices_end":[51,189],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[203,229],"treatment_indices_end":[224,241]}
{"text":"13) zyrtec 10 mg p.o. q. day .","problem":[],"test":[],"treatment":["zyrtec"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"a neurologic work-up was undertaken which included a ct scan of the head which revealed no acute bleed and a lumbar puncture which revealed a glucose of 72 , protein 65 , white blood cell count 19 , red blood cell count 11,500 with no evidence of xanthrochromasia .","problem":["acute bleed","xanthrochromasia"],"test":["a neurologic work-up","a glucose","protein","red blood cell count","a ct scan of the head","white blood cell count","a lumbar puncture"],"treatment":[],"problem_indices_start":[91,247],"problem_indices_end":[102,263],"test_indices_start":[0,51,107,140,158,171,199],"test_indices_end":[20,72,124,149,165,193,219],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hematocrit was 33.0 , platelet count 627 , white blood cell count 10,000 , mcv 79.8 .","problem":[],"test":["mcv","white blood cell count","platelet count","hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,22,43,75],"test_indices_end":[10,36,65,78],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has a history of critical aortic stenosis and mitral regurgitation .","problem":["mitral regurgitation","critical aortic stenosis"],"test":[],"treatment":[],"problem_indices_start":[29,58],"problem_indices_end":[53,78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"calculated ejection fraction was 45-50% .","problem":[],"test":["calculated ejection fraction"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vascular examination was notable for 1+ carotid impulses which were diminished and delayed and the above mentioned transmitted cardiac murmurs .","problem":["1+ carotid impulses","transmitted cardiac murmurs"],"test":["vascular examination"],"treatment":[],"problem_indices_start":[37,115],"problem_indices_end":[56,142],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mental status changes .","problem":["mental status changes"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a head ct scan and cervical spine series were negative .","problem":[],"test":["a head ct scan","cervical spine series"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,19],"test_indices_end":[14,40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mental status change , cellulitis","problem":["mental status change","cellulitis"],"test":[],"treatment":[],"problem_indices_start":[0,23],"problem_indices_end":[20,33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urinalysis revealed trace microscopic hematuria with 47 red blood cells per high powered field , 1+ bacteria .","problem":["trace microscopic hematuria","1+ bacteria"],"test":["urinalysis"],"treatment":[],"problem_indices_start":[20,97],"problem_indices_end":[47,108],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heart rate 60 , respiratory rate 18 , blood pressure 116\/80 , temperature 97.1 degrees , oxygen saturation 93% on room air .","problem":[],"test":["temperature","respiratory rate","blood pressure","oxygen saturation","heart rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,38,62,89],"test_indices_end":[10,32,52,73,106],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head ct scan performed in the emergency department revealed no bleed .","problem":["bleed"],"test":["head ct scan"],"treatment":[],"problem_indices_start":[63],"problem_indices_end":[68],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ast was 25 , alkaline phosphatase 130 , total bilirubin 3.2 , albumin 3.4 , calcium 8.8 .","problem":[],"test":["albumin","alkaline phosphatase","calcium","ast","total bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,40,62,76],"test_indices_end":[3,33,55,69,83],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"digoxin level was 0.8 .","problem":[],"test":["digoxin level"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6) abnormal liver function tests :","problem":["abnormal liver function tests"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is an 88 year-old woman undergoing treatment for a right lower extremity cellulitis who was transferred from child for worsening cellulitis and new confusion .","problem":["a right lower extremity cellulitis","worsening cellulitis","new confusion"],"test":[],"treatment":["treatment"],"problem_indices_start":[61,131,156],"problem_indices_end":[95,151,169],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47],"treatment_indices_end":[56]}
{"text":"neurological examination revealed that the patient was quite sedated at this time having received some medications .","problem":["quite sedated"],"test":["neurological examination"],"treatment":["medications"],"problem_indices_start":[55],"problem_indices_end":[68],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[103],"treatment_indices_end":[114]}
{"text":"the heart examination revealed that the patient had a sustained pmi which was located in the left mid clavicular line , s1 , near complete obliteration of the second heart sound by a two out of six high pitched murmur peaking at mid to late systole and heard across the precordium .","problem":["a two out of six high pitched murmur","a sustained pmi","near complete obliteration of the second heart sound"],"test":["the heart examination"],"treatment":[],"problem_indices_start":[52,125,181],"problem_indices_end":[67,177,217],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5) atrial fibrillation :","problem":["atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10) buspar 5 mg p.o. t.i.d.","problem":[],"test":[],"treatment":["buspar"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"1) aspirin 81 mg p.o. q. day .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"12) buspar 5 mg p.o. t.i.d.","problem":[],"test":[],"treatment":["buspar"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"the patient has a history of congestive heart failure .","problem":["congestive heart failure"],"test":[],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was arousable only to painful stimuli .","problem":[],"test":["painful stimuli"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26],"test_indices_end":[41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coagulation studies revealed a pt of 17.4 seconds with an inr of 2.1 , ptt 25.5 .","problem":[],"test":["coagulation studies","ptt","an inr","pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,31,55,71],"test_indices_end":[19,33,61,74],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's extremity examination was notable for erythema of the right calf with a small ulcer with a relatively clean base .","problem":["a small ulcer","erythema of the right calf"],"test":["the patient 's extremity examination"],"treatment":[],"problem_indices_start":[58,90],"problem_indices_end":[84,103],"test_indices_start":[0],"test_indices_end":[41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdominal examination revealed that the abdomen was soft , non-tender , non-distended , no organomegaly , no masses , normal active bowel sounds .","problem":["masses","non-tender","non-distended","organomegaly"],"test":["abdominal examination"],"treatment":[],"problem_indices_start":[59,72,91,109],"problem_indices_end":[69,85,103,115],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"skin examination was notable for a leg ulcer and cellulitis to be delineated below .","problem":["a leg ulcer","cellulitis"],"test":["skin examination"],"treatment":[],"problem_indices_start":[33,49],"problem_indices_end":[44,59],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head and neck examination was benign .","problem":[],"test":["head and neck examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7) potassium 20 meq p.o. q. day .","problem":[],"test":[],"treatment":["potassium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"neck was supple with no thyromegaly .","problem":["thyromegaly"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the neurology service evaluated the patient who felt that her agitation was most likely due to infection , her multiple medications , or her metabolic condition .","problem":["her agitation","infection","her metabolic condition"],"test":[],"treatment":["her multiple medications"],"problem_indices_start":[58,95,137],"problem_indices_end":[71,104,160],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[107],"treatment_indices_end":[131]}
{"text":"physical examination on admission revealed an elderly woman , sleeping , responsive only to noxious stimuli after having received some sedation in the emergency department .","problem":[],"test":["noxious stimuli","physical examination"],"treatment":["some sedation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,92],"test_indices_end":[20,107],"treatment_indices_start":[130],"treatment_indices_end":[143]}
{"text":"4) history of transient ischemic attack \/ cerebrovascular accident .","problem":["cerebrovascular accident","transient ischemic attack"],"test":[],"treatment":[],"problem_indices_start":[14,42],"problem_indices_end":[39,66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2) mitral regurgitation , 2+ on july of 1998 echocardiogram .","problem":["mitral regurgitation"],"test":["echocardiogram"],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[45],"test_indices_end":[59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3) status post fall .","problem":["fall"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9) amitriptyline 10 mg p.o. q.h.s.","problem":[],"test":[],"treatment":["amitriptyline"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"the patient 's antibiotics were discontinued with the thought that prolonged antibiotics only put her at more risk for infection .","problem":["infection"],"test":[],"treatment":["prolonged antibiotics","antibiotics"],"problem_indices_start":[124],"problem_indices_end":[133],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20,72],"treatment_indices_end":[31,93]}
{"text":"10) levofloxacin 250 mg p.o. q. day .","problem":[],"test":[],"treatment":["levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[16]}
{"text":"1) digoxin 0.125 mg p.o. q. day .","problem":[],"test":[],"treatment":["digoxin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"the patient decided not to pursue further testing with a neck ct scan .","problem":[],"test":["further testing","a neck ct scan"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[34,55],"test_indices_end":[49,69],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had also been noted to be confused and combative during that 24 hour period .","problem":["combative","confused"],"test":[],"treatment":[],"problem_indices_start":[30,43],"problem_indices_end":[38,52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4) zaroxolyn 0.25 mg p.o. q. day .","problem":[],"test":[],"treatment":["zaroxolyn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"2) digoxin 0.125 mg p.o. q. am .","problem":[],"test":[],"treatment":["digoxin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"lungs were clear to auscultation bilaterally .","problem":[],"test":["auscultation bilaterally"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[44],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3) lasix 40 mg p.o. b.i.d.","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"these liver function tests will be followed closely as an outpatient .","problem":[],"test":["these liver function tests"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2) mitral regurgitation .","problem":["mitral regurgitation"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1) aortic stenosis .","problem":["aortic stenosis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2) lasix 80 mg p.o. b.i.d.","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"7) kay ciel 20 meq p.o. q. day .","problem":[],"test":[],"treatment":["kay ciel"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"on admission , the patient was noted to have elevated bilirubins in the 3 range and mildly elevated alkaline phosphatase consistent with a cholestatic picture .","problem":["cholestatic picture","mildly elevated alkaline phosphatase","elevated bilirubins"],"test":[],"treatment":[],"problem_indices_start":[45,84,139],"problem_indices_end":[64,120,158],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9) fosamax 10 mg p.o. q. day .","problem":[],"test":[],"treatment":["fosamax"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"5) right lower extremity wound .","problem":["right lower extremity wound"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on admission to the emergency room , the patient was somewhat argumentative and confused as well as uncooperative with procedures .","problem":["argumentative","uncooperative with procedures","confused"],"test":[],"treatment":[],"problem_indices_start":[62,80,100],"problem_indices_end":[75,88,129],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8) history of vertebral body fractures .","problem":["vertebral body fractures"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4) status post fall :","problem":["fall"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5) zaroxolyn 2.5 mg p.o. q. day .","problem":[],"test":[],"treatment":["zaroxolyn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"3) aspirin 81 mg p.o. q. day .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"4) history of cerebrovascular disease .","problem":["cerebrovascular disease"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3) history of atrial fibrillation .","problem":["atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2) right lower extremity cellulitis :","problem":["right lower extremity cellulitis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8) fosamax 10 mg p.o. q. day .","problem":[],"test":[],"treatment":["fosamax"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"4) coumadin 2 mg p.o. q.h.s.","problem":[],"test":[],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"there was also a blowing holosystolic murmur heard at the patient 's apex to axilla .","problem":["a blowing holosystolic murmur"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was also a right leg fluid collection that was incised and drained on august 1 , 1998 .","problem":["a right leg fluid collection"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6) coumadin 2 mg p.o. q.h.s.","problem":[],"test":[],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"the patient was sent to rehabilitation on levofloxacin orally .","problem":[],"test":[],"treatment":["rehabilitation","levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24,42],"treatment_indices_end":[38,54]}
{"text":"6) history of temporal arteritis on chronic steroids .","problem":["temporal arteritis"],"test":[],"treatment":["chronic steroids"],"problem_indices_start":[14],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36],"treatment_indices_end":[52]}
{"text":"the patient 's admission chest x-ray revealed no infiltrate , no congestive heart failure .","problem":["infiltrate","congestive heart failure"],"test":["the patient 's admission chest x-ray"],"treatment":[],"problem_indices_start":[54,70],"problem_indices_end":[64,94],"test_indices_start":[0],"test_indices_end":[41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5) hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there were no spider angiomata .","problem":["spider angiomata"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient appeared to have no deficits at the time of discharge .","problem":["deficits"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6) atrial fibrillation .","problem":["atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5) prednisone 5 mg p.o. q.o.d.","problem":[],"test":[],"treatment":["prednisone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"she was able to move all four of her extremities in response to pain .","problem":[],"test":["pain"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[64],"test_indices_end":[68],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vital signs :","problem":[],"test":["vital signs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"although details were not available at the time of admission , apparently , she had done well until the 24 hours proceeding admission when the cellulitis was felt to be worsening .","problem":["the cellulitis"],"test":[],"treatment":[],"problem_indices_start":[139],"problem_indices_end":[153],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8) prednisone 5 mg p.o. q.o.d.","problem":[],"test":[],"treatment":["prednisone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"6) toprol xl 50 mg p.o. q. day .","problem":[],"test":[],"treatment":["toprol xl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"her deep tendon reflexes were slightly diminished at 1+ bilaterally , but symmetric .","problem":[],"test":["her deep tendon reflexes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following triage , the patient left without treatment .","problem":[],"test":["triage"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[16],"treatment_indices_start":[44],"treatment_indices_end":[53]}
{"text":"the patient presented with a chief complaint of r thumb injury .","problem":["r thumb injury"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ast 29 , alk 151 , total bilirubin 0.2 , total protein 7.2 , albumin 4.3 , globulins 2.9 , calcium 8.9 .","problem":[],"test":["total protein","total bilirubin","ast","calcium","globulins","alk","albumin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,9,19,41,61,75,91],"test_indices_end":[3,12,34,54,68,84,98],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 68 year old with acute leukemia .","problem":["acute leukemia"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the abdomen was soft , nontender and nondistended with no guarding and no hepatosplenomegaly .","problem":["nondistended","hepatosplenomegaly","guarding","nontender"],"test":[],"treatment":[],"problem_indices_start":[23,37,58,74],"problem_indices_end":[32,49,66,92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient began to experience urinary retention and was straight catheterized .","problem":["urinary retention"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an abdominal mri was performed to assess continued elevated liver enzymes ; however , the mri was negative .","problem":["elevated liver enzymes"],"test":["an abdominal mri","the mri"],"treatment":[],"problem_indices_start":[51],"problem_indices_end":[73],"test_indices_start":[0,86],"test_indices_end":[16,93],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"15) peridex 30 cc p.o. b.i.d. x 14 days .","problem":[],"test":[],"treatment":["peridex"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[11]}
{"text":"no chest pain .","problem":["chest pain"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sodium 138 , potassium 4.2 , chloride 98 , bun 21 , creatinine 0.7 , glucose 117 , white blood cell count 13,200 , hematocrit 22.5 , platelet count 40,000 .","problem":[],"test":["sodium","chloride","creatinine","potassium","hematocrit","glucose","platelet count","bun","white blood cell count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,29,43,52,69,83,115,133],"test_indices_end":[6,22,37,46,62,76,105,125,147],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"some shortness of breath with allergies , particularly cats .","problem":["some shortness of breath","allergies"],"test":[],"treatment":[],"problem_indices_start":[0,30],"problem_indices_end":[24,39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"11) simethicone 80 mg p.o. q.i.d. p.r.n. gas pain .","problem":["gas pain"],"test":[],"treatment":["simethicone"],"problem_indices_start":[41],"problem_indices_end":[49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[15]}
{"text":"the patient 's allergies include a questionable penicillin reaction ; however , the patient tolerated ampicillin well .","problem":["penicillin reaction","the patient 's allergies"],"test":[],"treatment":["ampicillin"],"problem_indices_start":[0,53],"problem_indices_end":[29,72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[107],"treatment_indices_end":[117]}
{"text":"the patient 's past medical history is significant for allergies , depression and anxiety , pleural thickening \/ asbestosis , chronic left bundle branch block , tonsillectomy , adenoidectomy , vein stripping ( 1968 ) , left wrist fracture ( 1994 ) , and hypercholesterolemia .","problem":["depression","hypercholesterolemia","pleural thickening","anxiety","chronic left bundle branch block","allergies","left wrist fracture","asbestosis"],"test":[],"treatment":["tonsillectomy","vein stripping","adenoidectomy"],"problem_indices_start":[60,72,87,97,118,131,224,259],"problem_indices_end":[69,82,94,115,128,163,243,279],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[166,182,198],"treatment_indices_end":[179,195,212]}
{"text":"the patient was begun on gentamicin , vancomycin and piperacillin , which was changed to gentamicin and ceftazidime .","problem":[],"test":[],"treatment":["gentamicin","gentamicin","piperacillin","ceftazidime","vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25,38,53,89,104],"treatment_indices_end":[35,48,65,99,115]}
{"text":"the patient does not recollect what her reaction to penicillin was .","problem":["her reaction"],"test":[],"treatment":["penicillin"],"problem_indices_start":[36],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[52],"treatment_indices_end":[62]}
{"text":"the patient 's family history was significant for a brother with colon cancer .","problem":["colon cancer"],"test":[],"treatment":[],"problem_indices_start":[70],"problem_indices_end":[82],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent examination was normocephalic and atraumatic .","problem":["atraumatic"],"test":["heent examination"],"treatment":[],"problem_indices_start":[40],"problem_indices_end":[50],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the regimen included cyclophosphamide , daunorubicin , prednisone , vincristine and peg-asparaginase .","problem":[],"test":[],"treatment":["the regimen","peg-asparaginase","vincristine","daunorubicin","cyclophosphamide","prednisone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,21,40,55,68,84],"treatment_indices_end":[11,37,52,65,79,100]}
{"text":"6) lactulose 30 milliliters p.o. q.2h. p.r.n. constipation .","problem":["constipation"],"test":[],"treatment":["lactulose"],"problem_indices_start":[46],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"platelets were 9,000 , hemoglobin 9.5 , temperature was 100.4 .","problem":[],"test":["hemoglobin","temperature","platelets"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,23,40],"test_indices_end":[9,33,51],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4) colace 100 mg p.o. b.i.d.","problem":[],"test":[],"treatment":["colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"5) lasix 40 mg p.o. q day .","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"3) cefazolin one gram iv q.8h. x 13days .","problem":[],"test":[],"treatment":["cefazolin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"a hickman catheter was placed and the patient was begun on chemotherapy .","problem":[],"test":[],"treatment":["chemotherapy","a hickman catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,59],"treatment_indices_end":[18,71]}
{"text":"8) miracle creamtopical q day p.r.n. skin irritation .","problem":["skin irritation"],"test":[],"treatment":["miracle creamtopical"],"problem_indices_start":[37],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[23]}
{"text":"the patient 's discharge medications include the following :","problem":[],"test":[],"treatment":["the patient 's discharge medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[41]}
{"text":"temperature 98.2 , blood pressure 134\/80 , respiratory rate 22 , pulse 102 .","problem":[],"test":["respiratory rate","pulse","temperature","blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,19,43,65],"test_indices_end":[11,33,59,70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10) senna tablets , two tablets p.o. b.i.d.","problem":[],"test":[],"treatment":["senna tablets"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[17]}
{"text":"9) sarna topical b.i.d. p.r.n. itching .","problem":["itching"],"test":[],"treatment":["sarna topical"],"problem_indices_start":[31],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"the patient was in her usual state of health until about three weeks prior to admission when she began to notice increased weakness and bruising .","problem":["bruising","increased weakness"],"test":[],"treatment":[],"problem_indices_start":[113,136],"problem_indices_end":[131,144],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac exam revealed an s1 and an s2 and a diffuse 2\/6 systolic murmur .","problem":["a diffuse 2\/6 systolic murmur"],"test":["cardiac exam"],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[71],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's liver function tests began to rise and she began to experience pulmonary symptoms including increased crackles .","problem":["increased crackles","pulmonary symptoms"],"test":["the patient 's liver function tests"],"treatment":[],"problem_indices_start":[83,112],"problem_indices_end":[101,130],"test_indices_start":[0],"test_indices_end":[40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"12) citrucel one tablespoon p.o. q day .","problem":[],"test":[],"treatment":["citrucel"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"the oropharynx was within normal limits with fillings and a partial upper plate .","problem":["a partial upper plate"],"test":[],"treatment":[],"problem_indices_start":[58],"problem_indices_end":[79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"16) robituss in ac five to ten milliliters p.o. q.h.s. p.r.n. cough .","problem":["cough"],"test":[],"treatment":["robituss in ac"],"problem_indices_start":[62],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[18]}
{"text":"the patient became constipated ; this resolved with laxatives .","problem":["constipated"],"test":[],"treatment":["laxatives"],"problem_indices_start":[19],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[52],"treatment_indices_end":[61]}
{"text":"13) k-dur 10 meq x three , p.o. b.i.d.","problem":[],"test":[],"treatment":["k-dur"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[9]}
{"text":"the patient was begun on nafcillin due to continued spiking .","problem":[],"test":[],"treatment":["nafcillin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25],"treatment_indices_end":[34]}
{"text":"the patient continued to spike and was enrolled in a randomized trial , the patient was randomized to ambisome antifungal treatment .","problem":[],"test":[],"treatment":["ambisome antifungal treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[102],"treatment_indices_end":[131]}
{"text":"the patient 's physical examination revealed a well-developed , well-nourished white female in no apparent distress .","problem":["apparent distress"],"test":["the patient 's physical examination"],"treatment":[],"problem_indices_start":[103],"problem_indices_end":[120],"test_indices_start":[0],"test_indices_end":[40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"thepatient developed a possible drug rash and nafcillin was changed to ancef .","problem":["drug rash"],"test":[],"treatment":["ancef","nafcillin"],"problem_indices_start":[32],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[46,71],"treatment_indices_end":[55,76]}
{"text":"14) zoloft 25 mg p.o. q day .","problem":[],"test":[],"treatment":["zoloft"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"pt 12.8 , ptt 19.1 .","problem":[],"test":["ptt","pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10],"test_indices_end":[2,13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"peripheral smear revealed blasts of 62% .","problem":[],"test":["blasts","peripheral smear"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,26],"test_indices_end":[16,32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the chest exam was clear to auscultation .","problem":[],"test":["auscultation","the chest exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,28],"test_indices_end":[14,40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"acute leukemia","problem":["acute leukemia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was decreased hearing bilaterally .","problem":["decreased hearing bilaterally"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no headache , no nausea , vomiting or diarrhea .","problem":["nausea","vomiting","headache","diarrhea"],"test":[],"treatment":[],"problem_indices_start":[3,17,26,38],"problem_indices_end":[11,23,34,46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient tolerated the chemotherapy regimen well .","problem":[],"test":[],"treatment":["the chemotherapy regimen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[46]}
{"text":"the patient began to spike and a blood culture grew out staphylococcusaureus .","problem":["staphylococcusaureus"],"test":["a blood culture"],"treatment":[],"problem_indices_start":[56],"problem_indices_end":[76],"test_indices_start":[31],"test_indices_end":[46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1) albuterol inhaler two puffs q.i.d. p.r.n. breathing difficulties .","problem":["breathing difficulties"],"test":[],"treatment":["albuterol inhaler"],"problem_indices_start":[45],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[20]}
{"text":"7) magnesium hydroxide 30 milliliters p.o. q day .","problem":[],"test":[],"treatment":["magnesium hydroxide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"the skin examination revealed the right breast had a dark two centimeter ecchymosis and the left medial thigh had two pale blue two centimeter macules .","problem":["pale blue two centimeter macules","a dark two centimeter ecchymosis"],"test":["the skin examination"],"treatment":[],"problem_indices_start":[51,118],"problem_indices_end":[83,150],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had a smear there consistent with all .","problem":["all"],"test":["a smear"],"treatment":[],"problem_indices_start":[46],"problem_indices_end":[49],"test_indices_start":[16],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient also had a history of platelet reaction .","problem":["platelet reaction"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2) calcium gluconate 1000 mg p.o. q day .","problem":[],"test":[],"treatment":["calcium gluconate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[20]}
{"text":"admitting labs were :","problem":[],"test":["admitting labs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the neck had a full range of motion , no lymphadenopathy .","problem":["lymphadenopathy"],"test":[],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient began neutropenic on day five of induction .","problem":["neutropenic"],"test":[],"treatment":[],"problem_indices_start":[18],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent examination notable for bilateral arcussenilis but otherwise unremarkable .","problem":["bilateral arcussenilis"],"test":["heent examination"],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[52],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no clubbing , cyanosis or edema and her peripheral pulses were trace palpable .","problem":["cyanosis","clubbing","edema"],"test":["her peripheral pulses"],"treatment":[],"problem_indices_start":[12,23,35],"problem_indices_end":[20,31,40],"test_indices_start":[45],"test_indices_end":[66],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she states this light-headedness is often associated with shortness of breath and diaphoresis occasionally with nausea .","problem":["diaphoresis","light-headedness","nausea","shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[16,58,82,112],"problem_indices_end":[32,77,93,118],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lopressor 100 mg p.o. b.i.d. ; nifedipine 10 mg p.o. t.i.d. ; timoptic solution 0.5% os b.i.d. ; coumadin 1 mg alternating with 1.5 mg q.o.d. at q.h.s. and haldol 2 mg p.o. q.h.s. p.r.n. in the evening , only for agitation associated with confusion .","problem":["agitation","confusion"],"test":[],"treatment":["coumadin","nifedipine","lopressor","timoptic solution","haldol"],"problem_indices_start":[213,239],"problem_indices_end":[222,248],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,31,62,97,156],"treatment_indices_end":[9,41,79,105,162]}
{"text":"the patient tolerated the procedure well and was found postoperatively to have some left upper extremity weakness on proximal greater than distal musculature .","problem":["some left upper extremity weakness"],"test":[],"treatment":["the procedure"],"problem_indices_start":[79],"problem_indices_end":[113],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[35]}
{"text":"ekg revealed a normal sinus rhythm with a rate of 69 , left ventricular hyper-trophy with poor anterior progression of r-waves .","problem":["left ventricular hyper-trophy","poor anterior progression of r-waves"],"test":["ekg"],"treatment":[],"problem_indices_start":[55,90],"problem_indices_end":[84,126],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"upon discharge it was the recommendation of the cardiology team that the patient 's prothrombin time be monitored weekly and be kept at a ratio of 3-4 iu .","problem":[],"test":["the patient 's prothrombin time"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[69],"test_indices_end":[105],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was maintained on heparin therapy initially but this was quickly switched over to coumadin anticoagulation therapy which she will need to be on long-term for her aortic valve replacement .","problem":[],"test":[],"treatment":["coumadin anticoagulation therapy","her aortic valve replacement","heparin therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,86,162],"treatment_indices_end":[37,118,190]}
{"text":"cardiac examination revealed a regular rate and rhythm with a normal s1 and s2 , 3\/6 systolic murmur at the right upper sternal border , no gallop was detected .","problem":["gallop","systolic murmur at the right upper sternal border"],"test":["cardiac examination"],"treatment":[],"problem_indices_start":[85,140],"problem_indices_end":[134,146],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has a history of glaucoma and a questionable history of claudication in her legs as well as a history of hypertension .","problem":["glaucoma","claudication in her legs","hypertension"],"test":[],"treatment":[],"problem_indices_start":[21,60,109],"problem_indices_end":[29,84,121],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sodium 141 , potassium 5.0 , bun 18 , creatinine 1.0 , pt 12.3 , ptt 24 , wbc 7.6 , hematocrit 41 , platelets 278,000 .","problem":[],"test":["platelets","ptt","pt","creatinine","sodium","hematocrit","potassium","bun","wbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,29,38,55,65,74,84,100],"test_indices_end":[6,22,32,48,57,68,77,94,109],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was admitted and evaluated by the cardiac surgery service after having undergone cardiac catheterization which revealed a 70% stenosis of her left circumflex artery , 50% stenosis of the left anterior descending and 10% stenosis of the right coronary artery .","problem":["70% stenosis of her left circumflex artery","50% stenosis of the left anterior descending","10% stenosis of the right coronary artery"],"test":["cardiac catheterization"],"treatment":[],"problem_indices_start":[126,171,220],"problem_indices_end":[168,215,261],"test_indices_start":[85],"test_indices_end":[108],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"carotid angiography revealed left internal carotid stenosis of 90% , right internal carotid artery " critical stenosis " .","problem":["left internal carotid stenosis of 90%","right internal carotid artery " critical stenosis ""],"test":["carotid angiography"],"treatment":[],"problem_indices_start":[29,69],"problem_indices_end":[66,130],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the pain and light-headedness is now severely lifestyle limiting and the patient requested evaluation for possible aortic valve replacement .","problem":["the pain","light-headedness"],"test":["evaluation"],"treatment":["aortic valve replacement"],"problem_indices_start":[0,13],"problem_indices_end":[8,29],"test_indices_start":[91],"test_indices_end":[101],"treatment_indices_start":[115],"treatment_indices_end":[139]}
{"text":"the patient has a history of exertional angina and chest pain associated with light-headedness for nine years which was noted to increase in frequency over the past year , then upon admission had light-headedness and chest pain with a dull pressure in her neck to her substernal area , with only minimal exertion such as " walking across the room " .","problem":["exertional angina","chest pain","light-headedness","chest pain","a dull pressure in her neck","light-headedness"],"test":[],"treatment":[],"problem_indices_start":[29,51,78,196,217,233],"problem_indices_end":[46,61,94,212,227,260],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was taken postoperatively the icu where she was extubated on postoperative day number one and by 5-11-92 she was noted to have markedly increased use of her right side , resolving aphasia and she was transferred to the floor with the residual deficit only noted to be some left upper extremity weakness .","problem":["aphasia","the residual deficit","some left upper extremity weakness"],"test":[],"treatment":[],"problem_indices_start":[184,234,272],"problem_indices_end":[191,254,306],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she denies any vomiting , states that the episodes usually last about five minutes and are relieved with rest .","problem":["vomiting","the episodes"],"test":[],"treatment":[],"problem_indices_start":[15,38],"problem_indices_end":[23,50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her neck showed no jvd , there was a slow carotid upstroke bilaterally , there were bilateral carotid bruits versus transmitted murmur .","problem":["jvd","a slow carotid upstroke bilaterally","transmitted murmur","bilateral carotid bruits"],"test":[],"treatment":[],"problem_indices_start":[19,35,84,116],"problem_indices_end":[22,70,108,134],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she also has a history of uterine fibroids , status post total abdominal hysterectomy .","problem":["uterine fibroids"],"test":[],"treatment":["total abdominal hysterectomy"],"problem_indices_start":[26],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[57],"treatment_indices_end":[85]}
{"text":"she has known bilateral carotid disease , stated to be greater than 70% bilaterally .","problem":["known bilateral carotid disease"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on physical examination she was afebrile with a blood pressure of 170\/100 , heart rate of 70 .","problem":["afebrile"],"test":["blood pressure","physical examination","heart rate"],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[40],"test_indices_start":[3,48,76],"test_indices_end":[23,62,86],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"medications on admission were only aspirin p.r.n. and timoptic solution 0.5% to the left eye twice a day .","problem":[],"test":[],"treatment":["medications on admission","timoptic solution 0.5%","aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,35,54],"treatment_indices_end":[24,42,76]}
{"text":"on 05-01-92 she was taken to the operating room at which time she underwent an aortic valve replacement with a # 19 st. jude valve , coronary artery bypass graft times one with saphenous vein graft from the posterior descending artery to the obtuse marginal and right carotid endarterectomy .","problem":[],"test":[],"treatment":["right carotid endarterectomy","coronary artery bypass graft","an aortic valve replacement","# 19 st. jude valve","saphenous vein graft"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[76,111,133,177,262],"treatment_indices_end":[103,130,161,197,290]}
{"text":"1. carotid stenosis .","problem":["carotid stenosis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , on 05-07-92 there was a a question of a new event with addition to the left upper extremity weakness , some noted right upper and right lower extremity discoordination .","problem":["some noted right upper and right lower extremity discoordination","the left upper extremity weakness","a new event"],"test":[],"treatment":[],"problem_indices_start":[48,77,113],"problem_indices_end":[59,110,177],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was begun on a heparin drip .","problem":[],"test":[],"treatment":["a heparin drip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17],"treatment_indices_end":[31]}
{"text":"the patient is a 76-year-old female who was admitted to the medicine service on 04-29-92 with a past history significant for aortic stenosis and chest pain who presented for evaluation for aortic valve replace-ment .","problem":["aortic stenosis","chest pain"],"test":["evaluation"],"treatment":["aortic valve replace-ment"],"problem_indices_start":[125,145],"problem_indices_end":[140,155],"test_indices_start":[174],"test_indices_end":[184],"treatment_indices_start":[189],"treatment_indices_end":[214]}
{"text":"she was extubated on postoperative day number one and otherwise had an unremarkable postoperative course with the exception of her left upper extremity weakness .","problem":["her left upper extremity weakness"],"test":[],"treatment":[],"problem_indices_start":[127],"problem_indices_end":[160],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she is transferred to rockdempbanri hospital on 05-28-92 to continue her rehabilitation .","problem":[],"test":[],"treatment":["her rehabilitation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[69],"treatment_indices_end":[87]}
{"text":"she underwent angiography on 5-9-92 which showed the right internal carotid artery to be patent , however there was highly significant stenosis of the left carotid artery and she was taken to the operating room later that day for a left carotid endarterectomy .","problem":["significant stenosis of the left carotid artery"],"test":["angiography"],"treatment":["a left carotid endarterectomy"],"problem_indices_start":[123],"problem_indices_end":[170],"test_indices_start":[14],"test_indices_end":[25],"treatment_indices_start":[230],"treatment_indices_end":[259]}
{"text":"past medical history is as stated above , aortic stenosis , found to be critical on echocardiogram on 4-13-92 , done in otte a , new jersey and was found to have left ventricular hypertrophy and ejection fraction of 58% , no right heart wall motion abnormali-ties and an aortic valve gradient of greater than 100 .","problem":["right heart wall motion abnormali-ties","left ventricular hypertrophy","aortic stenosis"],"test":["an aortic valve gradient","ejection fraction","echocardiogram"],"treatment":[],"problem_indices_start":[42,162,225],"problem_indices_end":[57,190,263],"test_indices_start":[84,195,268],"test_indices_end":[98,212,292],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 5-9-92 the right-sided symptoms worsened and she also had some elements of aphasia .","problem":["some elements of aphasia","the right-sided symptoms"],"test":[],"treatment":[],"problem_indices_start":[10,61],"problem_indices_end":[34,85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. aortic stenosis .","problem":["aortic stenosis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac risk factors hypercholesterolemia , hypertension , no history of tobacco use , diabetes or family history .","problem":["hypercholesterolemia","hypertension","diabetes"],"test":[],"treatment":[],"problem_indices_start":[21,44,87],"problem_indices_end":[41,56,95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 05-05-92 she was noted to convert to atrial fibrillation which resolved spontaneously a few days later .","problem":["atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[40],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. coronary artery disease .","problem":["coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was feeding herself and was very enthusiastic and energetic in her participation in her rehabilitation activities .","problem":[],"test":[],"treatment":["her rehabilitation activities"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[88],"treatment_indices_end":[117]}
{"text":"there was only diffuse small vessel disease noted .","problem":["diffuse small vessel disease"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was worked up aggressively with the physical therapy and occupational services , made good progress and began ambulating with assistance with a walker but with minimal assistance from an aid .","problem":[],"test":[],"treatment":["a walker"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[146],"treatment_indices_end":[154]}
{"text":"chest was clear to auscultation bilaterally .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 05-04-92 she was evaluated by the neurology service , who recommended a ct scan , however no evidence of infarction was detected .","problem":["infarction"],"test":["a ct scan"],"treatment":[],"problem_indices_start":[108],"problem_indices_end":[118],"test_indices_start":[73],"test_indices_end":[82],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her abdomen was soft , nontender with good bowel sounds .","problem":["nontender"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"your patient was admitted under the care of fong , coney n with a preliminary diagnosis of perforation .","problem":["perforation"],"test":[],"treatment":[],"problem_indices_start":[91],"problem_indices_end":[102],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following evaluation and treatment , the patient 's disposition at the end of the visit was admitted as an inpatient to ph university of medical center .","problem":[],"test":["evaluation"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[20],"treatment_indices_start":[25],"treatment_indices_end":[34]}
{"text":"the patient presented with a chief complaint of abd pain .","problem":["abd pain"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"history , physical , neuro exam normal","problem":[],"test":["neuro exam","physical"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10,21],"test_indices_end":[18,31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"monitor \/ return for nausea \/ vomiting , headache , visual \/ mental status changes or other concerns .","problem":["vomiting","nausea","headache","other concerns","visual \/ mental status changes"],"test":[],"treatment":[],"problem_indices_start":[21,30,41,52,86],"problem_indices_end":[27,38,49,82,100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head trauma - mva","problem":["head trauma"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"refrain from motrin at this time .","problem":[],"test":[],"treatment":["motrin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[19]}
{"text":"treatment rendered :","problem":[],"test":[],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"tylenol as needed .","problem":[],"test":[],"treatment":["tylenol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"3. k-dur 20 mg po q.day ,","problem":[],"test":[],"treatment":["k-dur"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"she had had no further episodes of tingling in her fingers after the initial episode which had prompted us originally to draw the ionized calcium .","problem":["tingling in her fingers"],"test":["the ionized calcium"],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[58],"test_indices_start":[126],"test_indices_end":[145],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. hypertrophic obstructive cardiomyopathy ,","problem":["hypertrophic obstructive cardiomyopathy"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the plan was to start her on heparin and coumadin and discontinue her heparin when her coumadin levels became therapeutic as judged by the prothrombin time \/ inr .","problem":[],"test":["inr","her coumadin levels","the prothrombin time"],"treatment":["coumadin","heparin","her heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[83,135,158],"test_indices_end":[102,155,161],"treatment_indices_start":[29,41,66],"treatment_indices_end":[36,49,77]}
{"text":"this is an 83-year-old female with a history of hypertrophic obstructive cardiomyopathy , status post mitral valve replacement in 1988 , chronic atrial fibrillation , hypertension , who presents for parathyroidectomy .","problem":["hypertrophic obstructive cardiomyopathy","hypertension","chronic atrial fibrillation"],"test":[],"treatment":["mitral valve replacement","parathyroidectomy"],"problem_indices_start":[48,137,167],"problem_indices_end":[87,164,179],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[102,199],"treatment_indices_end":[126,216]}
{"text":"7. norvasc 5 mg po q.day ,","problem":[],"test":[],"treatment":["norvasc"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"the electrocardiogram showed atrial fibrillation with slow ventricular response and digitalis effect as well as left ventricular hypertrophy .","problem":["atrial fibrillation","digitalis effect","left ventricular hypertrophy","slow ventricular response"],"test":["the electrocardiogram"],"treatment":[],"problem_indices_start":[29,54,84,112],"problem_indices_end":[48,79,100,140],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. atrial fibrillation , she is status post cardioversion 3-25-94 ,","problem":["atrial fibrillation"],"test":[],"treatment":["cardioversion"],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[44],"treatment_indices_end":[57]}
{"text":"1. laparoscopic cholecystectomy 03\/93 by dr. sapmal ,","problem":[],"test":[],"treatment":["laparoscopic cholecystectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[31]}
{"text":"at present , she can walk one to two blocks before having to stop because of shortness of breath .","problem":["shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[77],"problem_indices_end":[96],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. right cheek basal cell carcinoma ,","problem":["right cheek basal cell carcinoma"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. hypertension ,","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on the day of admission , the patient was brought to the operating room for parathyroidectomy .","problem":[],"test":[],"treatment":["parathyroidectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[76],"treatment_indices_end":[93]}
{"text":"she has noticed some generalized hoarseness in her voice for the past 5-6 months .","problem":["generalized hoarseness in her voice"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. lopressor 50 mg po b.i.d. ,","problem":[],"test":[],"treatment":["lopressor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"7. glaucoma ,","problem":["glaucoma"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. osteoarthritis ; she is to receive bilateral total knee replacements at some time in the near future ,","problem":["osteoarthritis"],"test":[],"treatment":["bilateral total knee replacements"],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[71]}
{"text":"impression was that this was an 83-year-old female with cardiac history , dyspnea on exertion , increased calcium and hyperparathyroidism who presents for parathyroidectomy .","problem":["increased calcium","hyperparathyroidism","dyspnea on exertion","cardiac history"],"test":[],"treatment":["parathyroidectomy"],"problem_indices_start":[56,74,96,118],"problem_indices_end":[71,93,113,137],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[155],"treatment_indices_end":[172]}
{"text":"there is no family history of parathyroid or thyroid diseases .","problem":["parathyroid or thyroid diseases"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition , she has some dysphagia , particularly has had some difficulties with swallowing .","problem":["some difficulties with swallowing","some dysphagia"],"test":[],"treatment":[],"problem_indices_start":[22,60],"problem_indices_end":[36,93],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. digoxin .25 mg po q.day ,","problem":[],"test":[],"treatment":["digoxin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"10. status post dilation and curettage ,","problem":[],"test":[],"treatment":["dilation and curettage"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[38]}
{"text":"admission white blood count 4.3 , hematocrit 31.0 , electrolytes were all within normal limits , glucose 218 , prothrombin time on admission was 15.1 with inr of 1.5 , partial thromboplastin time 23.3 .","problem":[],"test":["glucose","prothrombin time","partial thromboplastin time","inr","hematocrit","electrolytes","white blood count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10,34,52,97,111,155,168],"test_indices_end":[27,44,64,104,127,158,195],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. timoptic 0.5% b.i.d. to both eyes ,","problem":[],"test":[],"treatment":["timoptic"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"in addition , she is to follow up with her primary care physician to check her prothrombin time \/ inr as well as calcium , albumin and phosphate levels .","problem":[],"test":["calcium , albumin and phosphate levels","her prothrombin time","inr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[75,98,113],"test_indices_end":[95,101,151],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. coumadin 2.5 mg po q.day which was last taken two days prior to admission ,","problem":[],"test":[],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"12. status post left breast biopsy .","problem":[],"test":["left breast biopsy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , on postoperative day number two , the patient in the afternoon noticed some tingling in her hands and also some tingling hear her perioral region .","problem":["some tingling in her hands","some tingling hear her perioral region"],"test":[],"treatment":[],"problem_indices_start":[81,117],"problem_indices_end":[107,155],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is an 83-year-old female who presents for surgical evaluation for her hyperparathyroidism .","problem":["her hyperparathyroidism"],"test":["surgical evaluation"],"treatment":[],"problem_indices_start":[78],"problem_indices_end":[101],"test_indices_start":[54],"test_indices_end":[73],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the head , eyes , ears , nose and throat examination is notable for pupils which have irregular border and are very sluggishly reactive .","problem":["irregular border","very sluggishly reactive"],"test":["the head , eyes , ears , nose and throat examination"],"treatment":[],"problem_indices_start":[86,111],"problem_indices_end":[102,135],"test_indices_start":[0],"test_indices_end":[52],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. dilation and curettage in 1992 for polyps ,","problem":["polyps"],"test":[],"treatment":["dilation and curettage"],"problem_indices_start":[38],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[25]}
{"text":"7. history of glaucoma ,","problem":["glaucoma"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in august of 1996 while the patient was at retelk county medical center for replacement of her knees bilaterally , and on preoperative evaluation she was noted to have a high calcium and therefore the surgery was canceled .","problem":["a high calcium"],"test":["preoperative evaluation"],"treatment":["replacement of her knees bilaterally","the surgery"],"problem_indices_start":[168],"problem_indices_end":[182],"test_indices_start":[122],"test_indices_end":[145],"treatment_indices_start":[76,197],"treatment_indices_end":[112,208]}
{"text":"on physical examination , she is a pleasant woman in no acute distress .","problem":["acute distress"],"test":["physical examination"],"treatment":[],"problem_indices_start":[56],"problem_indices_end":[70],"test_indices_start":[3],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. lopid 600 mg po b.i.d. ,","problem":[],"test":[],"treatment":["lopid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"further testing revealed hyperparathyroidism as evidenced by an elevated pth .","problem":["an elevated pth","hyperparathyroidism"],"test":["further testing"],"treatment":[],"problem_indices_start":[25,61],"problem_indices_end":[44,76],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on postoperative day number five , the patient felt fine and had an inr of 1.9 with a prothrombin time of 16.6 .","problem":[],"test":["a prothrombin time","an inr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[65,84],"test_indices_end":[71,102],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. lasix 40 mg po q.day ,","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"her pulse is 72 , irregularly irregular , blood pressure 96\/60 , temperature 97.9 , respirations 18 .","problem":[],"test":["respirations","temperature","her pulse","blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,42,65,84],"test_indices_end":[9,56,76,96],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. norvasc 500 mg po q.day ,","problem":[],"test":[],"treatment":["norvasc"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"an ionized calcium was drawn which was low at 1.0 .","problem":[],"test":["an ionized calcium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"parathyroidectomy on 12-27-96 .","problem":[],"test":[],"treatment":["parathyroidectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[17]}
{"text":"4. hypertrophic obstructive cardiomyopathy ,","problem":["hypertrophic obstructive cardiomyopathy"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. rocaltrol 0.25 mg po b.i.d. ,","problem":[],"test":[],"treatment":["rocaltrol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"as a result , the patient was started on os-cal 250 mg po q.i.d. on postoperative day number three , her ionized calcium was 1.06 and her os-cal was increased to 500 q.i.d.","problem":[],"test":["her ionized calcium"],"treatment":["os-cal","her os-cal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[101],"test_indices_end":[120],"treatment_indices_start":[41,134],"treatment_indices_end":[47,144]}
{"text":"when walking outside , she stops multiple times because of shortness of breath .","problem":["shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[59],"problem_indices_end":[78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. os-cal 500 mg po q.i.d. ,","problem":[],"test":[],"treatment":["os-cal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"she gets short of breath walking up steps .","problem":["short of breath"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. hypertension , she has had hypertension for 15 years ,","problem":["hypertension","hypertension"],"test":[],"treatment":[],"problem_indices_start":[3,30],"problem_indices_end":[15,42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hyperparathyroidism .","problem":["hyperparathyroidism"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the review of systems is significant for a history of dyspnea on exertion .","problem":["dyspnea on exertion"],"test":["the review of systems"],"treatment":[],"problem_indices_start":[54],"problem_indices_end":[73],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. digoxin .25 mg po q.day ,","problem":[],"test":[],"treatment":["digoxin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"1. status post mitral valve replacement in 1988 .","problem":[],"test":[],"treatment":["mitral valve replacement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[39]}
{"text":"however , her ionized calcium decreased to 0.97 and she was given one amp of calcium gluconate .","problem":["her ionized calcium decreased"],"test":[],"treatment":["calcium gluconate"],"problem_indices_start":[10],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[77],"treatment_indices_end":[94]}
{"text":"3. lasix 40 mg po q.day ,","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"she has a st. jude 's mechanical valve and has been on coumadin since then ,","problem":[],"test":[],"treatment":["coumadin","a st. jude 's mechanical valve"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[8,60],"treatment_indices_end":[43,68]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. right cheek basal cell carcinoma to be removed in the future ,","problem":["right cheek basal cell carcinoma"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. non insulin dependent diabetes mellitus which was diagnosed in march , 1995 ,","problem":["non insulin dependent diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had no muscular weakness noted .","problem":["muscular weakness"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient reports that she will have revision of cataract surgery .","problem":[],"test":[],"treatment":["revision of cataract surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39],"treatment_indices_end":[67]}
{"text":"8. glucotrol 10 xl qam ,","problem":[],"test":[],"treatment":["glucotrol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"she is guaiac negative on rectal examination .","problem":[],"test":["rectal examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26],"test_indices_end":[44],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. lopressor 50 mg po b.i.d. ,","problem":[],"test":[],"treatment":["lopressor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"postoperatively , the patient did well and was able to cough and phonate completely with no changes from preoperative .","problem":["changes"],"test":[],"treatment":[],"problem_indices_start":[92],"problem_indices_end":[99],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. lopid 600 mg po b.i.d. ,","problem":[],"test":[],"treatment":["lopid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"1. coumadin 5 mg po q.day , then she will follow up with her primary care physician and decide the dosage thereafter ,","problem":[],"test":[],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"hyperparathyroidism .","problem":["hyperparathyroidism"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10. pilocarpine gel qhs to both eyes .","problem":[],"test":[],"treatment":["pilocarpine gel"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[19]}
{"text":"5. osteoarthritis ,","problem":["osteoarthritis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"11. status post cataract surgery ,","problem":[],"test":[],"treatment":["cataract surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[32]}
{"text":"10. glucotrol 10 mg qam .","problem":[],"test":[],"treatment":["glucotrol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"cardiovascular exam :","problem":[],"test":["cardiovascular exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient reports no masses in her neck .","problem":["masses in her neck"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. cataract surgery .","problem":[],"test":[],"treatment":["cataract surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[19]}
{"text":"iii \/ vi systolic click and irregularly irregular rhythm .","problem":["irregularly irregular rhythm","iii \/ vi systolic click"],"test":[],"treatment":[],"problem_indices_start":[0,28],"problem_indices_end":[23,56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her calcium was 8.5 , albumin 3.6 , and phosphate 4.5 .","problem":[],"test":["her calcium","albumin","phosphate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,22,40],"test_indices_end":[11,29,49],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. status post laparoscopic cholecystectomy ,","problem":[],"test":[],"treatment":["laparoscopic cholecystectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[43]}
{"text":"9. shingles .","problem":["shingles"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. left breast biopsy which was benign ,","problem":[],"test":["left breast biopsy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. non-insulin dependent diabetes mellitus ,","problem":["non-insulin dependent diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the right superior parathyroid gland was found to be markedly enlarged and consistent with an adenoma .","problem":["markedly enlarged","an adenoma"],"test":[],"treatment":[],"problem_indices_start":[53,91],"problem_indices_end":[70,101],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. status post mitral valve replacement ,","problem":[],"test":[],"treatment":["mitral valve replacement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[39]}
{"text":"2. k-dur 20 mg po q.day ,","problem":[],"test":[],"treatment":["k-dur"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"3. atrial fibrillation ,","problem":["atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"upper extremities are very brisk bilaterally and symmetrical 3+. there is positive tremor reflex on the left and absent on the right .","problem":["positive tremor reflex on the left","absent on the right"],"test":[],"treatment":[],"problem_indices_start":[74,113],"problem_indices_end":[108,132],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is allergic to hydralazine , codeine , ace inhibitors , nifedipine and percocet .","problem":["allergic"],"test":[],"treatment":["ace inhibitors","codeine","percocet","hydralazine","nifedipine"],"problem_indices_start":[15],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,41,51,68,83],"treatment_indices_end":[38,48,65,78,91]}
{"text":"ms. breunlinke is a 69 year-old right handed woman , status post surgical correction of a c-1 to c-2 dural avm in january , 1998 , now presenting with a one month history of increasing left sided weakness and pain with spasticity , occasional difficulty swallowing and abdominal pain .","problem":["pain","abdominal pain","increasing left sided weakness","spasticity","difficulty swallowing"],"test":[],"treatment":["surgical correction of a c-1 to c-2 dural avm"],"problem_indices_start":[174,209,219,243,269],"problem_indices_end":[204,213,229,264,283],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[65],"treatment_indices_end":[110]}
{"text":"anal tone is reduced .","problem":["reduced"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lower extremities show patellar reflexes 3+ left , 4+ right , no cross deductor reflexes and absent ankle jerks .","problem":[],"test":["cross deductor reflexes","patellar reflexes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[23,65],"test_indices_end":[40,88],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hematocrit is 37.6 , platelet count is 148,000 .","problem":[],"test":["hematocrit","platelet count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,21],"test_indices_end":[10,35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sodium 140 , potassium 3.8 , chloride 100 , bicarbonate of 30 , bun of 13 , creatinine 0.8 , serum glucose 228 .","problem":[],"test":["serum glucose","creatinine","bicarbonate","chloride","sodium","potassium","bun"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,29,44,64,76,93],"test_indices_end":[6,22,37,55,67,86,106],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on admission include cozaar 75 mg q.d. , coumadin 2 mg\/1 mg alternate days , synthroid 175 mcg q.d. , zoloft 50 mg q.d. , zantac 150 mg b.i.d. , diabeta 25 mg q.d. , proctofoam 1% q.i.d. , demerol 100 mg q 6 p.r.n. , oscal 2 tabs t.i.d. , multivitamins and kcl supplements , dulcolax 5 mg q.d. , senokot 2 tabs q h.s. , metamucil 1 tablespoon b.i.d. , detrol 2 mg b.i.d. , neurontin 200 mg t.i.d. , hydrodiuril 12.5 mg q.d. , valium 10 mg q 8 p.r.n. muscle spasm , insulin by sliding scale and levofloxacin 500 mg q.d. beginning october 23 , 1999 .","problem":["muscle spasm"],"test":[],"treatment":["diabeta","demerol","metamucil","zantac","valium","kcl supplements","zoloft","multivitamins","hydrodiuril","proctofoam","levofloxacin","coumadin","cozaar","proctofoam","insulin","synthroid","neurontin","senokot","detrol","dulcolax","oscal"],"problem_indices_start":[450],"problem_indices_end":[462],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21,41,77,102,122,145,166,189,217,239,257,275,296,320,352,373,399,426,465,494],"treatment_indices_end":[27,49,86,108,128,152,176,196,222,252,272,283,303,329,358,382,410,432,472,506]}
{"text":"rectal examination is nontender and stool is guaiac negative .","problem":["nontender"],"test":["rectal examination"],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[31],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urinalysis from october 21 , is positive for citrobacter susceptible to ciprofloxacin , gentamycin , nitrofurantoin , tetracycline and bactrim .","problem":["citrobacter"],"test":["urinalysis"],"treatment":["nitrofurantoin","tetracycline","bactrim","ciprofloxacin","gentamycin"],"problem_indices_start":[45],"problem_indices_end":[56],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[72,88,101,118,135],"treatment_indices_end":[85,98,115,130,142]}
{"text":"upon further review of dr. laymie fields , department of neuroradiology , review of the cervical spine on ct reveals no extrinsic compressive lesions impacting the spinal cord and no enhancing lesions of the spinal cord with contrast .","problem":["enhancing lesions of the spinal cord","extrinsic compressive lesions"],"test":["contrast","ct"],"treatment":[],"problem_indices_start":[120,183],"problem_indices_end":[149,219],"test_indices_start":[106,225],"test_indices_end":[108,233],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this pain often follows bowel movement but does occur spontaneously .","problem":["this pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pupils are 4-6 mm bilaterally , extraocular movements were full without nystagmus .","problem":["nystagmus"],"test":[],"treatment":[],"problem_indices_start":[72],"problem_indices_end":[81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on admission , a ct scan of the head with and without contrast was performed , showing a missing posterior arch at c-1 and metallic clips at the craniocervical junction consistent with prior surgical intervention .","problem":["a missing posterior arch at c-1"],"test":["a ct scan of the head"],"treatment":["prior surgical intervention","metallic clips at the craniocervical junction"],"problem_indices_start":[87],"problem_indices_end":[118],"test_indices_start":[15],"test_indices_end":[36],"treatment_indices_start":[123,185],"treatment_indices_end":[168,212]}
{"text":"she was found to have intermedullary lesion at c1-2 level which on biopsy showed abnormal vasculature , hemosiderin deposit , leading in turn to the discovery of a dural arteriovenous malformation at that level which was surgically corrected .","problem":["abnormal vasculature","hemosiderin deposit","a dural arteriovenous malformation","intermedullary lesion at c1-2 level"],"test":["biopsy"],"treatment":[],"problem_indices_start":[22,81,104,162],"problem_indices_end":[57,101,123,196],"test_indices_start":[67],"test_indices_end":[73],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was also given valium 5-10 mg p.o. t.i.d. for muscle spasm .","problem":["muscle spasm"],"test":[],"treatment":["valium"],"problem_indices_start":[58],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[33]}
{"text":"the postoperative period was complicated by transient swallowing difficulty , increasing left sided weakness and urinary retention .","problem":["urinary retention","transient swallowing difficulty","increasing left sided weakness"],"test":[],"treatment":[],"problem_indices_start":[44,78,113],"problem_indices_end":[75,108,130],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no arteriovenous malformations are identified ; there is no evidence of recurrence of her former vascular malformation .","problem":["her former vascular malformation","recurrence","arteriovenous malformations"],"test":[],"treatment":[],"problem_indices_start":[3,72,86],"problem_indices_end":[30,82,118],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on admission , heart is regular rate and rhythm without murmur .","problem":["murmur"],"test":[],"treatment":[],"problem_indices_start":[56],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the right upper extremity shows generalized reduction in strength , 4\/5 in all joints .","problem":["generalized reduction in strength"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"we recommend daily physical therapy and occupational therapy to maximize functional capacity with optimization of pharmacological regimen for spasticity including baclofen , valium and adequate analgesia .","problem":["spasticity","functional capacity"],"test":[],"treatment":["adequate analgesia","valium","physical therapy","pharmacological regimen","baclofen","occupational therapy"],"problem_indices_start":[73,142],"problem_indices_end":[92,152],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,40,114,163,174,185],"treatment_indices_end":[35,60,137,171,180,203]}
{"text":"she denies dysuria or excessive urinary frequency .","problem":["dysuria","excessive urinary frequency"],"test":[],"treatment":[],"problem_indices_start":[11,22],"problem_indices_end":[18,49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no intraspinal lesions are identified .","problem":["intraspinal lesions"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"note , the patient is not a candidate for magnetic resonance imaging secondary to ferromagnetic intracardiac pacing device .","problem":[],"test":["magnetic resonance imaging"],"treatment":["ferromagnetic intracardiac pacing device"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[42],"test_indices_end":[68],"treatment_indices_start":[82],"treatment_indices_end":[122]}
{"text":"over the past several weeks she has also developed severe intermittent abdominal pain , localized to the suprapubic area , left greater than right , occurring intermittently .","problem":["severe intermittent abdominal pain"],"test":[],"treatment":[],"problem_indices_start":[51],"problem_indices_end":[85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"significant for insulin dependent diabetes mellitus , atrial fibrillation , hypothyroidism , hypertension , depression , frequent urinary tract infections , neuropathic pain syndrome and osteoporosis .","problem":["hypertension","frequent urinary tract infections","neuropathic pain syndrome","osteoporosis","hypothyroidism","atrial fibrillation","depression","insulin dependent diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[16,54,76,93,108,121,157,187],"problem_indices_end":[51,73,90,105,118,154,182,199],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cerebellar ; the patient demonstrates an intention tremor on finger to nose with the left hand .","problem":["an intention tremor"],"test":["finger to nose"],"treatment":[],"problem_indices_start":[38],"problem_indices_end":[57],"test_indices_start":[61],"test_indices_end":[75],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the tone is markedly increased in bot legs with left greater than right .","problem":["markedly increased in bot legs"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was originally admitted to the verg medical center in january , 1998 , because of a one year history of left sided weakness and spasticity .","problem":["spasticity","left sided weakness"],"test":[],"treatment":[],"problem_indices_start":[108,132],"problem_indices_end":[127,142],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen is soft , with marked suprapubic tenderness and reduced bowel sounds .","problem":["reduced bowel sounds","marked suprapubic tenderness"],"test":[],"treatment":[],"problem_indices_start":[23,56],"problem_indices_end":[51,76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has diminished vibration and propioception in the left upper and lower extremity and decreased temperature , light touch and pinprick sensation in the right upper and lower extremity consistent with a high cervical spinal sensory level .","problem":["a high cervical spinal sensory level","decreased temperature","diminished vibration and propioception in the left upper and lower extremity"],"test":["pinprick sensation","light touch"],"treatment":[],"problem_indices_start":[16,97,211],"problem_indices_end":[92,118,247],"test_indices_start":[121,137],"test_indices_end":[132,155],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lungs are clear to auscultation bilaterally .","problem":[],"test":["auscultation bilaterally"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"upon further review of ct and angiography results with neuroradiology and neurology service , it was decided that ct myelography was not indicated at this time .","problem":[],"test":["angiography","ct myelography","ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[23,30,114],"test_indices_end":[25,41,128],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"as of the beginning of september , 1999 , she was able to swallow without difficulty , urinate without difficulty ( although bowel movements have been problematic ) .","problem":["problematic"],"test":[],"treatment":[],"problem_indices_start":[151],"problem_indices_end":[162],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"electrocardiogram shows no p-waves .","problem":["p-waves"],"test":["electrocardiogram"],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[34],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no clonus on the right but sustained clonus ( 10-12 beats ) on the left .","problem":["clonus on the right","sustained clonus ( 10-12 beats ) on the left"],"test":[],"treatment":[],"problem_indices_start":[12,36],"problem_indices_end":[31,80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"prothrombin time is 15.9 with an inr of 1.7 .","problem":[],"test":["prothrombin time","an inr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,30],"test_indices_end":[16,36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given aspirin 325 mg p.o. q.d.","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[29]}
{"text":"she was continued on demerol 50 mg q 6-8 hours p.r.n. for left arm and leg pain .","problem":["left arm and leg pain"],"test":[],"treatment":["demerol"],"problem_indices_start":[58],"problem_indices_end":[79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[28]}
{"text":"functionally , she was at the level of pre-gait training and able to stand and take several steps with upper body support .","problem":[],"test":[],"treatment":["upper body support","pre-gait training"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39,103],"treatment_indices_end":[56,121]}
{"text":"over the past 4-5 weeks her functional level has progressively deteriorated .","problem":["her functional level"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left arm shows a flexor contracture and markedly increased tone .","problem":["markedly increased tone","a flexor contracture"],"test":[],"treatment":[],"problem_indices_start":[15,40],"problem_indices_end":[35,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the left upper extremity shows reduction in motor power ranging from 2\/5 in the triceps , 4\/5 in the biceps , and 3-4\/5 in the wrists and hand intrinsics .","problem":["reduction in motor power"],"test":[],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her left arm has developed a flexure contraction and she reports intermitttent pain in the left arm and leg which occurs both spontaneously and is also triggered by contact .","problem":["a flexure contraction","intermitttent pain in the left arm and leg"],"test":[],"treatment":[],"problem_indices_start":[27,65],"problem_indices_end":[48,107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left sided spastic hemiparesis , status post surgical correction of c-1 , c-2 dural avm .","problem":["left sided spastic hemiparesis"],"test":[],"treatment":["surgical correction of c-1 , c-2 dural avm"],"problem_indices_start":[0],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[45],"treatment_indices_end":[87]}
{"text":"angiography performed on october 31 , 1999 , showed normal vascular distribution of the head and neck with no recurrence of arteriovenous malformation .","problem":["normal vascular distribution of the head and neck","recurrence of arteriovenous malformation"],"test":["angiography"],"treatment":[],"problem_indices_start":[52,110],"problem_indices_end":[101,150],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has developed some new swallowing difficulty and since her transfer to a long term inpatient care facility , she has lost ten pounds .","problem":["new swallowing difficulty"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coumadin was discontinued .","problem":[],"test":[],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"fine motor movements are slow but accurate in the left and right hands .","problem":["slow"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white blood count is 7,000 .","problem":[],"test":["white blood count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"during this admission , the patient was started on baclofen 10 mg p.o. t.i.d. for spasticity .","problem":["spasticity"],"test":[],"treatment":["baclofen"],"problem_indices_start":[82],"problem_indices_end":[92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[51],"treatment_indices_end":[59]}
{"text":"the right arm shows moderate increased tone .","problem":["moderate increased tone"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient feels this is secondary to her hemorrhoids , although it does not clearly localize to the rectum .","problem":["her hemorrhoids"],"test":[],"treatment":[],"problem_indices_start":[39],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ptt is 24 .","problem":[],"test":["ptt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following evaluation and treatment , the patient 's disposition at the end of the visit was admitted as an inpatient to ro woodma healthcare .","problem":[],"test":["evaluation"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[20],"treatment_indices_start":[25],"treatment_indices_end":[34]}
{"text":"the patient presented with a chief complaint of epigastric pain \/ abd pain .","problem":["abd pain","epigastric pain"],"test":[],"treatment":[],"problem_indices_start":[48,66],"problem_indices_end":[63,74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's preliminary admitting physician is priesdouet , ch j and the preliminary diagnosis is cholecystitis .","problem":["cholecystitis"],"test":[],"treatment":[],"problem_indices_start":[106],"problem_indices_end":[119],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"low lying placenta ; past medical history , history of ; urinary tract infection , history of","problem":["low lying placenta","urinary tract infection"],"test":[],"treatment":[],"problem_indices_start":[0,57],"problem_indices_end":[18,80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"active labor","problem":["active labor"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"height 66 heent normal neck normal breasts normal nipples normal chest normal cor normal abdomen normal extrem normal skin normal nodes normal vulva normal vagina normal cervix normal os normal adnexae normal uterus normal uterine size in weeks normal 12","problem":[],"test":["height","heent"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10],"test_indices_end":[6,15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vaginal delivery with second degree laceration","problem":["second degree laceration"],"test":[],"treatment":["vaginal delivery"],"problem_indices_start":[22],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"she delivered a 3550 gram male infant on 08\/31\/2004 at 09:33 pm with apgar scores of 9 and 9 at one and five minutes respectively at 41.0 weeks gestation via spontaneous vertex vaginal delivery .","problem":[],"test":["apgar scores"],"treatment":["spontaneous vertex vaginal delivery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[69],"test_indices_end":[81],"treatment_indices_start":[158],"treatment_indices_end":[193]}
{"text":"multivitamins and folate ( fam pren forte )","problem":[],"test":[],"treatment":["multivitamins","multivitamins","folate ( fam pren forte )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,18],"treatment_indices_end":[13,43]}
{"text":"routine post partum care","problem":[],"test":[],"treatment":["routine post partum care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"chorioamnionitis .","problem":["chorioamnionitis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"spontaneous vertex vaginal delivery","problem":[],"test":[],"treatment":["spontaneous vertex vaginal delivery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[35]}
{"text":"nuchal cord .","problem":["nuchal cord"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"active labor .","problem":["active labor"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following evaluation and treatment , the patient 's disposition at the end of the visit was treated and released .","problem":[],"test":["evaluation"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[20],"treatment_indices_start":[25],"treatment_indices_end":[34]}
{"text":"the patient presented with a chief complaint of abd pain .","problem":["abd pain"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5) ppd anergic .","problem":["ppd anergic"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt was 12.6 and ptt was 29 .","problem":[],"test":["pt","ptt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16],"test_indices_end":[2,19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mr. breutzfarstxei is a 30 year old man with recently diagnosed acquired immunodeficiency syndrome and pneumocystis carinii pneumonia who presented with pneumonia , developed adult respiratory distress syndrome , and died in the hospital after failed efforts of ventilatory support .","problem":["pneumonia","adult respiratory distress syndrome","pneumocystis carinii pneumonia","acquired immunodeficiency syndrome"],"test":[],"treatment":["ventilatory support"],"problem_indices_start":[64,103,153,175],"problem_indices_end":[98,133,162,210],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[262],"treatment_indices_end":[281]}
{"text":"on admission , white count was 7.2 with 57% neutrophils , 40% lymphocytes , l mononuclear cell , and 1.6 eosinophils .","problem":[],"test":["neutrophils","mononuclear cell","eosinophils","lymphocytes","white count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[15,44,62,78,105],"test_indices_end":[26,55,73,94,116],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"stool was sent for ova and parasites .","problem":["ova","parasites"],"test":["stool"],"treatment":[],"problem_indices_start":[19,27],"problem_indices_end":[22,36],"test_indices_start":[0],"test_indices_end":[5],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his arterial blood gas on 50% was po2 92 , pco2 24 , and ph 7.46 .","problem":[],"test":["po2","his arterial blood gas","pco2","ph"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,34,43,57],"test_indices_end":[22,37,47,59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 02\/11\/91 , the patient again appeared more comfortable this time with 50% facemask but then required more oxygen , dropped his o2 saturations , and was intubated on 02\/11\/91 .","problem":[],"test":["his o2 saturations"],"treatment":["50% facemask","oxygen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[126],"test_indices_end":[144],"treatment_indices_start":[73,109],"treatment_indices_end":[85,115]}
{"text":"the patient was also covered with erythromycin and gentamicin for coverage of community acquired pneumonias and gram negative rods .","problem":["gram negative rods","community acquired pneumonias"],"test":[],"treatment":["gentamicin","erythromycin"],"problem_indices_start":[78,112],"problem_indices_end":[107,130],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34,51],"treatment_indices_end":[46,61]}
{"text":"actually in reviewing the records at this point , it appears that pentamidine was not started initially so on the antibiotics of erythromycin and gentamicin , the patient 's respiratory status worsened and his ldh climbed so he began pentamidine on 02\/10\/91 .","problem":[],"test":["his ldh"],"treatment":["erythromycin","the antibiotics","gentamicin","pentamidine","pentamidine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[211],"test_indices_end":[218],"treatment_indices_start":[66,110,129,146,239],"treatment_indices_end":[77,125,141,156,250]}
{"text":"review of liver function tests revealed a cholestatic picture which was not previously found and it was felt that this was secondary to the bactrim which had been recently stopped anyway .","problem":["a cholestatic picture"],"test":["liver function tests"],"treatment":["the bactrim"],"problem_indices_start":[40],"problem_indices_end":[61],"test_indices_start":[10],"test_indices_end":[30],"treatment_indices_start":[136],"treatment_indices_end":[147]}
{"text":"titers for cmv and epstein-barr virus were sent and a titer for toxoplasma was sent .","problem":["epstein-barr virus","cmv","toxoplasma"],"test":["titers","a titer"],"treatment":[],"problem_indices_start":[11,19,64],"problem_indices_end":[14,37,74],"test_indices_start":[0,52],"test_indices_end":[6,59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he required elevated ventilatory pressures with pips often above 60 .","problem":[],"test":["pips"],"treatment":["elevated ventilatory pressures"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[48],"test_indices_end":[52],"treatment_indices_start":[12],"treatment_indices_end":[42]}
{"text":"at discharge after about two weeks post-extubation , he had an o2 saturation of approximately 95% on room air .","problem":[],"test":["o2 saturation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[63],"test_indices_end":[76],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"due to continued worsening pulmonary status and an overall grim prognosis , the family decided , in consultation with the medical team , to withdraw ventilatory support .","problem":["continued worsening pulmonary status"],"test":[],"treatment":["ventilatory support"],"problem_indices_start":[7],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[149],"treatment_indices_end":[168]}
{"text":"he initially did well after extubation and completed approximately two weeks of bactrim and a steroid taper .","problem":[],"test":[],"treatment":["bactrim","a steroid taper","extubation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28,80,92],"treatment_indices_end":[38,87,107]}
{"text":"the patient 's liver function tests appeared to improve .","problem":[],"test":["the patient 's liver function tests"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , on 02\/10\/91 , his respiratory rate increased and his oxygen saturation decreased .","problem":[],"test":["his oxygen saturation","his respiratory rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24,59],"test_indices_end":[44,80],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was seen in flfdmc where he was noted to have jaundice and newly palpable liver edge .","problem":["newly palpable liver edge","jaundice"],"test":[],"treatment":[],"problem_indices_start":[49,62],"problem_indices_end":[57,87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"soft with bowel sounds and there was mid epigastric and right upper quadrant tenderness .","problem":["mid epigastric and right upper quadrant tenderness"],"test":[],"treatment":[],"problem_indices_start":[37],"problem_indices_end":[87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was actually intubated and underwent bronchoscopy where the diagnosis was made with a positive toluidine blue study .","problem":["a positive toluidine blue study"],"test":[],"treatment":["bronchoscopy"],"problem_indices_start":[87],"problem_indices_end":[118],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40],"treatment_indices_end":[52]}
{"text":"alt was 181 , ast was 156 , ldh was 336 , alkaline phosphatase was 214 , and bilirubin was 12.7 total .","problem":[],"test":["bilirubin","ldh","alt","ast","alkaline phosphatase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,14,28,42,77],"test_indices_end":[3,17,31,62,86],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's abdominal ct scan showed no liver disease and no obstruction .","problem":["obstruction","liver disease"],"test":["the patient 's abdominal ct scan"],"treatment":[],"problem_indices_start":[48,69],"problem_indices_end":[61,80],"test_indices_start":[0],"test_indices_end":[37],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was transferred to the intensive care unit on 12\/12\/90 on gentamicin , vancomycin , pentamidine , and prednisone .","problem":[],"test":[],"treatment":["pentamidine","gentamicin","prednisone","vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61,74,87,105],"treatment_indices_end":[71,84,98,115]}
{"text":"revealed icteric sclerae , the oropharynx with extensive thrush , and an ulcer under his tongue .","problem":["an ulcer under his tongue","the oropharynx with extensive thrush","icteric sclerae"],"test":[],"treatment":[],"problem_indices_start":[9,27,70],"problem_indices_end":[24,63,95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , the patient 's respiratory status continued to decline and we were unable to maintain oxygen saturations above 80% even using reverse i to e ventilation , paralysis , sedation , and other modes of ventilation .","problem":[],"test":["oxygen saturations"],"treatment":["reverse i to e ventilation","sedation","other modes of ventilation","paralysis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[101],"test_indices_end":[119],"treatment_indices_start":[141,170,182,197],"treatment_indices_end":[167,179,190,223]}
{"text":"the patient required 100% oxygen to maintain adequate oxygen saturations on the ventilator .","problem":[],"test":[],"treatment":["100% oxygen","the ventilator"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21,76],"treatment_indices_end":[32,90]}
{"text":"these were supported with blood products and hematology was consulted .","problem":[],"test":[],"treatment":["blood products"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[40]}
{"text":"he was started on pentamidine , especially in light of the fact that it was felt that his liver function tests were due possibly to bactrim .","problem":[],"test":["his liver function tests"],"treatment":["pentamidine","bactrim"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[86],"test_indices_end":[110],"treatment_indices_start":[18,132],"treatment_indices_end":[29,139]}
{"text":"the patient actually developed decreasing counts with white count as low as 1.75 , hematocrit as low as 26 , and platelets as low as 68 noted on 02\/15\/91 .","problem":["decreasing counts"],"test":["hematocrit","platelets","white count"],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[48],"test_indices_start":[54,83,113],"test_indices_end":[65,93,122],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"showed regular rate and rhythm without murmurs , rubs , or gallops .","problem":["gallops","rubs","murmurs"],"test":[],"treatment":[],"problem_indices_start":[39,49,59],"problem_indices_end":[46,53,66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient expired after the endotracheal tube was withdrawn at 6:40 p.m.","problem":[],"test":[],"treatment":["the endotracheal tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[43]}
{"text":"on presentation , the patient was a young appearing hispanic male in mild respiratory distress with a blood pressure of 140\/90 , heart rate 120 , respirations 32 , and temperature 101 .","problem":["mild respiratory distress"],"test":["a blood pressure","heart rate","temperature","respirations"],"treatment":[],"problem_indices_start":[69],"problem_indices_end":[94],"test_indices_start":[100,129,146,168],"test_indices_end":[116,139,158,179],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 02\/06\/91 , he was seen in flfdmc and at that point , his temperature was noted to be 101.4 and he had malaise and diarrhea .","problem":["diarrhea","malaise"],"test":["his temperature"],"treatment":[],"problem_indices_start":[105,117],"problem_indices_end":[112,125],"test_indices_start":[56],"test_indices_end":[71],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 02\/13\/91 , the patient had a bronchoalveolar lavage performed which showed a toluidine blue with many pneumocysts noted .","problem":["a toluidine blue","many pneumocysts"],"test":["a bronchoalveolar lavage"],"treatment":[],"problem_indices_start":[78,100],"problem_indices_end":[94,116],"test_indices_start":[30],"test_indices_end":[54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in terms of pulmonary function , it was felt that one possibility was that the patient was a bactrim failure for pcp although this was unusual .","problem":["a bactrim failure","pcp"],"test":[],"treatment":[],"problem_indices_start":[91,113],"problem_indices_end":[108,116],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in terms of his liver abnormalities , it was felt that viral hepatitis was in the differential as well as several opportunistic infections of the liver but also was felt that bactrim could be a cause of these abnormalities .","problem":["several opportunistic infections of the liver","his liver abnormalities","these abnormalities","viral hepatitis"],"test":[],"treatment":["bactrim"],"problem_indices_start":[12,55,106,203],"problem_indices_end":[35,70,151,222],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[175],"treatment_indices_end":[182]}
{"text":"sodium was 133 , potassium was 4.2 , chloride 100 , co2 19 , bun 21 , creatinine 1.2 , and glucose 122 .","problem":[],"test":["glucose","potassium","sodium","chloride","creatinine","bun","co2"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,17,37,52,61,70,91],"test_indices_end":[6,26,45,55,64,80,98],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"also of note at that point , hepatitis c virus serologies had come back positive .","problem":[],"test":["hepatitis c virus serologies"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[29],"test_indices_end":[57],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's penile ulcer was cultured and grew positive herpes simplex virus and the patient was started on acyclovir .","problem":["positive herpes simplex virus","the patient 's penile ulcer"],"test":[],"treatment":["acyclovir"],"problem_indices_start":[0,55],"problem_indices_end":[32,84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[116],"treatment_indices_end":[125]}
{"text":"2) pneumocystis carinii pneumonia .","problem":["pneumocystis carinii pneumonia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"discussions were begun with the family regarding limits of supportive care .","problem":[],"test":[],"treatment":["supportive care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[59],"treatment_indices_end":[74]}
{"text":"1) hiv positive with a cd4 count of 74 .","problem":["hiv positive"],"test":["a cd4 count"],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[21],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"they felt that it was most likely secondary to bactrim and these actually were getting better when the patient died .","problem":[],"test":[],"treatment":["bactrim"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47],"treatment_indices_end":[54]}
{"text":"1) acquired immunodeficiency syndrome .","problem":["acquired immunodeficiency syndrome"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bone marrow biopsy was not attempted .","problem":[],"test":["bone marrow biopsy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 02\/08\/91 , the patient called dr. seen because of increased shortness of breath and malaise .","problem":["increased shortness of breath","malaise"],"test":[],"treatment":[],"problem_indices_start":[53,87],"problem_indices_end":[82,94],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"had tubular breath sounds especially in the lower lung fields .","problem":["tubular breath sounds"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mr. breutzfarstxei was recently diagnosed with acquired immunodeficiency syndrome when he had pneumocystis carinii pneumonia on 01\/17\/91 .","problem":["acquired immunodeficiency syndrome","pneumocystis carinii pneumonia"],"test":[],"treatment":[],"problem_indices_start":[47,94],"problem_indices_end":[81,124],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was given supplemental oxygen .","problem":[],"test":[],"treatment":["supplemental oxygen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[32]}
{"text":"2) recent pcp .","problem":["recent pcp"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient underwent liver biopsy on 02\/16\/91 and the results of this were pending when the patient died .","problem":[],"test":["liver biopsy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[18],"test_indices_end":[30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an autopsy will be performed .","problem":[],"test":["an autopsy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was admitted for work-up of his cholestatic jaundice picture along with work-up for his pulmonary process and treatment of both .","problem":["his cholestatic jaundice picture","his pulmonary process"],"test":["work-up","work-up"],"treatment":["treatment"],"problem_indices_start":[40,96],"problem_indices_end":[72,117],"test_indices_start":[29,84],"test_indices_end":[36,91],"treatment_indices_start":[122],"treatment_indices_end":[131]}
{"text":"however , at this point , his liver function test abnormalities appeared more consistent with a cholestatic picture with his direct bilirubin being 12.1 and total being 14.1 .","problem":["a cholestatic picture","his liver function test abnormalities"],"test":["total","his direct bilirubin"],"treatment":[],"problem_indices_start":[26,94],"problem_indices_end":[63,115],"test_indices_start":[121,157],"test_indices_end":[141,162],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no costovertebral angle tenderness .","problem":["costovertebral angle tenderness"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4) venereal disease history .","problem":["venereal disease history"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3) adult respiratory distress syndrome .","problem":["adult respiratory distress syndrome"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his chest x-ray showed bilateral nodular infiltrates .","problem":["bilateral nodular infiltrates"],"test":["his chest x-ray"],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[52],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no other cultures grew out and the patient 's clinical status deteriorated .","problem":[],"test":["other cultures"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was admitted to the retelk county medical center at that time and was treated with bactrim and steroids .","problem":[],"test":[],"treatment":["steroids","bactrim"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[86,98],"treatment_indices_end":[93,106]}
{"text":"his penis had a 1\/2 cm ulcer with yellowish discharge .","problem":["yellowish discharge","1\/2 cm ulcer"],"test":[],"treatment":[],"problem_indices_start":[16,34],"problem_indices_end":[28,53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had no cervical adenopathy and his neck was supple .","problem":["cervical adenopathy"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3) status post right elbow surgery .","problem":[],"test":[],"treatment":["right elbow surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[34]}
{"text":"he had guaiac positive stools .","problem":["guaiac positive stools"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an autopsy was performed as per the family 's wishes .","problem":[],"test":["an autopsy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"( on 02\/06 , his bilirubin had been 7.2 with 6 direct ) .","problem":[],"test":["his bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at that time , his oxygen saturation was only 90% on room air and his chest x-ray showed no change .","problem":[],"test":["his chest x-ray","his oxygen saturation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[15,66],"test_indices_end":[36,81],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cultures were taken and he was sent out .","problem":[],"test":["cultures"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his oxygen saturation at that time was only 86% on room air and he was admitted .","problem":[],"test":["his oxygen saturation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"initially , the patient did well in terms of his pre-status and required less oxygen .","problem":[],"test":[],"treatment":["oxygen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[78],"treatment_indices_end":[84]}
{"text":"fortunately , no evidence of baratroma was ever discerned .","problem":["baratroma"],"test":[],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following evaluation and treatment , the patient 's disposition at the end of the visit was admitted as an inpatient to daughtersvillshamen's hospital .","problem":[],"test":["evaluation"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[20],"treatment_indices_start":[25],"treatment_indices_end":[34]}
{"text":"the patient presented with a chief complaint of hematuria .","problem":["hematuria"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's preliminary admitting physician is linkethore , hansverllen g and the preliminary diagnosis is hematuria .","problem":["hematuria"],"test":[],"treatment":[],"problem_indices_start":[115],"problem_indices_end":[124],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient denies melena , hematochezia , nausea , and abdominal pain .","problem":["abdominal pain","nausea","melena","hematochezia"],"test":[],"treatment":[],"problem_indices_start":[19,28,43,56],"problem_indices_end":[25,40,49,70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdominal ct while in the emergency department revealed likely primary colorectal adenocarcinoma with multiple liver metastases .","problem":["primary colorectal adenocarcinoma","multiple liver metastases"],"test":["abdominal ct"],"treatment":[],"problem_indices_start":[63,102],"problem_indices_end":[96,127],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. question of history of avn or osseous necrosis","problem":["avn","osseous necrosis"],"test":[],"treatment":[],"problem_indices_start":[26,33],"problem_indices_end":[29,49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient received two units of packed red blood cells and the hematocrit rose to 30 the following day .","problem":[],"test":["the hematocrit"],"treatment":["packed red blood cells"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[61],"test_indices_end":[75],"treatment_indices_start":[34],"treatment_indices_end":[56]}
{"text":"the patient is allergic to msg from which he gets hives .","problem":["hives","allergic"],"test":[],"treatment":[],"problem_indices_start":[15,50],"problem_indices_end":[23,55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 71-year-old police chief who presents with painless jaundice x1 day .","problem":["painless jaundice"],"test":[],"treatment":[],"problem_indices_start":[60],"problem_indices_end":[77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"biopsy was taken at colonoscopy on 7\/5\/99 .","problem":[],"test":["biopsy","colonoscopy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,20],"test_indices_end":[6,31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was to follow-up with the petersly hospital and medical center as an outpatient for further treatment .","problem":[],"test":[],"treatment":["further treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[96],"treatment_indices_end":[113]}
{"text":"glucotrol 10 q.a.m. and vitamins","problem":[],"test":[],"treatment":["glucotrol","vitamins"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,24],"treatment_indices_end":[9,32]}
{"text":"the patient presented to the emergency department with a complaint of painless jaundice , weight loss , and fatigue .","problem":["painless jaundice","fatigue","weight loss"],"test":[],"treatment":[],"problem_indices_start":[70,90,108],"problem_indices_end":[87,101,115],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"also denies tenesmus .","problem":["tenesmus"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"iron 300 mg p.o. t.i.d. , glucotrol , acel 10 mg p.o. q.d. , and bactrim ss 1 tablet p.o. b.i.d.","problem":[],"test":[],"treatment":["iron","bactrim ss","glucotrol","acel"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,26,38,65],"treatment_indices_end":[4,35,42,75]}
{"text":"he also noted a 23 pound weight loss in the past 11 months despite having an increased appetite .","problem":["an increased appetite","a 23 pound weight loss"],"test":[],"treatment":[],"problem_indices_start":[14,74],"problem_indices_end":[36,95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. type ii diabetes mellitus diagnosed 06\/94 , well-controlled with last hemoglobin a1c 6.2","problem":["type ii diabetes mellitus"],"test":["last hemoglobin a1c"],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[28],"test_indices_start":[68],"test_indices_end":[87],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient denies night sweats in the past month .","problem":["night sweats"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hematocrit was 24 in the emergency department .","problem":[],"test":["hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his wife noted personality changes with increased irritability .","problem":["personality changes","increased irritability"],"test":[],"treatment":[],"problem_indices_start":[15,40],"problem_indices_end":[34,62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient also complained of fatigue and " feeling down " .","problem":["" feeling down "","fatigue"],"test":[],"treatment":[],"problem_indices_start":[31,43],"problem_indices_end":[38,69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient states that he is occasionally constipated .","problem":["occasionally constipated"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. vocal cord polyps","problem":["vocal cord polyps"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his condition is stable and he was discharged with the following medications :","problem":[],"test":[],"treatment":["the following medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[51],"treatment_indices_end":[76]}
{"text":"4. history of hyperkalemia .","problem":["hyperkalemia"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was generally in excellent health with a past medical history significant only for noninsulin dependent diabetes mellitus who was presented with painless jaundice x2 days .","problem":["noninsulin dependent diabetes mellitus","painless jaundice"],"test":[],"treatment":[],"problem_indices_start":[95,157],"problem_indices_end":[133,174],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head ct was done with final results pending on discharge .","problem":[],"test":["head ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on the day prior to admission , the patient 's family noted that " he looked yellow " and presented to the lorough medical center 's emergency department this after noon .","problem":["yellow"],"test":[],"treatment":[],"problem_indices_start":[87],"problem_indices_end":[93],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's father died at the age of 83 of chf .","problem":["chf"],"test":[],"treatment":[],"problem_indices_start":[52],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"question rta type 4","problem":["rta type 4"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a repeat chest x-ray done for dyspnea showed persistent pleural effusion with atelectasis versus pneumonia .","problem":["persistent pleural effusion","pneumonia","dyspnea","atelectasis"],"test":["a repeat chest x-ray"],"treatment":[],"problem_indices_start":[30,45,78,97],"problem_indices_end":[37,72,89,106],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dilaudid 2 to 4 mg po q3h prn pain , ativan 1 mg po q12h prn anxiety , zofran 8 mg po q8h prn nausea , compazine 10 mg po q6h prn nausea , decadron 20 mg po q6h x 2 doses .","problem":["nausea","nausea","anxiety","pain"],"test":[],"treatment":["compazine","decadron","dilaudid","ativan","zofran"],"problem_indices_start":[30,61,94,130],"problem_indices_end":[34,68,100,136],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,37,71,103,139],"treatment_indices_end":[8,43,77,112,147]}
{"text":"the patient has not obtained gynecologic care for 32 years until april 2004 when an increase in abdominal gerd and urinary symptoms lead her to initial consultation with dr. lentny farstnappsshee in gobrew street , denlandcobridclevena , west virginia 28880 .","problem":["urinary symptoms","abdominal gerd"],"test":[],"treatment":["gynecologic care"],"problem_indices_start":[96,115],"problem_indices_end":[110,131],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[45]}
{"text":"she was told to make an appointment two weeks after her surgery for removal of her retention sutures .","problem":[],"test":[],"treatment":["her surgery","her retention sutures","removal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[52,68,79],"treatment_indices_end":[63,75,100]}
{"text":"on postoperative day eight which is memorial day the patient was started on carboplatin-taxolchemo therapy , which she tolerated without complication .","problem":["complication"],"test":[],"treatment":["carboplatin-taxolchemo therapy"],"problem_indices_start":[137],"problem_indices_end":[149],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[76],"treatment_indices_end":[106]}
{"text":"at that time a pelvic ultrasound was performed showing extensive fluid and clear mass within the pelvi-abdominal cavity .","problem":["clear mass","extensive fluid"],"test":["a pelvic ultrasound"],"treatment":[],"problem_indices_start":[55,75],"problem_indices_end":[70,85],"test_indices_start":[13],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on postoperative day one , the patient 's urine culture came back with moderate e. coli .","problem":["moderate e. coli"],"test":["the patient 's urine culture"],"treatment":[],"problem_indices_start":[76],"problem_indices_end":[92],"test_indices_start":[27],"test_indices_end":[60],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"included prinzide 12.5 mg po daily , albuterol inhaler prn","problem":[],"test":[],"treatment":["albuterol inhaler","prinzide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9,37],"treatment_indices_end":[17,54]}
{"text":"she was also started on decadron in preparation for her chemotherapy .","problem":[],"test":[],"treatment":["decadron","her chemotherapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24,52],"treatment_indices_end":[32,68]}
{"text":"she was started on levofloxacin 500 mg po daily .","problem":[],"test":[],"treatment":["levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[31]}
{"text":"hypertension , asthma , obesity , history of heart murmur , hemorrhoids , whooping cough as a child .","problem":["obesity","hypertension","hemorrhoids","whooping cough","heart murmur","asthma"],"test":[],"treatment":[],"problem_indices_start":[0,15,24,45,60,74],"problem_indices_end":[12,21,31,57,71,88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient developed ulceration after im injection .","problem":["ulceration"],"test":[],"treatment":["im injection"],"problem_indices_start":[22],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39],"treatment_indices_end":[51]}
{"text":"tonsillectomy in 1947 , removal of a renal calculus in 1979 , cholecystectomy in 1986 .","problem":["a renal calculus"],"test":[],"treatment":["removal","cholecystectomy","tonsillectomy"],"problem_indices_start":[35],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,24,62],"treatment_indices_end":[13,31,77]}
{"text":"the patient tolerated nasogastric tube clamping trials with high residuals in the 600 cc range .","problem":["high residuals"],"test":["nasogastric tube clamping trials"],"treatment":[],"problem_indices_start":[60],"problem_indices_end":[74],"test_indices_start":[22],"test_indices_end":[54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her urine output subsequently increased .","problem":[],"test":["her urine output"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on postoperative day four , the patient continued to have nasogastric tube in place .","problem":[],"test":[],"treatment":["nasogastric tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[58],"treatment_indices_end":[74]}
{"text":"total abdominal hysterectomy , bilateral salpingooophorectomy , bilateral lymph node dissection , omentectomy , lysis of adhesions , removal of mass from surface of transverse colon .","problem":["mass","adhesions"],"test":[],"treatment":["bilateral lymph node dissection","lysis","removal","omentectomy","total abdominal hysterectomy","bilateral salpingooophorectomy"],"problem_indices_start":[121,144],"problem_indices_end":[130,148],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,31,64,98,112,133],"treatment_indices_end":[28,61,95,109,117,140]}
{"text":"at this point she had an elevated ca 125 at 440 and came to dr. chabechird for further consultation .","problem":["an elevated ca"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was instructed to take 20 mg at 11 pm the night before her next chemotherapy and 8 am on the morning of chemotherapy .","problem":[],"test":[],"treatment":["chemotherapy","her next chemotherapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[67,116],"treatment_indices_end":[88,128]}
{"text":"her levofloxacin was continued .","problem":[],"test":[],"treatment":["her levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"on postoperative day two , her foley was discontinued .","problem":[],"test":[],"treatment":["her foley"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[36]}
{"text":"she also had an episode of nausea with some emesis , after being treated with zofran with no relief , a nasogastric tube was placed which drained 1200 cc of bilious fluid .","problem":["some emesis","nausea","no relief","bilious fluid"],"test":[],"treatment":["zofran","a nasogastric tube"],"problem_indices_start":[27,39,90,157],"problem_indices_end":[33,50,99,170],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[78,102],"treatment_indices_end":[84,120]}
{"text":"achest x-ray done at that time showed left pleural effusion and small right pleural effusion , not pulmonary edema and left lower lobe consolidations .","problem":["pulmonary edema","left pleural effusion","small right pleural effusion","left lower lobe consolidations"],"test":["achest x-ray"],"treatment":[],"problem_indices_start":[38,64,99,119],"problem_indices_end":[59,92,114,149],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she also has food allergies to raw vegetables as well as some shortness of breath and throat constriction with shrimp .","problem":["throat constriction","some shortness of breath","food allergies"],"test":[],"treatment":[],"problem_indices_start":[13,57,86],"problem_indices_end":[27,81,105],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the postoperative recovery room the patient had a hematocrit of 29.2 with low urine output .","problem":["low urine output"],"test":["a hematocrit"],"treatment":[],"problem_indices_start":[77],"problem_indices_end":[93],"test_indices_start":[51],"test_indices_end":[63],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on postoperative day three , the patient had a port placed .","problem":[],"test":[],"treatment":["a port"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[45],"treatment_indices_end":[51]}
{"text":"the patient was admitted on 05\/16\/2004 for bowel preparation before the surgery .","problem":[],"test":[],"treatment":["bowel preparation","the surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[43,68],"treatment_indices_end":[60,79]}
{"text":"the report from the frozen section sent in the surgery came back with poorly differentiated adenocarcinoma , possibly serous carcinoma of the ovary .","problem":["poorly differentiated adenocarcinoma","serous carcinoma of the ovary"],"test":["the frozen section"],"treatment":["the surgery"],"problem_indices_start":[70,118],"problem_indices_end":[106,147],"test_indices_start":[16],"test_indices_end":[34],"treatment_indices_start":[43],"treatment_indices_end":[54]}
{"text":"64-year-old g5p5 postmenopausal for 10 years with a history of two months of progressive abdominal distention , crampy abdominal pain , urinary frequency and diarrhea .","problem":["progressive abdominal distention","urinary frequency","crampy abdominal pain","diarrhea"],"test":[],"treatment":[],"problem_indices_start":[77,112,136,158],"problem_indices_end":[109,133,153,166],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hypertension , asthma for 10 years , no hospitalizations , obesity , history of heart murmur , hemorrhoids and whooping cough as a child .","problem":["hypertension","asthma","whooping cough","obesity","heart murmur","hemorrhoids"],"test":[],"treatment":["hospitalizations"],"problem_indices_start":[0,15,59,80,95,111],"problem_indices_end":[12,21,66,92,106,125],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40],"treatment_indices_end":[56]}
{"text":"she also had one episode of shortness of breath .","problem":["shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[28],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"remarkable for colon cancer in her mother and maternal grandfather .","problem":["colon cancer"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 05\/17\/2004 the patient underwent atotal abdominal hysterectomy , bilateral salpingooophorectomy , bilateral node dissection , omentectomy , lysis of adhesions , removal of mass from surface of transverse colon .","problem":["adhesions","mass"],"test":[],"treatment":["lysis","removal","omentectomy","atotal abdominal hysterectomy","bilateral salpingooophorectomy","bilateral node dissection"],"problem_indices_start":[152,175],"problem_indices_end":[161,179],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36,68,101,129,143,164],"treatment_indices_end":[65,98,126,140,148,171]}
{"text":"she was given 1 unit of packed red blood cell .","problem":[],"test":[],"treatment":["packed red blood cell"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[45]}
{"text":"the patient was afebrile , her vital signs were stable and she maintained a good urine output .","problem":["afebrile"],"test":["her vital signs","urine output"],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[24],"test_indices_start":[27,81],"test_indices_end":[42,93],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was started on clear fluids with a nasogastric clamped .","problem":[],"test":[],"treatment":["a nasogastric"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37],"treatment_indices_end":[50]}
{"text":"no regular breast self examination , has not had a mammogram .","problem":[],"test":["a mammogram","regular breast self examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3,49],"test_indices_end":[34,60],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"demerol .","problem":[],"test":[],"treatment":["demerol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"on postoperative nine , her jp drain was discontinued .","problem":[],"test":[],"treatment":["her jp drain"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[36]}
{"text":"the patient was transferred to the floor without any complications .","problem":["any complications"],"test":[],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"colace 100 mg po bid , albuterol inhalers two puffs inhaled qid prn wheezing and asthma symptoms .","problem":["asthma symptoms","wheezing"],"test":[],"treatment":["colace","albuterol inhalers"],"problem_indices_start":[68,81],"problem_indices_end":[76,96],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,23],"treatment_indices_end":[6,41]}
{"text":"g5 , p5 normal pap smears , sexual active without dyspareunia .","problem":["dyspareunia"],"test":[],"treatment":[],"problem_indices_start":[50],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ovarian cancer .","problem":["ovarian cancer"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mri showed a large fluid filled abdomen with a relatively small mass measuring about 5 to 6 cm in the right pelvis .","problem":["a relatively small mass","a large fluid filled abdomen"],"test":["mri"],"treatment":[],"problem_indices_start":[11,45],"problem_indices_end":[39,68],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had episodes of bradycardia without subsequent fall in blood pressure at the beginning of his admission .","problem":["bradycardia","subsequent fall in blood pressure"],"test":[],"treatment":[],"problem_indices_start":[19,39],"problem_indices_end":[30,72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no clubbing or cyanosis .","problem":["clubbing","cyanosis"],"test":[],"treatment":[],"problem_indices_start":[3,15],"problem_indices_end":[11,23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on january 5 , he had a chest xray with a left apicalpneumothorax but was stable on chest xray of january 7 .","problem":["a left apicalpneumothorax"],"test":["a chest xray","chest xray"],"treatment":[],"problem_indices_start":[40],"problem_indices_end":[65],"test_indices_start":[22,84],"test_indices_end":[34,94],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , given his rapid clinical decline , this was deferred and i do not suspect that he will be a candidate for this , as the degree of his decline bodes a poor prognosis for him .","problem":["his rapid clinical decline","his decline"],"test":[],"treatment":[],"problem_indices_start":[16,140],"problem_indices_end":[42,151],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"maalox plus , extra strength , 15 cc p.o. q 6 hours prn indigestion ; magnesium sulfate ; sliding scale iv and potassium chloride , sliding scale iv .","problem":["indigestion"],"test":[],"treatment":["maalox plus , extra strength","magnesium sulfate","potassium chloride"],"problem_indices_start":[56],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,70,111],"treatment_indices_end":[28,87,129]}
{"text":"tylenol , 650 mg p.o. q 4 prn ; allopurinol , 100 mg p.o. q.d. ; peridex mouthwash , 10 ml b.i.d.; cholysteramineresin , 4 grams p.o. q.d. ; clotrimazole , one troche p.o. q.i.d. ; fentanyl patch , 100 mcg per hour topical q 72 hours ; glipizide , 10 mg p.o. q.d.; atarax , 25 operating table 50 mg p.o. q 6 to 8 hours prn itching ; regular sliding scale insulin ; kbl mouthwash , 15 ccp .o. q.d. prn mouth discomfort ; lactulose , 30 ml p.o. q.i.d. that was started on january 30 , for no bowel movements with instructions to continue until bowel movement and then decrease to b.i.d. or q.d. ; lidocaine , 2% , 10 ml ur q 3 to 4 hours prn for pain around foley site ; ativan , 0.25 to 0.5 mg iv q 4 to 6 hours prn anxiety with instructions to use caution .","problem":["itching","anxiety","bowel movements","pain around foley site","mouth discomfort"],"test":[],"treatment":["tylenol","clotrimazole","fentanyl patch","lidocaine","regular sliding scale insulin","glipizide","peridex mouthwash","lactulose","kbl mouthwash","atarax","ativan","cholysteramineresin","allopurinol"],"problem_indices_start":[323,401,490,644,715],"problem_indices_end":[330,417,505,666,722],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,32,65,99,141,181,236,265,333,365,420,595,669],"treatment_indices_end":[7,43,82,118,153,195,245,271,362,378,429,604,675]}
{"text":"sodium 137 , potassium 4.5 , chloride97 , bicarb 24 , bun 124 , creatinine 4.1 , glucose 144 , ast 49 , alt33 , alkaline phosphatase 253 , total bili 1.6 , calcium 9.2 , magnesium 2.3 , albumin 3.4 .","problem":[],"test":["chloride97","bicarb","ast","potassium","alkaline phosphatase","creatinine","calcium","sodium","total bili","albumin","magnesium","alt33","bun","glucose"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,29,42,54,64,81,95,104,112,139,156,170,186],"test_indices_end":[6,22,39,48,57,74,88,98,109,132,149,163,179,193],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lasix , 80 ; avandia , 4 b.i.d. ; glipizide , 10 b.i.d.; imdur , 30 ; allopurinol ; zocor , 20 ; prilosec , 20 , potassium , 40 ; oxycontin , 30 b.i.d.; subcutaneous heparin ; unasyn , 1.5 grams q 6 ; combivent and morphine prn .","problem":[],"test":[],"treatment":["combivent","prilosec","lasix","morphine","avandia","zocor","oxycontin","glipizide","subcutaneous heparin","allopurinol","unasyn","imdur","potassium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,13,34,57,70,84,97,113,130,153,176,201,215],"treatment_indices_end":[5,20,43,62,81,89,105,122,139,173,182,210,223]}
{"text":"the plan will be to continue to try to alternate albumin and lasix to mobilize his fluid .","problem":["his fluid"],"test":[],"treatment":["albumin","lasix"],"problem_indices_start":[79],"problem_indices_end":[88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49,61],"treatment_indices_end":[56,66]}
{"text":"he received a two week course of broad spectrum antibiotics and will be maintained on levofloxacin iv for prophylaxis against sbp .","problem":["sbp"],"test":[],"treatment":["broad spectrum antibiotics","prophylaxis","levofloxacin iv"],"problem_indices_start":[126],"problem_indices_end":[129],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[33,86,106],"treatment_indices_end":[59,101,117]}
{"text":"this had to be performed by ir because the pocket was too deep to access from the bedside .","problem":["the pocket"],"test":[],"treatment":[],"problem_indices_start":[39],"problem_indices_end":[49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on january 1 , a chest tube was placed for a loculated pleural effusion .","problem":["a loculated pleural effusion"],"test":[],"treatment":["a chest tube"],"problem_indices_start":[43],"problem_indices_end":[71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[27]}
{"text":"he had experienced some constipation for the few months prior with lighter colored stools , darkened urine and fatigue for months with increased shortness of breath , orthopnea and dyspnea on exertion .","problem":["some constipation","lighter colored stools","dyspnea","orthopnea","increased shortness of breath","darkened urine","fatigue"],"test":[],"treatment":[],"problem_indices_start":[19,67,92,111,135,167,181],"problem_indices_end":[36,89,106,118,164,176,188],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hydrocortisone , 1% topical cream q 6 to 8 hours prn itching .","problem":["itching"],"test":[],"treatment":["hydrocortisone"],"problem_indices_start":[53],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[14]}
{"text":"cultures were negative and onlyon one gram stain did it show rare gram negative rods .","problem":["rare gram negative rods"],"test":["cultures","one gram stain","cultures"],"treatment":[],"problem_indices_start":[61],"problem_indices_end":[84],"test_indices_start":[0,34],"test_indices_end":[8,48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"discussion , at that point in time , should occur with the family about comfort measures and about weaning him from his medications to make him more comfortable .","problem":[],"test":[],"treatment":["comfort measures","his medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[72,116],"treatment_indices_end":[88,131]}
{"text":"white blood count 4.36 , hematocrit 26.1 with platelets of 107,000 , mcv 81 .","problem":[],"test":["platelets","hematocrit","white blood count","mcv"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,25,46,69],"test_indices_end":[17,35,55,72],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neurologic examination - alert and oriented x 3 , slurred and slow speech , distractable .","problem":["slurred and slow speech","distractable"],"test":["neurologic examination"],"treatment":[],"problem_indices_start":[50,76],"problem_indices_end":[73,88],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an ercp performed there showed a long segment of distal narrowing of the common bileduct and a transhepatic biliary drain was placed there on december 29 .","problem":["a long segment of distal narrowing of the common bileduct"],"test":["an ercp"],"treatment":["a transhepatic biliary drain"],"problem_indices_start":[31],"problem_indices_end":[88],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[93],"treatment_indices_end":[121]}
{"text":"the patient had signs and symptoms develop of sbp , also with an elevated white count .","problem":["signs","an elevated white count","symptoms","sbp"],"test":[],"treatment":[],"problem_indices_start":[16,26,46,62],"problem_indices_end":[21,34,49,85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest xray is still consistent with volume overload .","problem":["volume overload"],"test":["chest xray"],"treatment":[],"problem_indices_start":[36],"problem_indices_end":[51],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest xray was consistent with pleurodesis .","problem":["pleurodesis"],"test":["chest xray"],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[42],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"levofloxacin , 250 mg p.o. q.d. ; albuterol and atrovent nebs q 4 to6 hours as needed prn wheeze .","problem":["wheeze"],"test":[],"treatment":["levofloxacin","albuterol and atrovent nebs"],"problem_indices_start":[90],"problem_indices_end":[96],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,34],"treatment_indices_end":[12,61]}
{"text":"from a pulmonary standpoint , he continued to complain of shortness of breath .","problem":["shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[58],"problem_indices_end":[77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is a 61 year old male with a history of diabetes , coronary artery disease , hepatitis c , and asthma who was diagnosed recently with pancreatic cancer after he presented to seph'sju memorial after a motor vehicle accident .","problem":["diabetes","pancreatic cancer","coronary artery disease","hepatitis c","asthma"],"test":[],"treatment":[],"problem_indices_start":[45,56,82,100,139],"problem_indices_end":[53,79,93,106,156],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he will be maintained on levofloxacin for prophylaxis against sbp .","problem":["sbp"],"test":[],"treatment":["levofloxacin","prophylaxis"],"problem_indices_start":[62],"problem_indices_end":[65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25,42],"treatment_indices_end":[37,53]}
{"text":"the patient 's abdominal fluid cell counts showed 2400 white blood cells , 500 red cells with 82 polyps , 11 lymphs , 7 monos .","problem":[],"test":["lymphs","white blood cells","monos","red cells","polyps","the patient 's abdominal fluid cell counts"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,60,84,102,114,125],"test_indices_end":[47,77,93,108,120,130],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he is also on reglan , 10 mg p.o. q h ; miracle topical cream to affected area ; also sarna , topical cream , b.i.d.","problem":["affected area"],"test":[],"treatment":["sarna , topical cream","reglan","miracle topical cream"],"problem_indices_start":[65],"problem_indices_end":[78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14,40,86],"treatment_indices_end":[20,61,107]}
{"text":"his pain here has been controlled , initially on oxycontin with morphine for breakthrough pain .","problem":["his pain","breakthrough pain"],"test":[],"treatment":["oxycontin","morphine"],"problem_indices_start":[0,77],"problem_indices_end":[8,94],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49,64],"treatment_indices_end":[58,72]}
{"text":"his appetite is decreasing somewhat as his disease process progresses , therefore , we have liberalized his diet for him to take what he wishes .","problem":["his disease process"],"test":[],"treatment":[],"problem_indices_start":[39],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"as he becomes progressively more somnolent , this will likely need to be switched to iv pain medications only .","problem":["progressively more somnolent"],"test":[],"treatment":["iv pain medications"],"problem_indices_start":[14],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[85],"treatment_indices_end":[104]}
{"text":"echocardiogram showed 50% ejection fraction with mild mitral regurgitation .","problem":["mild mitral regurgitation"],"test":["echocardiogram"],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[74],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest had diffuse crackles bilaterally halfway up .","problem":["diffuse crackles bilaterally"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient initially came for workup of pancreatic cancer with a questions of palliative chemotherapy .","problem":["pancreatic cancer"],"test":["workup"],"treatment":["palliative chemotherapy"],"problem_indices_start":[41],"problem_indices_end":[58],"test_indices_start":[31],"test_indices_end":[37],"treatment_indices_start":[79],"treatment_indices_end":[102]}
{"text":"ocean spray q.i.d. to nares prn nasal dryness .","problem":["nasal dryness"],"test":[],"treatment":["ocean spray"],"problem_indices_start":[32],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"multivitamin , one tab q.d. morphine immediate release , msir , 15 to 30 mg p.o. q 2 to 3 hours prn pain .","problem":["pain"],"test":[],"treatment":["multivitamin","msir","morphine immediate release"],"problem_indices_start":[100],"problem_indices_end":[104],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,28,57],"treatment_indices_end":[12,54,61]}
{"text":"coronary - irregular pvcs , s1 , s2 normal , positive systolic murmur at the left upper sternal border radiating throughout .","problem":["positive systolic murmur at the left upper sternal border","irregular pvcs"],"test":[],"treatment":[],"problem_indices_start":[11,45],"problem_indices_end":[25,102],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , with persistent abdomen distention , there is likely restrictive deficit and , in addition , after each tap , he at times became hypotensive and with some mild fluid resuscitation decompensated with pulmonary edema , requiring both albumin and lasix to try to mobilize third space fluids .","problem":["third space fluids","hypotensive","pulmonary edema","restrictive deficit","persistent abdomen distention"],"test":["tap"],"treatment":["some mild fluid resuscitation","lasix","albumin"],"problem_indices_start":[15,63,139,209,279],"problem_indices_end":[44,82,150,224,297],"test_indices_start":[114],"test_indices_end":[117],"treatment_indices_start":[160,242,254],"treatment_indices_end":[189,249,259]}
{"text":"asthma .","problem":["asthma"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient gets very somnolent with ativan .","problem":["very somnolent"],"test":[],"treatment":["ativan"],"problem_indices_start":[17],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37],"treatment_indices_end":[43]}
{"text":"chest ct revealed a pulmonary nodule .","problem":["a pulmonary nodule"],"test":["chest ct"],"treatment":[],"problem_indices_start":[18],"problem_indices_end":[36],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had a creatinine of 4.0 on admission and this decreased down to the mid ones with fluid , currently at 1.7 on discharge .","problem":[],"test":["a creatinine"],"treatment":["fluid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[7],"test_indices_end":[19],"treatment_indices_start":[85],"treatment_indices_end":[90]}
{"text":"hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen was distended , tympanitic , mildly tender epigastrium and right lower quadrant .","problem":["mildly tender epigastrium and right lower quadrant","tympanitic","distended"],"test":[],"treatment":[],"problem_indices_start":[12,24,37],"problem_indices_end":[21,34,87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on january 4 , he had a desaturation .","problem":["a desaturation"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had an elevated bilirubin on admission with decreased output of biliary drain .","problem":["an elevated bilirubin","decreased output"],"test":[],"treatment":["biliary drain"],"problem_indices_start":[16,56],"problem_indices_end":[37,72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[76],"treatment_indices_end":[89]}
{"text":"he was treated broadly with amp , levo and flagyl .","problem":[],"test":[],"treatment":["amp","levo","flagyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28,34,43],"treatment_indices_end":[31,38,49]}
{"text":"no rebound or guarding .","problem":["rebound","guarding"],"test":[],"treatment":[],"problem_indices_start":[3,14],"problem_indices_end":[10,22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was transferred from an outside hospital for a second opinion regarding workup of his pancreatic cancer .","problem":["his pancreatic cancer"],"test":["workup"],"treatment":[],"problem_indices_start":[94],"problem_indices_end":[115],"test_indices_start":[84],"test_indices_end":[90],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"clinically , this was consistent with sbp , although unfortunately , fluid was never sent for cytology and a lot of those white cells are most likely due to his cancer .","problem":["those white cells","his cancer","sbp"],"test":["cytology"],"treatment":[],"problem_indices_start":[38,116,157],"problem_indices_end":[41,133,167],"test_indices_start":[94],"test_indices_end":[102],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he denied any fevers , chills or night sweats .","problem":["night sweats","chills","fevers"],"test":[],"treatment":[],"problem_indices_start":[14,23,33],"problem_indices_end":[20,29,45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdominal ct revealed a 3.0 to 4.0 centimeter lesion in the pancreatic head .","problem":["a 3.0 to 4.0 centimeter lesion in the pancreatic head"],"test":["abdominal ct"],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[75],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"given that he will need continued taps,","problem":[],"test":["continued taps,"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24],"test_indices_end":[39],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his apical pneumothorax from the outside hospital had resolved .","problem":["his apical pneumothorax"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the drain was replaced over the wire , 8-10 by ir , when it was accidentally removed .","problem":[],"test":[],"treatment":["the drain"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"diabetes .","problem":["diabetes"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"from a heme standpoint , he presented anemic and with an elevated pt inr .","problem":["anemic","an elevated pt inr"],"test":[],"treatment":[],"problem_indices_start":[38,54],"problem_indices_end":[44,72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coronary artery disease with congestive heart failure .","problem":["coronary artery disease","congestive heart failure"],"test":[],"treatment":[],"problem_indices_start":[0,29],"problem_indices_end":[23,53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had reported an approximately 30 pound weight loss in six weeks .","problem":["30 pound weight loss in six weeks"],"test":[],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"from his urinalysis , he has mostly a prerenal state .","problem":["a prerenal state"],"test":["his urinalysis"],"treatment":[],"problem_indices_start":[36],"problem_indices_end":[52],"test_indices_start":[5],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hepatitis c .","problem":["hepatitis c"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he has nystatin suspension mouthwash , 10 cc swish and swallow q.i.d. he gets serax , 15 to 30 mg p.o. q h.s. prni nsomnia .","problem":["nsomnia"],"test":[],"treatment":["nystatin suspension mouthwash","serax"],"problem_indices_start":[115],"problem_indices_end":[122],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[7,78],"treatment_indices_end":[36,83]}
{"text":"on january 2 , pleurodesis was performed .","problem":[],"test":[],"treatment":["pleurodesis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[26]}
{"text":"his ca99 was normal .","problem":[],"test":["his ca99"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , this resolved on its own over the hospital course .","problem":[],"test":[],"treatment":["the hospital course"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40],"treatment_indices_end":[59]}
{"text":"psoriasis .","problem":["psoriasis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his avandia was discontinued secondary to the side effect profile .","problem":["the side effect profile"],"test":[],"treatment":["his avandia"],"problem_indices_start":[42],"problem_indices_end":[65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"the morphine is for breakthrough pain .","problem":["breakthrough pain"],"test":[],"treatment":["the morphine"],"problem_indices_start":[20],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"heart rate was 78 , blood pressure 98\/50 , respiratory rate of 32 , satting 91% on four liters .","problem":[],"test":["blood pressure","heart rate","respiratory rate","satting"],"treatment":["four liters"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,20,43,68],"test_indices_end":[10,34,59,75],"treatment_indices_start":[83],"treatment_indices_end":[94]}
{"text":"he was treated with broad spectrum antibiotics for a 14 day course for clinical sbp .","problem":["clinical sbp"],"test":[],"treatment":["broad spectrum antibiotics"],"problem_indices_start":[71],"problem_indices_end":[83],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[46]}
{"text":"his inr normalized , however , unfortunately , he developed bilateral deep venous thromboses during his hospital course and will be maintained on lovenox .","problem":["bilateral deep venous thromboses"],"test":["his inr"],"treatment":["lovenox","his hospital course"],"problem_indices_start":[60],"problem_indices_end":[92],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[100,146],"treatment_indices_end":[119,153]}
{"text":"he is being maintained on glipizide and sliding scale insulin .","problem":[],"test":[],"treatment":["sliding scale insulin","glipizide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,40],"treatment_indices_end":[35,61]}
{"text":"brain ct was negative , as was a bronchoscopy with lavage .","problem":[],"test":["a bronchoscopy","brain ct"],"treatment":["lavage"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,31],"test_indices_end":[8,45],"treatment_indices_start":[51],"treatment_indices_end":[57]}
{"text":"pancreatic cancer","problem":["pancreatic cancer"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neck was supple with no lymphadenopathy .","problem":["lymphadenopathy"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was ruled out for a myocardial infarction .","problem":["a myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he did not show any episodes of bradycardia throughout the remainder of his hospital course .","problem":["bradycardia"],"test":[],"treatment":["his hospital course"],"problem_indices_start":[32],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[72],"treatment_indices_end":[91]}
{"text":"extremities had 2+ bilateral lower extremity edema to knees .","problem":["2+ bilateral lower extremity edema to knees"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he is also on a fentanyl patch , 100 mcg q 72 hours .","problem":[],"test":[],"treatment":["a fentanyl patch"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[30]}
{"text":"heent - normocephalic \/ atraumatic , extraocular movements are intact , pupils equal , round and reactive to light and accommodation .","problem":["atraumatic"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he also required ffp initially to reverse his coagulopathy .","problem":["his coagulopathy"],"test":[],"treatment":["ffp"],"problem_indices_start":[42],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17],"treatment_indices_end":[20]}
{"text":"theyalso had diabetes and hypertension .","problem":["hypertension","diabetes"],"test":[],"treatment":[],"problem_indices_start":[13,26],"problem_indices_end":[21,38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vq was indeterminate .","problem":[],"test":["vq"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , he does require diuresis to prevent increased volume overload in his lungs from his hypoalbunemic state .","problem":["increased volume overload","his hypoalbunemic state"],"test":[],"treatment":["diuresis"],"problem_indices_start":[46,90],"problem_indices_end":[71,113],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[34]}
{"text":"in general , this is an obese male in mild respiratory distress .","problem":["mild respiratory distress"],"test":[],"treatment":[],"problem_indices_start":[38],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he required a few transfusions during his hospital course .","problem":[],"test":[],"treatment":["his hospital course","a few transfusions"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12,38],"treatment_indices_end":[30,57]}
{"text":"lenis were negative at that time .","problem":[],"test":["lenis"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[5],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mother and father died of heart failure .","problem":["heart failure"],"test":[],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"significant for recently diagnosed pancreatic cancer .","problem":["recently diagnosed pancreatic cancer"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"diabetes .","problem":["diabetes"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was afebrile .","problem":["afebrile"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gout .","problem":["gout"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[4],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sister with stomach cancer .","problem":["stomach cancer"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he underwent abdominal paracentesis approximately two times a week for therapeutic .","problem":[],"test":[],"treatment":["he underwent abdominal paracentesis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[35]}
{"text":"hypercholesterolemia .","problem":["hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if severe , then proceed to er for evaluation .","problem":[],"test":["evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[35],"test_indices_end":[45],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"amoxicillin 1,000 mg po bid x 28 doses","problem":[],"test":[],"treatment":["amoxicillin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"her pain currently is 5\/10 .","problem":["her pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"other diagnosis ; conditions , infections , complications , affecting treatment \/ stay obesity htn high cholesterol tobacco fhx of cad ett 12\/94 ( - ) ischemia echo 02\/89 nl ett 03\/89 , 07\/90 c \/ w nd ische","problem":["ischemia","cad","high cholesterol","nd ische","htn","obesity"],"test":["nl ett","echo"],"treatment":["ett"],"problem_indices_start":[87,95,99,131,151,198],"problem_indices_end":[94,98,115,134,159,206],"test_indices_start":[160,171],"test_indices_end":[164,177],"treatment_indices_start":[135],"treatment_indices_end":[138]}
{"text":"mri hida ct","problem":[],"test":["hida","mri","ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,4,9],"test_indices_end":[3,8,11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt was seen by gi on 13 egd was performed hd2 which was negative for gastritis , stricture or ulcer .","problem":["gastritis","stricture","ulcer"],"test":["egd"],"treatment":[],"problem_indices_start":[69,81,94],"problem_indices_end":[78,90,99],"test_indices_start":[24],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"afferent limb of the roux en y anastamosis was visualized however the efferent limb could not be explored .","problem":[],"test":[],"treatment":["roux en y anastamosis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[42]}
{"text":"override added on 01\/23\/05 by dainsaylesnoort , ager , m.d. , ph.d. on order for clarithromycin po ( ref # 99052380 )","problem":[],"test":[],"treatment":["clarithromycin po"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[81],"treatment_indices_end":[98]}
{"text":"pt had hida scan which was negative for obstruction , and ct was unremarkable .","problem":["obstruction"],"test":["ct","hida scan"],"treatment":[],"problem_indices_start":[40],"problem_indices_end":[51],"test_indices_start":[7,58],"test_indices_end":[16,60],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if fevers , chills , nausea , vomiting , diarrhea , increasing pain with food please call dr. gaetzfreierm 's office or pcp .","problem":["vomiting","increasing pain with food","fevers","nausea","diarrhea","chills"],"test":[],"treatment":[],"problem_indices_start":[3,12,21,30,41,52],"problem_indices_end":[9,18,27,38,49,77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"simvastatin and clarithromycin","problem":[],"test":[],"treatment":["clarithromycin","simvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,16],"treatment_indices_end":[11,30]}
{"text":"wellbutrin sr ( bupropion hcl sustained release ) 200 mg po bid","problem":[],"test":[],"treatment":["wellbutrin sr ( bupropion hcl sustained release )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[49]}
{"text":"percocet , iv contrast , lisinopril , atenolol","problem":[],"test":[],"treatment":["percocet","lisinopril","atenolol","iv contrast"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,11,25,38],"treatment_indices_end":[8,22,35,46]}
{"text":"the pt is a 55yo f s \/ p roux en y gbp in 12\/20 presenting to the ed this am c \/ o mod severe midepigastric pain .","problem":["mod severe midepigastric pain"],"test":[],"treatment":["roux en y gbp"],"problem_indices_start":[83],"problem_indices_end":[112],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25],"treatment_indices_end":[38]}
{"text":"she has also had intermittent post-prandial nausea \/ satiety for which she had been scheduled for an outpt egd with gi on 2\/8 .","problem":["intermittent post-prandial nausea \/ satiety"],"test":["an outpt egd","gi"],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[60],"test_indices_start":[98,116],"test_indices_end":[110,118],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"plans to follow up with outpatient mra to rule out ischemic causes of post prandial pain , as well as hida with ck challenge to evaluate for biliary dyskinesia without stasis .","problem":["post prandial pain","biliary dyskinesia"],"test":["outpatient mra","hida with ck challenge"],"treatment":[],"problem_indices_start":[70,141],"problem_indices_end":[88,159],"test_indices_start":[24,102],"test_indices_end":[38,124],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"takes hubby 's sl ntg barium swallow 04\/89 ( - ) ugi 06\/91 ( - )","problem":[],"test":["barium swallow","ugi"],"treatment":["sl ntg"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[27,54],"test_indices_end":[41,57],"treatment_indices_start":[20],"treatment_indices_end":[26]}
{"text":"please continue taking the antibiotics for h. pylori for full course ( 26 more days ) .","problem":["h. pylori"],"test":[],"treatment":["the antibiotics"],"problem_indices_start":[43],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[38]}
{"text":"esomeprazole 20 mg po bid x 28 doses","problem":[],"test":[],"treatment":["esomeprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"ros ( - ) emesis \/ brbpr\/melena \/ fever\/chills \/ sob .","problem":["fever\/chills","brbpr\/melena","emesis","sob"],"test":[],"treatment":[],"problem_indices_start":[10,19,34,49],"problem_indices_end":[16,31,46,52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"simvastatin and clarithromycin","problem":[],"test":[],"treatment":["simvastatin","clarithromycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,16],"treatment_indices_end":[11,30]}
{"text":"lamictal ( lamotrigine ) 150 mg po bid","problem":[],"test":[],"treatment":["lamictal ( lamotrigine )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"gastritis","problem":["gastritis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"potassium chloride slow rel. ( kcl slow release ) 40 meq po qd as per sc","problem":[],"test":[],"treatment":["potassium chloride slow rel. ( kcl slow release )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[49]}
{"text":"hydrochlorothiazide 25 mg po qd zocor ( simvastatin ) 40 mg po qhs","problem":[],"test":[],"treatment":["hydrochlorothiazide","zocor ( simvastatin )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,32],"treatment_indices_end":[19,53]}
{"text":"pt will finish course of h. pylori treatment as well .","problem":[],"test":[],"treatment":["h. pylori treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25],"treatment_indices_end":[44]}
{"text":"for h.pylori .","problem":["h.pylori"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"each 20 meq dose to be given with 4 oz of fluid cozaar ( losartan ) 50 mg po qd","problem":[],"test":[],"treatment":["cozaar ( losartan )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48],"treatment_indices_end":[67]}
{"text":"h.pylori tx .","problem":[],"test":[],"treatment":["h.pylori tx"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"simvastatin and clarithromycin","problem":[],"test":[],"treatment":["simvastatin","clarithromycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,16],"treatment_indices_end":[11,30]}
{"text":"clarithromycin 500 mg po bid x 28 doses","problem":[],"test":[],"treatment":["clarithromycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[14]}
{"text":"pt was found to be h. pylori positive and therefore was started on empiric treatment .","problem":["h. pylori positive"],"test":[],"treatment":["empiric treatment"],"problem_indices_start":[19],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[67],"treatment_indices_end":[84]}
{"text":"she notes that she has had this pain since thursday , and that it becomes much worse within 15 min of consuming a meal .","problem":["this pain"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she describes the pain as band-like \/ radiating to both sides but not the back .","problem":["the pain"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gastritis","problem":["gastritis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"h. pylori tx .","problem":[],"test":[],"treatment":["h. pylori tx"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"will need to call for outpatient mra and hida with cck challenge to evaluate biliary system and mesenteric vasculature .","problem":[],"test":["mra","hida with cck challenge"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[33,41],"test_indices_end":[36,64],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"principal discharge diagnosis ; responsible after study for causing admission ) gastritis","problem":["gastritis"],"test":[],"treatment":[],"problem_indices_start":[80],"problem_indices_end":[89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"simvastatin and clarithromycin","problem":[],"test":[],"treatment":["clarithromycin","simvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,16],"treatment_indices_end":[11,30]}
{"text":"pt was tolerating regular diet by hd4 , and gi felt that further workup could be continued as an outpatient .","problem":[],"test":["further workup"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[57],"test_indices_end":[71],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 5-29-00 , she underwent thyroidectomy with removal of a 3.3 centimeter right lobe microfollicular adenoma and left lobe 6 mm .","problem":["a 3.3 centimeter right lobe microfollicular adenoma"],"test":[],"treatment":["removal","thyroidectomy"],"problem_indices_start":[57],"problem_indices_end":[108],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,46],"treatment_indices_end":[40,53]}
{"text":"papillary carcinoma .","problem":["papillary carcinoma","papillary carcinoma"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her deep tendon reflexes are symmetric .","problem":[],"test":["her deep tendon reflexes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chronic lymphocytic thyroiditis , status post right total and left subtotal oophorectomy , asthma , migraine , history of droperidol allergy .","problem":["migraine","chronic lymphocytic thyroiditis","droperidol allergy","asthma"],"test":[],"treatment":["right total and left subtotal oophorectomy"],"problem_indices_start":[0,91,100,122],"problem_indices_end":[31,97,108,140],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[46],"treatment_indices_end":[88]}
{"text":"there was no evidence of any middle compartment lymphadenopathy or spread of the tumor outside the thyroid .","problem":["any middle compartment lymphadenopathy","the tumor"],"test":[],"treatment":[],"problem_indices_start":[25,77],"problem_indices_end":[63,86],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"include a blood pressure of 174\/84 , respirations 14 , pulse 89 , temperature 98.9 , o2 sat 98% .","problem":[],"test":["respirations","pulse","a blood pressure","temperature","o2 sat"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[8,37,55,66,85],"test_indices_end":[24,49,60,77,91],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left thyroid occult papillary carcinoma .","problem":["left thyroid occult papillary carcinoma"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"carotid pulsations are normal without bruit .","problem":["bruit"],"test":[],"treatment":[],"problem_indices_start":[38],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has no dyspnea or dysphagia .","problem":["dyspnea","dysphagia"],"test":[],"treatment":[],"problem_indices_start":[11,22],"problem_indices_end":[18,31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has developed symptoms from a right lower dominant nodule with pressure discomfort in the neck .","problem":["pressure discomfort in the neck","a right lower dominant nodule","symptoms"],"test":[],"treatment":[],"problem_indices_start":[18,32,67],"problem_indices_end":[26,61,98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen is soft , non-tender , with no organomegaly or masses .","problem":["masses","organomegaly","non-tender"],"test":[],"treatment":[],"problem_indices_start":[18,39,55],"problem_indices_end":[28,51,61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her sutures were removed on postoperative day # one , at which time she went home in satisfactory condition .","problem":[],"test":[],"treatment":["her sutures"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"on physical exam , she is a healthy-appearing female with a normal voice and no exophthalmos .","problem":["exophthalmos"],"test":["physical exam"],"treatment":[],"problem_indices_start":[80],"problem_indices_end":[92],"test_indices_start":[3],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no family history of thyroid cancer .","problem":["thyroid cancer"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 51 year-old female , with a non-toxic multinodular goiter .","problem":["a non-toxic multinodular goiter"],"test":[],"treatment":[],"problem_indices_start":[43],"problem_indices_end":[74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has not received prior radiation exposure .","problem":[],"test":[],"treatment":["prior radiation exposure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[45]}
{"text":"clear to auscultation and percussion .","problem":[],"test":["percussion","auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[9,26],"test_indices_end":[21,36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"palpation of the neck discloses a multinodular goiter , larger on the right side , with no associated cervical lymphadenopathy .","problem":["associated cervical lymphadenopathy","a multinodular goiter"],"test":["palpation"],"treatment":[],"problem_indices_start":[32,91],"problem_indices_end":[53,126],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vital signs :","problem":[],"test":["vital signs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"non-toxic multinodular goiter .","problem":["non-toxic multinodular goiter"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"thyroidectomy .","problem":[],"test":[],"treatment":["thyroidectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"her heart rhythm is regular with a normal s1-s2 , and no murmur .","problem":["murmur"],"test":["her heart rhythm"],"treatment":[],"problem_indices_start":[57],"problem_indices_end":[63],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. synthroid 0.125 mg. daily .","problem":[],"test":[],"treatment":["synthroid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"bilaterally without stridor .","problem":["stridor"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. she will remove the neck suture lines steri-strips in 10 days .","problem":[],"test":[],"treatment":["the neck suture lines steri-strips"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[53]}
{"text":"abnormal pap test , history of ; bacterial vaginitis ; contraception management ; hiv counseled","problem":["abnormal pap test","bacterial vaginitis"],"test":[],"treatment":["contraception management"],"problem_indices_start":[0,33],"problem_indices_end":[17,52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[55],"treatment_indices_end":[79]}
{"text":"mouth normal neck normal thyroid wnl breasts normal no distinct masses nipples normal inverted [ b ] , evert w \/ stimulation chest normal lcta cor normal rrr abdomen normal gravid extrem normal skin normal nodes normal vulva normal no lesions , white d \/ c at introitus vagina normal sml amt thin white d \/ c ph 4.5 , koh +amine , ns +clue , neg trich cervix normal 1\/100\/0 srom clear os normal closed adnexae normal no palp masses , nt uterus normal gravid uterine size in weeks normal term rectum normal no ext lesions","problem":["white d \/ c at introitus","distinct masses","inverted","lesions","ext lesions","palp masses","sml amt thin white d \/ c","srom"],"test":["koh","ns","ph"],"treatment":["evert w \/ stimulation"],"problem_indices_start":[55,86,235,245,284,374,420,509],"problem_indices_end":[70,94,242,269,308,378,431,520],"test_indices_start":[309,318,331],"test_indices_end":[311,321,333],"treatment_indices_start":[103],"treatment_indices_end":[124]}
{"text":"she delivered a 3680 gram male infant on 10\/12\/2004 at 10:17 pm with apgar scores of 9 and 9 at one and five minutes respectively at 40.0 weeks gestation via spontaneous vertex vaginal delivery .","problem":[],"test":["apgar scores"],"treatment":["spontaneous vertex vaginal delivery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[69],"test_indices_end":[81],"treatment_indices_start":[158],"treatment_indices_end":[193]}
{"text":"metronidazole tablets ( flagyl ) ; multivitamins and folate capsules ( stuart prenatal with folate )","problem":[],"test":[],"treatment":["metronidazole tablets ( flagyl )","multivitamins and folate capsules ( stuart prenatal with folate )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,35],"treatment_indices_end":[32,100]}
{"text":"vaginal delivery with second degree laceration","problem":["second degree laceration"],"test":[],"treatment":["vaginal delivery"],"problem_indices_start":[22],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"srom in labor","problem":["labor","srom"],"test":[],"treatment":[],"problem_indices_start":[0,8],"problem_indices_end":[4,13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"spontaneous vertex vaginal delivery","problem":[],"test":[],"treatment":["spontaneous vertex vaginal delivery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[35]}
{"text":"srom in labor .","problem":["srom","labor"],"test":[],"treatment":[],"problem_indices_start":[0,8],"problem_indices_end":[4,13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"antimicrobial therapy","problem":[],"test":[],"treatment":["antimicrobial therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[21]}
{"text":"srom .","problem":["srom"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[4],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"32 y \/ o woman with h \/ o anxiety and depression and prior suicide attempt presents with tca and celexa overdose , tremulous \/ light-headed , felt better post charcoal .","problem":["anxiety","tremulous","tca and celexa overdose","prior suicide attempt","depression","light-headed"],"test":[],"treatment":["charcoal"],"problem_indices_start":[26,38,53,89,115,127],"problem_indices_end":[33,48,74,112,124,139],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[159],"treatment_indices_end":[167]}
{"text":"3\/7 -- repeat hco3 24 and 26 without bicarb drip .","problem":[],"test":["repeat hco3"],"treatment":["bicarb drip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[7],"test_indices_end":[18],"treatment_indices_start":[37],"treatment_indices_end":[48]}
{"text":"folate ( folic acid ) 1 mg po qd zantac ( ranitidine hcl ) 150 mg po bid mvi therapeutic w \/ minerals ( therap vits \/ minerals ) 1 tab po qd thiamine hcl 100 mg po qd","problem":[],"test":[],"treatment":["thiamine hcl","mvi therapeutic w \/ minerals ( therap vits \/ minerals )","folate ( folic acid )","zantac ( ranitidine hcl )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,33,73,141],"treatment_indices_end":[21,58,128,153]}
{"text":"principal discharge diagnosis ; responsible after study for causing admission ) tca overdose","problem":["tca overdose"],"test":[],"treatment":[],"problem_indices_start":[80],"problem_indices_end":[92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"other diagnosis ; conditions , infections , complications , affecting treatment \/ stay depression ( depression )","problem":["depression ( depression )"],"test":[],"treatment":[],"problem_indices_start":[87],"problem_indices_end":[112],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tca overdose","problem":["tca overdose"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rehabilitation","problem":[],"test":[],"treatment":["rehabilitation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[14]}
{"text":"no ekg changes , marijuana in urine , hco3 22 .","problem":[],"test":["marijuana in urine","hco3"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17,38],"test_indices_end":[35,42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"transferred to floor on day of admission with no acute medical issues ; awaiting psych eval .","problem":["acute medical issues"],"test":["psych eval"],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[69],"test_indices_start":[81],"test_indices_end":[91],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ekg without changes .","problem":[],"test":["ekg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dr. ee , patient to arrange , no known allergies","problem":["known allergies"],"test":[],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"not actively suicidal .","problem":["actively suicidal"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tca overdose","problem":["tca overdose"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"of note , nortriptyline level came back as 43 ( subtherapeutic -- normal 50-150 ) .","problem":[],"test":["nortriptyline level"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"best team eval found bed at psych rehab facility .","problem":[],"test":["best team eval"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"your patient was admitted under the care of sapsclyss , leo r with a preliminary diagnosis of pneumonia , .","problem":["pneumonia"],"test":[],"treatment":[],"problem_indices_start":[94],"problem_indices_end":[103],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following evaluation and treatment , the patient 's disposition at the end of the visit was admitted as an inpatient to heaonboburg linpack grant medical center .","problem":[],"test":["evaluation"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[20],"treatment_indices_start":[25],"treatment_indices_end":[34]}
{"text":"the patient presented with a chief complaint of wheezes .","problem":["wheezes"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. right sided sciatica procedure :","problem":[],"test":[],"treatment":["right sided sciatica procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[33]}
{"text":"his examination was completely unremarkable .","problem":[],"test":["his examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was admitted , taken to the operating room where he underwent l5-s1 right hemilaminectomy and discectomy .","problem":[],"test":[],"treatment":["l5-s1 right hemilaminectomy","discectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[65,97],"treatment_indices_end":[92,107]}
{"text":"over the next three days he increased his activity gradually , was able to do stairs with physical therapy and had pain which could be controlled with oral analgesics .","problem":["pain"],"test":[],"treatment":["physical therapy","oral analgesics"],"problem_indices_start":[115],"problem_indices_end":[119],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[90,151],"treatment_indices_end":[106,166]}
{"text":"in september 1992 ct myelogram showed a lateral l-1 s-1 disc bulge and small l-4-4 bulge .","problem":["a lateral l-1 s-1 disc bulge","small l-4-4 bulge"],"test":["ct myelogram"],"treatment":[],"problem_indices_start":[38,71],"problem_indices_end":[66,88],"test_indices_start":[18],"test_indices_end":[30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 42 year old gentleman who suffered lower back pain during an accident at work in 1990 .","problem":["lower back pain"],"test":[],"treatment":[],"problem_indices_start":[52],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right laminectomy and discectomy by dr. small , neurosurgery .","problem":[],"test":[],"treatment":["right laminectomy","discectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,22],"treatment_indices_end":[17,32]}
{"text":"this gradually increased until june 1992 where he had recurrent severe right sided sciatica .","problem":["recurrent severe right sided sciatica"],"test":[],"treatment":[],"problem_indices_start":[54],"problem_indices_end":[91],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he is discharged on percocet , colace and motrin .","problem":[],"test":[],"treatment":["colace","percocet","motrin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20,31,42],"treatment_indices_end":[28,37,48]}
{"text":"he has had no change in pain in the last few months .","problem":["pain"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"discharge orders ( medications instructions to patient , follow-up care ) :","problem":[],"test":[],"treatment":["medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[30]}
{"text":"multivitamins and folate","problem":[],"test":[],"treatment":["multivitamins","folate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,18],"treatment_indices_end":[13,24]}
{"text":"current smoker , history of ; depression , history of ; isoimmunization , rh ; undesired fertility","problem":["undesired fertility","isoimmunization , rh","depression"],"test":[],"treatment":[],"problem_indices_start":[30,56,79],"problem_indices_end":[40,76,98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"early labor \/ rule out labor","problem":["labor","early labor"],"test":[],"treatment":[],"problem_indices_start":[0,23],"problem_indices_end":[11,28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nuchal cord , x 1- reduced prior to delivery .","problem":["nuchal cord"],"test":[],"treatment":["delivery"],"problem_indices_start":[0],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36],"treatment_indices_end":[44]}
{"text":"home with self-care ( routine discharge )","problem":[],"test":[],"treatment":["self-care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10],"treatment_indices_end":[19]}
{"text":"spontaneous vertex vaginal delivery","problem":[],"test":[],"treatment":["spontaneous vertex vaginal delivery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[35]}
{"text":"this 22 year old gravida 4 para 2012 was admitted to the naliheall county memorial hospital obstetrical service on 10\/29\/2003 at 11:14 pm for the indication ( s ) : early labor \/ rule out labor .","problem":["labor","early labor"],"test":[],"treatment":[],"problem_indices_start":[165,188],"problem_indices_end":[176,193],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pp sterilization","problem":[],"test":[],"treatment":["pp sterilization"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"normal vaginal delivery","problem":[],"test":[],"treatment":["normal vaginal delivery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[23]}
{"text":"she delivered a 3263 gram female infant on 10\/30\/2003 at 05:03 am with apgar scores of 8 and 9 at one and five minutes respectively at 40.1 weeks gestation via spontaneous vertex vaginal delivery .","problem":[],"test":["apgar scores"],"treatment":["spontaneous vertex vaginal delivery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[71],"test_indices_end":[83],"treatment_indices_start":[160],"treatment_indices_end":[195]}
{"text":"electrocardiogram showed sinus tachycardia at a rate of 123 beats per minute compared to previous electrocardiogram of 1\/29 there were no significant changes .","problem":["significant changes","sinus tachycardia"],"test":["previous electrocardiogram","electrocardiogram"],"treatment":[],"problem_indices_start":[25,138],"problem_indices_end":[42,157],"test_indices_start":[0,89],"test_indices_end":[17,115],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was diuresed with intravenous lasix to which he responded with at lease a 2l urine output on the first day and 1.5l the second day .","problem":[],"test":["urine output"],"treatment":["intravenous lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[80],"test_indices_end":[92],"treatment_indices_start":[21],"treatment_indices_end":[38]}
{"text":"history of colon cancer status post hemicolectomy .","problem":["colon cancer"],"test":[],"treatment":["hemicolectomy"],"problem_indices_start":[11],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36],"treatment_indices_end":[49]}
{"text":"there were no wheezes or rhonchi .","problem":["wheezes","rhonchi"],"test":[],"treatment":[],"problem_indices_start":[14,25],"problem_indices_end":[21,32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was continued on antibiotics for possible pneumonia .","problem":["pneumonia"],"test":[],"treatment":["antibiotics"],"problem_indices_start":[54],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[40]}
{"text":"a chest x-ray showed clearing of the opacities in the chest x-ray that were consistent with pulmonary edema because he continued to have some abnormality in the right lower lobe .","problem":["the opacities","pulmonary edema","some abnormality in the right lower lobe"],"test":["the chest x-ray","a chest x-ray"],"treatment":[],"problem_indices_start":[33,92,137],"problem_indices_end":[46,107,177],"test_indices_start":[0,50],"test_indices_end":[13,65],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the antibiotic chosen was levaquin 500 mg 1 tab per day .","problem":[],"test":[],"treatment":["the antibiotic","levaquin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,26],"treatment_indices_end":[14,34]}
{"text":"the patient had missed his usual monthly change of his suprapubic catheter and felt discomfort and noticed some blood at the site of the catheter .","problem":["discomfort","some blood at the site"],"test":[],"treatment":["his suprapubic catheter"],"problem_indices_start":[84,107],"problem_indices_end":[94,129],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[51],"treatment_indices_end":[74]}
{"text":"the patient 's abdominal pain should be followed over the next week or so in case it does not respond to prilosec .","problem":["the patient 's abdominal pain"],"test":[],"treatment":["prilosec"],"problem_indices_start":[0],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[110],"treatment_indices_end":[118]}
{"text":"5. combivent 3 puffs four times per day .","problem":[],"test":[],"treatment":["combivent"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"no orthopnea .","problem":["orthopnea"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the ticarcillin was stopped after two days when it was felt that he did not have a serious pneumonia .","problem":["a serious pneumonia"],"test":[],"treatment":["the ticarcillin"],"problem_indices_start":[81],"problem_indices_end":[100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"the patient denies any recent upper respiratory infections , no fevers , no chills , no change in cough , sputum .","problem":["change in cough","chills","fevers","recent upper respiratory infections","sputum"],"test":[],"treatment":[],"problem_indices_start":[23,64,76,88,106],"problem_indices_end":[58,70,82,103,112],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood urea nitrogen 11 , creatinine .6 , uric acid 3.0 , alkaline phosphatase 78 , creatinine phosphokinase isoenzymes too low , hematocrit 41 , white blood cell count 11.6 .","problem":["creatinine phosphokinase isoenzymes too low"],"test":["white blood cell count","blood urea nitrogen","creatinine","uric acid","hematocrit","alkaline phosphatase"],"treatment":[],"problem_indices_start":[83],"problem_indices_end":[126],"test_indices_start":[0,25,41,57,129,145],"test_indices_end":[19,35,50,77,139,167],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given respiratory therapy in the way of nebulizer treatments in the oaksgekesser\/ memorial hospital emergency room because of a longstanding desire by patient and family to refrain from intubation to be considered do not resuscitate .","problem":[],"test":[],"treatment":["nebulizer treatments","intubation","respiratory therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,56,202],"treatment_indices_end":[41,76,212]}
{"text":"1. ativan 1 mg po twice a day .","problem":[],"test":[],"treatment":["ativan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"the patient had been taking his usual medications and using his nasal oxygen at home .","problem":[],"test":[],"treatment":["his nasal oxygen at home","his usual medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28,60],"treatment_indices_end":[49,84]}
{"text":"no paroxysmal nocturnal dyspnea .","problem":["paroxysmal nocturnal dyspnea"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. sorbitol 30 cc every other day .","problem":[],"test":[],"treatment":["sorbitol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"the patient did have any nausea , vomiting or evidence of gastrointestinal bleeding .","problem":["nausea","vomiting","gastrointestinal bleeding"],"test":[],"treatment":[],"problem_indices_start":[25,34,58],"problem_indices_end":[31,42,83],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he needed to go to a rehab facility for continued respiratory therapy and for physical therapy to increase his muscle strength .","problem":[],"test":[],"treatment":["physical therapy","a rehab facility","continued respiratory therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,40,78],"treatment_indices_end":[35,69,94]}
{"text":"coronary artery disease .","problem":["coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is a 76 year old white male with severe chronic obstructive pulmonary disease who has had several recent admissions to oaksgekesser\/ memorial hospital for respiratory insuffiencey most often secondary to pneumonia .","problem":["pneumonia","respiratory insuffiencey","severe chronic obstructive pulmonary disease"],"test":[],"treatment":[],"problem_indices_start":[38,160,209],"problem_indices_end":[82,184,218],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. prednisone 40 mg per day to be tapered over two weeks .","problem":[],"test":[],"treatment":["prednisone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"congestive heart failure .","problem":["congestive heart failure"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"these were thought to be consistent either with pneumonia or asymmetric pulmonary edema .","problem":["asymmetric pulmonary edema","pneumonia"],"test":[],"treatment":[],"problem_indices_start":[48,61],"problem_indices_end":[57,87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"i think his breathing was as good as to be expected with the amount of severe chronic obstructive pulmonary disease he had .","problem":["severe chronic obstructive pulmonary disease"],"test":[],"treatment":[],"problem_indices_start":[71],"problem_indices_end":[115],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his initial blood gases on 40% 02 was p02 102 , pc02 115 , ph 7.11 .","problem":[],"test":["his initial blood gases","p02","ph","pc02"],"treatment":["40% 02"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,38,48,59],"test_indices_end":[23,41,52,61],"treatment_indices_start":[27],"treatment_indices_end":[33]}
{"text":"4. history of colon cancer with a colectomy in the past .","problem":["colon cancer"],"test":[],"treatment":["a colectomy"],"problem_indices_start":[14],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32],"treatment_indices_end":[43]}
{"text":"however he was transferred to the medical intensive care unit where he received continuous respiratory therapy in theway of albuterol nebulizers as well as nasal oxygen , intravenous steroids and intravenous antibiotics .","problem":[],"test":[],"treatment":["intravenous steroids","intravenous antibiotics","albuterol nebulizers","continuous respiratory therapy","nasal oxygen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[80,124,156,171,196],"treatment_indices_end":[110,144,168,191,219]}
{"text":"heart exam revealed a soft s1 and s2 , no murmur was heard , no s3 .","problem":["murmur","s3"],"test":["heart exam"],"treatment":[],"problem_indices_start":[42,64],"problem_indices_end":[48,66],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's respiratory status continued to improve but towards the last 2-3 days of his hospitalization the amount of improvement was minimal .","problem":["the patient 's respiratory status"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. lasix 40 mg per day .","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"6. aerobid three puffs twice a day .","problem":[],"test":[],"treatment":["aerobid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"the patient 's major improvement came after the first two days with brisk diuresis with lasix .","problem":[],"test":[],"treatment":["lasix","brisk diuresis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[73,93],"treatment_indices_end":[87,98]}
{"text":"1. atonic bladder with a suprapubic tube .","problem":["atonic bladder"],"test":[],"treatment":["a suprapubic tube"],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[40]}
{"text":"the patient was doing relatively at home until one day prior to admission he complained discomfort over a suprapubic catheter area .","problem":["discomfort"],"test":[],"treatment":["a suprapubic catheter area"],"problem_indices_start":[88],"problem_indices_end":[98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[104],"treatment_indices_end":[130]}
{"text":"the patient at that time noted slight shortness of breath but was sent home anyway .","problem":["slight shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. coronary artery disease with a history of angina in the distant past .","problem":["angina","coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[3,45],"problem_indices_end":[26,51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neurological exam revealed an alert and oriented x 3 elderly male .","problem":[],"test":["neurological exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen was soft , nontender with no masses palpable .","problem":["masses palpable","nontender"],"test":[],"treatment":[],"problem_indices_start":[19,37],"problem_indices_end":[28,52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. levaquin 500 mg per day to be continued until 4\/12\/99 .","problem":[],"test":[],"treatment":["levaquin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"he had a blood pressure 110\/70 , heart rate 110 beats per minute and regular , respiratory rate 25 .","problem":[],"test":["heart rate","respiratory rate","a blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[7,33,79],"test_indices_end":[23,43,95],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. ativan .5 mg twice a day .","problem":[],"test":[],"treatment":["ativan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"neck exam revealed no jugular venous distention and no masses .","problem":["masses","jugular venous distention"],"test":["neck exam"],"treatment":[],"problem_indices_start":[22,55],"problem_indices_end":[47,61],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urine analysis showed 20-50 white blood cells and 3-5 red blood cells .","problem":[],"test":["urine analysis","red blood cells","white blood cells"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,28,54],"test_indices_end":[14,45,69],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. trusopt 1 gtt left eye three times a day .","problem":[],"test":[],"treatment":["trusopt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"sodium 148 , potassium 3.4 , glucose 174 , p02 102 , pc02 115 , ph 7.11 on 40% 02 .","problem":[],"test":["sodium","potassium","ph","pc02","glucose","p02"],"treatment":["40% 02"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,29,43,53,64],"test_indices_end":[6,22,36,46,57,66],"treatment_indices_start":[75],"treatment_indices_end":[81]}
{"text":"4. nasal oxygen 3l per minute .","problem":[],"test":[],"treatment":["nasal oxygen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"by the time the patient arrived at the oaksgekesser\/ memorial hospital emergency room he was in moderate respiratory distress .","problem":["moderate respiratory distress"],"test":[],"treatment":[],"problem_indices_start":[96],"problem_indices_end":[125],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"while in the oaksgekesser\/ memorial hospital the patient on 4\/4\/99 complained of mild epigastric discomfort because he was put in cimetidine while in the intensive care unit for prophylaxis against peptic ulcer disease .","problem":["mild epigastric discomfort","peptic ulcer disease"],"test":[],"treatment":["cimetidine","prophylaxis"],"problem_indices_start":[81,198],"problem_indices_end":[107,218],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[130,178],"treatment_indices_end":[140,189]}
{"text":"atonic bladder with suprapubic catheter .","problem":["atonic bladder"],"test":[],"treatment":["suprapubic catheter"],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[39]}
{"text":"there were new air space opacifications in the left apex and the right lower lobe .","problem":["new air space opacifications in the left apex and the right lower lobe"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was an elderly frail gentleman in moderate respiratory distress .","problem":["moderate respiratory distress"],"test":[],"treatment":[],"problem_indices_start":[37],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after one day in the medical intensive care unit the patient was stable enough to go to the floor where he continued the rest of his treatment .","problem":[],"test":[],"treatment":["his treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[129],"treatment_indices_end":[142]}
{"text":"deep tendon reflexes were symmetrical in all extremities .","problem":[],"test":["deep tendon reflexes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was brought to the emergency room one day prior to admission where he was evaluated by urology and had his catheter changed .","problem":[],"test":[],"treatment":["his catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[115],"treatment_indices_end":[127]}
{"text":"the patient was noted to be confused and to be disoriented toward the end of the day after complaining of shortness of breath for most of the day .","problem":["confused","shortness of breath","disoriented"],"test":[],"treatment":[],"problem_indices_start":[28,47,106],"problem_indices_end":[36,58,125],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"respiratory failure .","problem":["respiratory failure"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rectal exam was unremarkable with stool heme negative .","problem":[],"test":["stool heme","rectal exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,34],"test_indices_end":[11,44],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"anxiety .","problem":["anxiety"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on the day of admission the patient noticed increasing shortness of breath .","problem":["increasing shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[44],"problem_indices_end":[74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"during that period of time he received nebulizer treatments with albuterol .","problem":[],"test":[],"treatment":["nebulizer treatments","albuterol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39,65],"treatment_indices_end":[59,74]}
{"text":"a chest x-ray in the oaksgekesser\/ memorial hospital emergency room showed new changes on his chest x-ray on top of his usual severe bilateral emphysema_____ with scarring in both lungs .","problem":["scarring in both lungs","his usual severe bilateral emphysema_____","new changes"],"test":["a chest x-ray","his chest x-ray"],"treatment":[],"problem_indices_start":[75,116,163],"problem_indices_end":[86,157,185],"test_indices_start":[0,90],"test_indices_end":[13,105],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"as the patient 's diuresis continued his respiratory status improved .","problem":["his respiratory status"],"test":[],"treatment":["the patient 's diuresis"],"problem_indices_start":[42],"problem_indices_end":[64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[31]}
{"text":"lung exam revealed decreased breath sounds as well as crackles in the bases .","problem":["crackles in the bases","decreased breath sounds"],"test":["lung exam"],"treatment":[],"problem_indices_start":[19,54],"problem_indices_end":[42,75],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. heparin 5000 units subcutaneously twice a day .","problem":[],"test":[],"treatment":["heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"the patient was upgraded to prilosec 20 mg per day for possible treatment of gastritis or gastroesophageal reflux disease .","problem":["gastroesophageal reflux disease","gastritis"],"test":[],"treatment":["prilosec"],"problem_indices_start":[77,90],"problem_indices_end":[86,121],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28],"treatment_indices_end":[36]}
{"text":"he was in moderate respiratory distress .","problem":["moderate respiratory distress"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. anxiety .","problem":["anxiety"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"they wanted the patient to return to his home after a stay at a rehab facility .","problem":[],"test":[],"treatment":["a rehab facility"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[62],"treatment_indices_end":[78]}
{"text":"he also denies any chest pain .","problem":["chest pain"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his temperature was 98f .","problem":[],"test":["his temperature"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this consisted of continued nebulizer treatments as well as intravenous antibiotics and intravenous solu-medrol .","problem":[],"test":[],"treatment":["nebulizer treatments","intravenous solu-medrol","intravenous antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28,60,88],"treatment_indices_end":[48,83,111]}
{"text":"4. brimonidine 1 gtt left eye three times a day .","problem":[],"test":[],"treatment":["brimonidine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"associated medical problems include :","problem":["associated medical problems"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. xalatan eyedrops 1 gtt in left eye per day .","problem":[],"test":[],"treatment":["xalatan eyedrops"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[19]}
{"text":"3. xalatan 0.005% one gtt left eye qhs .","problem":[],"test":[],"treatment":["xalatan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"he was also started on intravenous ticarcillin for possible gram negative pneumonia .","problem":["gram negative pneumonia"],"test":[],"treatment":["intravenous ticarcillin"],"problem_indices_start":[60],"problem_indices_end":[83],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[46]}
{"text":"it is hoped that when he is transferred to a rehab facility that he will continue with physical therapy to regain his strength and regain independence in activities of daily living .","problem":[],"test":[],"treatment":["physical therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[87],"treatment_indices_end":[103]}
{"text":"1. albuterol 2.5 mg in 2.5 normal saline q4h .","problem":[],"test":[],"treatment":["2.5 normal saline","albuterol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,23],"treatment_indices_end":[12,40]}
{"text":"he had a normal head , eyes , ears , nose and throat exam .","problem":[],"test":["head , eyes , ears , nose and throat exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16],"test_indices_end":[57],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"11. prilosec 20 mg per day .","problem":[],"test":[],"treatment":["prilosec"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"severe chronic obstructive pulmonary disease .","problem":["severe chronic obstructive pulmonary disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10. trusopt 1gtt in left eye three times a day .","problem":[],"test":[],"treatment":["trusopt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[11]}
{"text":"right lower lobe pneumonia .","problem":["right lower lobe pneumonia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was felt that his respiratory status has been maximally treated by then .","problem":["his respiratory status"],"test":[],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. alphagan 1 gtt in left eye three times a day .","problem":[],"test":[],"treatment":["alphagan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"continue current medication","problem":[],"test":[],"treatment":["current medication"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9],"treatment_indices_end":[27]}
{"text":"noncardiac chest pain","problem":["noncardiac chest pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given printed instructions for chest pain ( english ) .","problem":["chest pain"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"labs stable , ntg sublingual , stress mibi was negative for ischemia .","problem":["ischemia"],"test":["stress mibi","labs"],"treatment":["ntg sublingual"],"problem_indices_start":[60],"problem_indices_end":[68],"test_indices_start":[0,31],"test_indices_end":[4,42],"treatment_indices_start":[14],"treatment_indices_end":[28]}
{"text":"return to the ed for worsening chest pain , shortness of breath , nausea \/ vomiting , fever \/ chills , weakness \/ dizziness\/numbness , or any other problems .","problem":["nausea","worsening chest pain","any other problems","dizziness\/numbness","vomiting","fever","weakness","chills","shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[21,44,66,75,86,94,103,114,138],"problem_indices_end":[41,63,72,83,91,100,111,132,156],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cp","problem":["cp"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[2],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"continuing taking meds she prescribed .","problem":[],"test":[],"treatment":["meds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[22]}
{"text":"anxiety nos","problem":["anxiety nos"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"psychological assessment , past medication responses discussed .","problem":[],"test":["psychological assessment"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no new meds for now","problem":[],"test":[],"treatment":["new meds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"atrovent neb qid , albuterol neb qid , ipratropium neb bid , flovent inh bid , serevent inh bid , and prednisone 30 qd taper .","problem":[],"test":[],"treatment":["ipratropium neb","albuterol neb","flovent inh","prednisone","serevent inh","atrovent neb"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,19,39,61,79,102],"treatment_indices_end":[12,32,54,72,91,112]}
{"text":"no n \/ v\/ha \/ d no sweats , no chills , of abdominal pain , no chest pain , no pleuricy , no lee , no paresthesias , no numbness , no shoulder pain , no jaw pain .","problem":["pleuricy","v\/ha","n","sweats","shoulder pain","paresthesias","d","lee","abdominal pain","chills","numbness","chest pain","jaw pain"],"test":[],"treatment":[],"problem_indices_start":[3,7,14,19,31,43,63,79,93,102,120,134,153],"problem_indices_end":[4,11,15,25,37,57,73,87,96,114,128,147,161],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"niacin , vit .","problem":[],"test":[],"treatment":["niacin","vit"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,9],"treatment_indices_end":[6,12]}
{"text":"heparin while having a demand ischemic episode","problem":["a demand ischemic episode"],"test":[],"treatment":["heparin"],"problem_indices_start":[21],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"copd exacerbation with nstemi","problem":["nstemi","copd exacerbation"],"test":[],"treatment":[],"problem_indices_start":[0,23],"problem_indices_end":[17,29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"copd ( s \/ p lung resection fev1 25% ) , chronic pericardial effusion , pvd , r renal artery stenosis , osteoporosis , presbylaryngis","problem":["osteoporosis","r renal artery stenosis","copd","pvd","chronic pericardial effusion","presbylaryngis"],"test":["fev1"],"treatment":["lung resection"],"problem_indices_start":[0,41,72,78,104,119],"problem_indices_end":[4,69,75,101,116,133],"test_indices_start":[28],"test_indices_end":[32],"treatment_indices_start":[13],"treatment_indices_end":[27]}
{"text":"98.4 , 94 , 22 , 120\/96 , 98% on 2l. nad , using scalenes , at \/ nc , no oral lesions , bibasilar rales otherwise clear , good air movement , rrr , no mrg , ntnd +bs , no cce , 2+ dps .","problem":["bibasilar rales","nad","oral lesions"],"test":["scalenes"],"treatment":[],"problem_indices_start":[37,73,88],"problem_indices_end":[40,85,103],"test_indices_start":[49],"test_indices_end":[57],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"copd exacerpation with troponin leak likely nstemi secondary to demand ischemia .","problem":["troponin leak","copd exacerpation","demand ischemia","nstemi"],"test":[],"treatment":[],"problem_indices_start":[0,23,44,64],"problem_indices_end":[17,36,50,79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please evaluate ambutlation ability and o2 requirement","problem":[],"test":["o2 requirement"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[40],"test_indices_end":[54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"salmeterol xinafoate and levofloxacin","problem":[],"test":[],"treatment":["levofloxacin","salmeterol xinafoate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,25],"treatment_indices_end":[20,37]}
{"text":"steroid psychosis no benzos","problem":["steroid psychosis"],"test":[],"treatment":["benzos"],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[27]}
{"text":"likely exacerbation possibly from uri \/ pneumonia .","problem":["exacerbation","uri","pneumonia"],"test":[],"treatment":[],"problem_indices_start":[7,34,40],"problem_indices_end":[19,37,49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"override added on 12\/06\/05 by belb , britherl , m.d. on order for zocor po ( ref # 33033281 )","problem":[],"test":[],"treatment":["zocor po"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[66],"treatment_indices_end":[74]}
{"text":"override added on 12\/07\/05 by belb , britherl , m.d. on order for atorvastatin po ( ref # 33823759 )","problem":[],"test":[],"treatment":["atorvastatin po"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[66],"treatment_indices_end":[81]}
{"text":"please evaluate resolution of cardiac troponin leak and stable ekg .","problem":["cardiac troponin leak"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mvi , cardiac diet","problem":["mvi"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"took prednisone 40 at home and presented to ed where found to have 1mm lateral st depressions and slight troponin and mb leak .","problem":["1mm lateral st depressions","slight troponin and mb leak"],"test":[],"treatment":["prednisone 40"],"problem_indices_start":[67,98],"problem_indices_end":[93,125],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[5],"treatment_indices_end":[18]}
{"text":"severe copd pneumonia recovering alcoholic recovering barbituate abuse unexplained hct drop poor appetite x 1 week","problem":["poor appetite","severe copd","unexplained hct drop","pneumonia"],"test":[],"treatment":[],"problem_indices_start":[0,12,71,92],"problem_indices_end":[11,21,91,105],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"wbc 12.91","problem":[],"test":["wbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"niacin , vit .","problem":[],"test":[],"treatment":["vit","niacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,9],"treatment_indices_end":[6,12]}
{"text":"override added on 12\/06\/05 by belb , britherl , m.d. on order for levaquin po ( ref # 57095042 )","problem":[],"test":[],"treatment":["levaquin po"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[66],"treatment_indices_end":[77]}
{"text":"levaquin 500 qd empirically","problem":[],"test":[],"treatment":["levaquin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"cardiac enzymes trending down on 12.7.05 , anticoagulated while having leak .","problem":[],"test":["leak","cardiac enzymes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,71],"test_indices_end":[15,75],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"responsible after study for causing admission ) copd exacerbation with nstemi","problem":["copd exacerbation","nstemi"],"test":[],"treatment":[],"problem_indices_start":[48,71],"problem_indices_end":[65,77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac enzymes bid while actively having leak , asa","problem":["leak"],"test":["cardiac enzymes"],"treatment":["asa"],"problem_indices_start":[42],"problem_indices_end":[46],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[49],"treatment_indices_end":[52]}
{"text":"vitamin c ( ascorbic acid ) 1,000 mg po qd ecasa ( aspirin enteric coated ) 81 mg po qd calcium carbonate ( 500 mg elemental ca++ ) 500 mg po bid prednisone 20 mg po qam starting today ( 12\/09 )","problem":[],"test":[],"treatment":["vitamin c ( ascorbic acid )","prednisone","calcium carbonate ( 500 mg elemental ca++ )","ecasa ( aspirin enteric coated )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,43,88,146],"treatment_indices_end":[27,75,131,156]}
{"text":"small pleural effusion , flat diaphrams no acute changes","problem":["small pleural effusion","acute changes"],"test":[],"treatment":[],"problem_indices_start":[0,43],"problem_indices_end":[22,56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"attending evaluation","problem":[],"test":["attending evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"copd exacerbation","problem":["copd exacerbation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lisinopril 5 mg po qd","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"serevent diskus ( salmeterol diskus ) 1 puff inh bid","problem":[],"test":[],"treatment":["serevent diskus ( salmeterol diskus )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[37]}
{"text":"flovent ( fluticasone propionate ) 44 mcg inh bid starting today ( 12\/09 ) levaquin ( levofloxacin ) 500 mg po qd","problem":[],"test":[],"treatment":["levaquin ( levofloxacin )","flovent ( fluticasone propionate )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,75],"treatment_indices_end":[34,100]}
{"text":"likely having a nstemi secondary to demand .","problem":["demand","a nstemi"],"test":[],"treatment":[],"problem_indices_start":[14,36],"problem_indices_end":[22,42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"aputum cultures pending .","problem":[],"test":["aputum cultures"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4 days of worsening sob with sore throat and cough productive of yellow \/ green sputum .","problem":["worsening sob","sore throat","cough productive of yellow \/ green sputum"],"test":[],"treatment":[],"problem_indices_start":[10,29,45],"problem_indices_end":[23,40,86],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"administer iron products a minimum of 2 hours before or after a levofloxacin or ciprofloxacin dose dose","problem":[],"test":[],"treatment":["levofloxacin","ciprofloxacin","iron products"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[11,64,80],"treatment_indices_end":[24,76,93]}
{"text":"please evaluate resolution of copd exacerbation and need for any further antibiocis","problem":["copd exacerbation"],"test":[],"treatment":["any further antibiocis"],"problem_indices_start":[30],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61],"treatment_indices_end":[83]}
{"text":"potassium chloride and lisinopril","problem":[],"test":[],"treatment":["potassium chloride","lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,23],"treatment_indices_end":[18,33]}
{"text":"b-3 and atorvastatin calcium","problem":[],"test":[],"treatment":["b-3","atorvastatin calcium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,8],"treatment_indices_end":[3,28]}
{"text":"i - heparin for ptt 50-70 durin enzyme leak . metoprolol 12 qid .","problem":["ptt","enzyme leak"],"test":[],"treatment":["metoprolol","heparin"],"problem_indices_start":[16,32],"problem_indices_end":[19,43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4,46],"treatment_indices_end":[11,56]}
{"text":"if on tube feeds , please cycle ( hold 1 hr before to 2 hr after )","problem":[],"test":[],"treatment":["tube feeds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6],"treatment_indices_end":[16]}
{"text":"taper over 2 weeks multivitamin therapeutic ( therapeutic multivi ... ) 5 milliliters po qd","problem":[],"test":[],"treatment":["multivitamin therapeutic ( therapeutic multivi ... )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[71]}
{"text":"salmeterol xinafoate and levofloxacin","problem":[],"test":[],"treatment":["salmeterol xinafoate","levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,25],"treatment_indices_end":[20,37]}
{"text":"r - monitor on telemetry","problem":[],"test":[],"treatment":["telemetry"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[24]}
{"text":"82f with copd exacerpation","problem":["copd exacerpation"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please taper off your prednisone within 2 weeks","problem":[],"test":[],"treatment":["prednisone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[32]}
{"text":"alendronate 70 mg po qweek","problem":[],"test":[],"treatment":["alendronate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"b-3 and simvastatin","problem":[],"test":[],"treatment":["b-3","simvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,8],"treatment_indices_end":[3,19]}
{"text":"take with 8 oz of plain water albuterol inhaler 2 puff inh qid starting today ( 12\/09 ) atrovent inhaler ( ipratropium inhaler ) 2 puff inh qid starting today ( 12\/09 )","problem":[],"test":[],"treatment":["albuterol inhaler","atrovent inhaler ( ipratropium inhaler )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30,88],"treatment_indices_end":[47,128]}
{"text":"echo -","problem":[],"test":["echo"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"fatigue secondary to worsening dyspnea .","problem":["worsening dyspnea","fatigue"],"test":[],"treatment":[],"problem_indices_start":[0,21],"problem_indices_end":[7,38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nka admit diagnosis :","problem":["nka"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"toprol xl ( metoprolol succinate extended release ) 25 mg po qd starting today ( 12\/09 )","problem":[],"test":[],"treatment":["toprol xl ( metoprolol succinate extended release )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[51]}
{"text":"ppi prophylaxis","problem":[],"test":[],"treatment":["ppi prophylaxis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"p - no evidence of failure","problem":["evidence of failure"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"insulin , celexa , protonix , ambien and pancreas .","problem":[],"test":[],"treatment":["protonix","insulin","pancreas","celexa","ambien"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,10,19,30,41],"treatment_indices_end":[7,16,27,36,49]}
{"text":"his hematocrit at the time of admission was 20.5 , after having been 32 one week earlier .","problem":[],"test":["his hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vital signs showed his blood pressure to be slightly decreased at 120\/60 , pulse 64 , respirations 16 , temperature 98.8 , o2 sat 95 .","problem":["slightly decreased"],"test":["pulse","his blood pressure","vital signs","respirations","temperature","o2 sat"],"treatment":[],"problem_indices_start":[44],"problem_indices_end":[62],"test_indices_start":[0,19,75,86,104,123],"test_indices_end":[11,37,80,98,115,129],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"trace edema without cyanosis or clubbing .","problem":["cyanosis","trace edema","clubbing"],"test":[],"treatment":[],"problem_indices_start":[0,20,32],"problem_indices_end":[11,28,40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was treated with octreotide to try to slow down the bleeding .","problem":["the bleeding"],"test":[],"treatment":["octreotide"],"problem_indices_start":[51],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[30]}
{"text":"back without cva or spinal tenderness .","problem":["cva or spinal tenderness"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"significant for fatigue and increased abdominal discomfort .","problem":["increased abdominal discomfort","fatigue"],"test":[],"treatment":[],"problem_indices_start":[16,28],"problem_indices_end":[23,58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"despite all these measures , his bleeding was never totally controlled .","problem":["his bleeding"],"test":[],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bowel sounds positive , soft , mildly tender in the epigastrium without hepatosplenomegaly , mass or tenderness .","problem":["mildly tender in the epigastrium","tenderness","mass","hepatosplenomegaly"],"test":[],"treatment":[],"problem_indices_start":[31,72,93,101],"problem_indices_end":[63,90,97,111],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"evidence of anemia with being pale , but anicteric , no oral lesions .","problem":["oral lesions","evidence of anemia","being pale"],"test":[],"treatment":[],"problem_indices_start":[0,24,56],"problem_indices_end":[18,34,68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his platelet count was maintained with platelet transfusion as necessary .","problem":[],"test":["his platelet count"],"treatment":["platelet transfusion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[39],"treatment_indices_end":[59]}
{"text":"endoscopy showed multiple angio ectasias throughout the stomach .","problem":["multiple angio ectasias throughout the stomach"],"test":["endoscopy"],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[63],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the cause of death was a combination of gi bleeding felt to be ultimately related to his known metastatic pancreatic cancer .","problem":["death","his known metastatic pancreatic cancer","gi bleeding"],"test":[],"treatment":[],"problem_indices_start":[13,40,85],"problem_indices_end":[18,51,123],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he then had an angiogram with gel foam to try to control his gi bleed .","problem":["his gi bleed"],"test":[],"treatment":["an angiogram with gel foam"],"problem_indices_start":[57],"problem_indices_end":[69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[38]}
{"text":"he received multiple treatments for this over the succeeding weeks .","problem":[],"test":[],"treatment":["multiple treatments"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[31]}
{"text":"the assessment was that he had a gi bleed .","problem":["a gi bleed"],"test":["the assessment"],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[41],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at that point he had a change in mental status and was no longer responsive .","problem":["no longer responsive","a change in mental status"],"test":[],"treatment":[],"problem_indices_start":[21,55],"problem_indices_end":[46,75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has a known history of pancreatic adenocarcinoma .","problem":["pancreatic adenocarcinoma"],"test":[],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he is admitted at this time because of significant gi bleeding .","problem":["significant gi bleeding"],"test":[],"treatment":[],"problem_indices_start":[39],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"r elbow injury","problem":["r elbow injury"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"r elbow strain","problem":["r elbow strain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"xray - no evidence of effusion or fracture","problem":["effusion","fracture"],"test":["xray"],"treatment":[],"problem_indices_start":[22,34],"problem_indices_end":[30,42],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"do gentle range of motion exercises for the next few days .","problem":[],"test":[],"treatment":["gentle range of motion exercises"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[35]}
{"text":"the patient was given printed instructions for sprains , fractures and bruises ( english ) .","problem":["bruises","sprains","fractures"],"test":[],"treatment":[],"problem_indices_start":[47,57,71],"problem_indices_end":[54,66,78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"motrin 400-600 mg every 8 hours as needed for pain","problem":["pain"],"test":[],"treatment":["motrin"],"problem_indices_start":[46],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"it is recommended that you receive follow-up care with the department of orthopaedics if your symptoms are not improved in 5-7 days .","problem":["your symptoms"],"test":[],"treatment":[],"problem_indices_start":[89],"problem_indices_end":[102],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"do no strenuous activity until your symptoms are improved .","problem":["your symptoms"],"test":[],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"use ice to sore areas for the next few days .","problem":["sore areas"],"test":[],"treatment":["ice"],"problem_indices_start":[11],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[7]}
{"text":"yesterday morning , he developed intermittent substernal chest pain with radiation to the left shoulder that worsened with any activity and any motion of his shoulders .","problem":["radiation to the left shoulder","intermittent substernal chest pain"],"test":[],"treatment":[],"problem_indices_start":[33,73],"problem_indices_end":[67,103],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"they felt that there was obstruction and possible obstruction to airflow generating some obstructive apnea , as well as partial obstructive events .","problem":["obstruction","partial obstructive events","obstruction to airflow","some obstructive apnea"],"test":[],"treatment":[],"problem_indices_start":[25,50,84,120],"problem_indices_end":[36,72,106,146],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was taken to the cardiac catheterization lab where cath showed top-normal lvedp at 12 ; no af ; widely patent rca stent ; mild cad in the left coronary artery symptom ; widely patent diagonal 1 at the site of prior ptca .","problem":["widely patent diagonal 1","af","mild cad in the left coronary artery symptom","widely patent rca stent"],"test":["cath"],"treatment":["prior ptca"],"problem_indices_start":[94,99,125,172],"problem_indices_end":[96,122,169,196],"test_indices_start":[54],"test_indices_end":[58],"treatment_indices_start":[212],"treatment_indices_end":[222]}
{"text":"also , a long discussion was taken with the patient as most of his chest discomfort happens when he is quite anxious .","problem":["his chest discomfort","anxious"],"test":[],"treatment":[],"problem_indices_start":[63,109],"problem_indices_end":[83,116],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he has a history of hypertension , diabetes , and high cholesterol .","problem":["hypertension","diabetes","high cholesterol"],"test":[],"treatment":[],"problem_indices_start":[20,35,50],"problem_indices_end":[32,43,66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"regular rate and rhythm ; s1-s2 ; positive s4 ; no murmur .","problem":["murmur"],"test":[],"treatment":[],"problem_indices_start":[51],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was told that he should discus with his pcp further gi testing , as well as medications for anxiety .","problem":["anxiety"],"test":["further gi testing"],"treatment":["medications"],"problem_indices_start":[104],"problem_indices_end":[111],"test_indices_start":[56],"test_indices_end":[74],"treatment_indices_start":[88],"treatment_indices_end":[99]}
{"text":"he was transferred to the ro woodma healthcare for further cardiac care .","problem":[],"test":[],"treatment":["further cardiac care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[51],"treatment_indices_end":[71]}
{"text":"he also became short of breath with climbing a flight of stairs .","problem":["short of breath"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coronary artery disease ; hypertension ; hyperlipidemia ; sleep apnea ; diabetes type 2 .","problem":["hypertension","hyperlipidemia","coronary artery disease","diabetes type 2","sleep apnea"],"test":[],"treatment":[],"problem_indices_start":[0,26,41,58,72],"problem_indices_end":[23,38,55,69,87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was trace mitral regurgitation .","problem":["trace mitral regurgitation"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sodium 139 ; potassium 4.1 ; bun 15 ; creatinine 1.1 ; magnesium 1.6 ; sgpt 19 ; sgot 20 ; alkaline phosphatase 66 ; total bilirubin 0.6 ; direct bilirubin 0.2 ; total cholesterol 234 ; triglycerides 274 ; hdl 44 ; ldl 135 ; hemoglobin a1c 6.7 ; white cell count 6.1 ; hematocrit 36.4 ; platelet count 201 .","problem":[],"test":["sgpt","direct bilirubin","total bilirubin","sgot","a1c","creatinine","alkaline phosphatase","potassium","hematocrit","magnesium","sodium","total cholesterol","triglycerides","platelet count","ldl","white cell count","hdl","bun","hemoglobin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,29,38,55,71,81,91,117,139,162,186,206,215,225,236,246,269,287],"test_indices_end":[6,22,32,48,64,75,85,111,132,155,179,199,209,218,235,239,262,279,301],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the er , he received 3 sublingual nitroglycerins and 1 mg of dilaudid .","problem":[],"test":[],"treatment":["3 sublingual nitroglycerins","dilaudid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24,64],"treatment_indices_end":[51,72]}
{"text":"the patient also complained of intermittent right neck swelling , and recommendations are to consider a ct scan with contrast to evaluate nodes in his neck .","problem":["nodes in his neck","intermittent right neck swelling"],"test":["a ct scan with contrast"],"treatment":[],"problem_indices_start":[31,138],"problem_indices_end":[63,155],"test_indices_start":[102],"test_indices_end":[125],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no evidence of pericardial effusion .","problem":["pericardial effusion"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"include lisinopril 5 mg p.o. every day ; nitroglycerin sublingual p.r.n.; toprol xl 100 mg p.o. every day ; plavix 75 mg p.o. every day ; avandia 4 mg p.o. every day ; lipitor 40 mg p.o. every day ; tricor 145 mg p.o. every day .","problem":[],"test":[],"treatment":["lisinopril","toprol xl","avandia","nitroglycerin sublingual","lipitor","tricor","plavix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[8,41,74,108,138,168,199],"treatment_indices_end":[18,65,83,114,145,175,205]}
{"text":"the results of the pfts are unavailable at the time of this dictation .","problem":[],"test":["the pfts"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[15],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"apparently once his pain was free , his ekg was noted to have hyperacute t-wave anteriorly without progression .","problem":["hyperacute t-wave anteriorly","progression","his pain"],"test":["his ekg"],"treatment":[],"problem_indices_start":[16,62,99],"problem_indices_end":[24,90,110],"test_indices_start":[36],"test_indices_end":[43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in 2003 , he had a non st elevation mi , came to the rwh , and had a cath done , which showed a 40% rca , which was hazy .","problem":["a 40% rca","hazy","a non st elevation mi"],"test":["a cath"],"treatment":[],"problem_indices_start":[17,94,116],"problem_indices_end":[38,103,120],"test_indices_start":[67],"test_indices_end":[73],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tricor 145 mg p.o. every day .","problem":[],"test":[],"treatment":["tricor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"his blood pressure was 114 to 123\/62 .","problem":[],"test":["his blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"diabetes ; hypertension ; hyperlipidemia .","problem":["hyperlipidemia","hypertension","diabetes"],"test":[],"treatment":[],"problem_indices_start":[0,11,26],"problem_indices_end":[8,23,40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"since then , the patient has occasional chest pain with emotional stress , when he is angry or upset .","problem":["occasional chest pain","emotional stress"],"test":[],"treatment":[],"problem_indices_start":[29,56],"problem_indices_end":[50,72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was noted to have an episode of desaturation into the 80% range while sleeping .","problem":["desaturation into the 80% range"],"test":[],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he underwent lower extremity study to rule out a dvt in both legs .","problem":["a dvt in both legs"],"test":["lower extremity study"],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[65],"test_indices_start":[13],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pulmonary consult was done , and it was felt that the patient should undergo a formal sleep study , full pfts , and a repeat ct scan in 1 year to assess for pulmonary nodule that was seen .","problem":["pulmonary nodule"],"test":["a formal sleep study","pulmonary consult","a repeat ct scan","full pfts"],"treatment":[],"problem_indices_start":[157],"problem_indices_end":[173],"test_indices_start":[0,77,100,116],"test_indices_end":[17,97,109,132],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on physical exam today , the patient did not have any swelling , and he states that he did not feel the swelling was present .","problem":["any swelling","the swelling"],"test":["physical exam"],"treatment":[],"problem_indices_start":[50,100],"problem_indices_end":[62,112],"test_indices_start":[3],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nitroglycerin 1 tablet sublingual q. 5 minutes x3 p.r.n. chest pain .","problem":["chest pain"],"test":[],"treatment":["nitroglycerin"],"problem_indices_start":[57],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"the patient was advised that he needs to speak with his pcp about medication for antianxiety and \/ or further testing or counseling to help control his anxiety level .","problem":["his anxiety level"],"test":["further testing"],"treatment":["medication for antianxiety","counseling"],"problem_indices_start":[148],"problem_indices_end":[165],"test_indices_start":[102],"test_indices_end":[117],"treatment_indices_start":[66,121],"treatment_indices_end":[92,131]}
{"text":"prior to discharge today , he underwent pfts .","problem":[],"test":["pfts"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[40],"test_indices_end":[44],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient underwent a sleep study , the first part , which showed that he had 75 respiratory events observed with apnea , hypopnea index of 11 an hour .","problem":["75 respiratory events","apnea"],"test":["hypopnea index","a sleep study"],"treatment":[],"problem_indices_start":[80,116],"problem_indices_end":[101,121],"test_indices_start":[22,124],"test_indices_end":[35,138],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"they recommended that the patient may benefit from a trial of continuous positive pressure at the bedside .","problem":[],"test":[],"treatment":["continuous positive pressure at the bedside"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[62],"treatment_indices_end":[105]}
{"text":"soft , nontender , nondistended ; no guarding ; no masses ; positive bowel sounds x4 .","problem":["masses","guarding"],"test":["bowel sounds"],"treatment":[],"problem_indices_start":[37,51],"problem_indices_end":[45,57],"test_indices_start":[69],"test_indices_end":[81],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he then underwent a ct scan to rule out a pe .","problem":["a pe"],"test":["a ct scan"],"treatment":[],"problem_indices_start":[40],"problem_indices_end":[44],"test_indices_start":[18],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"temperature 97.9 .","problem":[],"test":["temperature"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he does have a lot of anxiety .","problem":["anxiety"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"avandia 4 mg p.o. every day .","problem":[],"test":[],"treatment":["avandia"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"the mean heart rate was 68 .","problem":[],"test":["the mean heart rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he underwent a ptc stenting of an rca with a vision stent , 3 x 18 .","problem":[],"test":[],"treatment":["a ptc stenting of an rca","a vision stent"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,43],"treatment_indices_end":[37,57]}
{"text":"the patient underwent an adenosine stress test , where he exercised for 4 minutes , reaching 65% of predicted heart rate .","problem":[],"test":["an adenosine stress test"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22],"test_indices_end":[46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"prilosec 20 mg p.o. every day .","problem":[],"test":[],"treatment":["prilosec"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"the myocardial perfusion images show no definite evidence of ischemia .","problem":["ischemia"],"test":["the myocardial perfusion images"],"treatment":[],"problem_indices_start":[61],"problem_indices_end":[69],"test_indices_start":[0],"test_indices_end":[31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"diagonal 1 also had a 99% stenosis .","problem":["a 99% stenosis"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ativan 0.5 mg p.o. b.i.d. p.r.n. anxiety .","problem":["anxiety"],"test":[],"treatment":["ativan"],"problem_indices_start":[33],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"there was no evidence of mvp .","problem":["mvp"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"based on all the tests above , it was felt that the patient was stable for discharge home .","problem":[],"test":["all the tests above"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[9],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"adenosine stress test .","problem":[],"test":["adenosine stress test"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the lv contractile function was normal .","problem":[],"test":["the lv contractile function"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the right ventricle was not dilated .","problem":["dilated"],"test":[],"treatment":[],"problem_indices_start":[28],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he also received lipitor 80 mg , plavix 300 , heparin iv , integrelin double bolus , followed by a drip .","problem":[],"test":[],"treatment":["lipitor","plavix","integrelin double bolus","heparin iv","a drip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17,33,46,59,97],"treatment_indices_end":[24,39,56,82,103]}
{"text":"coronary angiogram .","problem":[],"test":["coronary angiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he did not have chest pain .","problem":["chest pain"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient ruled out for an mi with negative ck x4 and negative troponin x4 .","problem":["an mi"],"test":[],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ekg was negative for ischemia .","problem":["ischemia"],"test":["ekg"],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[29],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest x-ray .","problem":[],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he used ativan in the hospital , which helped him .","problem":[],"test":[],"treatment":["ativan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[8],"treatment_indices_end":[14]}
{"text":"he received an angio-seal to the right common femoral artery .","problem":[],"test":[],"treatment":["an angio-seal to the right common femoral artery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[60]}
{"text":"the patient is a 55-year-old gentleman with a history of cad status post non st elevation mi in 11\/17 who presents with chest pain x 48 hours .","problem":["chest pain","non st elevation mi","cad"],"test":[],"treatment":[],"problem_indices_start":[57,73,120],"problem_indices_end":[60,92,130],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest ct .","problem":[],"test":["chest ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was trace aortic insufficiency .","problem":["trace aortic insufficiency"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he underwent an echocardiogram , which showed an ef of 60% .","problem":[],"test":["an ef","an echocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13,46],"test_indices_end":[30,51],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , please note that this nodule has been stable over time .","problem":["this nodule"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no other noted disease .","problem":["other noted disease"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient will need to have a followup sleep study done as above per the recommendations based on the results .","problem":[],"test":["a followup sleep study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[30],"test_indices_end":[52],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"during the hospital course , the patient was started on a ppi , nexium , for concerns of acid reflux .","problem":["acid reflux"],"test":[],"treatment":["nexium","a ppi"],"problem_indices_start":[89],"problem_indices_end":[100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[56,64],"treatment_indices_end":[61,70]}
{"text":"there was no obvious segmental wall-motion abnormality .","problem":["segmental wall-motion abnormality"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right groin status post catheterization showed no hematoma or bruit .","problem":["bruit","hematoma","status post catheterization"],"test":[],"treatment":[],"problem_indices_start":[12,50,62],"problem_indices_end":[39,58,67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , his nitroglycerin was old and the script was expired .","problem":[],"test":[],"treatment":["the script","his nitroglycerin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10,40],"treatment_indices_end":[27,50]}
{"text":"aspirin 325 mg p.o. every day .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"the patient has been scheduled to have the second part of the sleep study done on june 18 , 2006 , at 8:30 p.m. at rwh in the esley community hospital , 10th floor sleep lab , phone number 133-225-1257 .","problem":[],"test":["the sleep study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[58],"test_indices_end":[73],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the systolic function was within normal limits .","problem":[],"test":["the systolic function"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after that , he was pain-free .","problem":["pain-free"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no evidence of lv hypertrophy .","problem":["lv hypertrophy"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lower extremity pulses were intact without any edema .","problem":["edema"],"test":["lower extremity pulses"],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[52],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heart rate 69 to 80 .","problem":[],"test":["heart rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"plavix 75 mg p.o. every day .","problem":[],"test":[],"treatment":["plavix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"lung sounds clear bilaterally .","problem":[],"test":["lung sounds"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was mild posterior vasal thinning .","problem":["mild posterior vasal thinning"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no aortic stenosis .","problem":["aortic stenosis"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"part 1 of a sleep study .","problem":[],"test":["part 1 of a sleep study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he denies diaphoresis or nausea .","problem":["diaphoresis","nausea"],"test":[],"treatment":[],"problem_indices_start":[10,25],"problem_indices_end":[21,31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the systolic function was within normal limits .","problem":[],"test":["the systolic function"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"room air saturation 96% .","problem":[],"test":["room air saturation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest pain .","problem":["chest pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"toprol xl 100 mg p.o. every day .","problem":[],"test":[],"treatment":["toprol xl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"there was no evidence of la dilatation .","problem":["la dilatation"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lopressor iv was given to control his heart rate .","problem":[],"test":["his heart rate"],"treatment":["lopressor iv"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[34],"test_indices_end":[48],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"lisinopril 5 mg p.o. every day .","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"an ivus was done , and it was felt that it was more severe .","problem":[],"test":["an ivus"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he went to the padrugmoff hospital emergency room after trying nitroglycerin at home .","problem":[],"test":[],"treatment":["nitroglycerin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[63],"treatment_indices_end":[76]}
{"text":"lipitor 40 mg p.o. every day .","problem":[],"test":[],"treatment":["lipitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"the patient presented with a chief complaint of cp .","problem":["cp"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's preliminary admitting physician is kotedaizreke , lila and the preliminary admitting diagnosis is cp .","problem":["cp"],"test":[],"treatment":[],"problem_indices_start":[118],"problem_indices_end":[120],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following evaluation and treatment , the patient 's disposition at the end of the visit was admitted as an inpatient to ro woodma healthcare .","problem":[],"test":["evaluation"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[20],"treatment_indices_start":[25],"treatment_indices_end":[34]}
{"text":"she had no murmurs and no gallops .","problem":["gallops","murmurs"],"test":[],"treatment":[],"problem_indices_start":[11,26],"problem_indices_end":[18,33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following balloon angioplasty , there was a local dissection with evidence of intraluminal thrombus , with a greater than 10% loss in the initial gain following coronary angioplasty .","problem":["intraluminal thrombus","a greater than 10% loss in the initial gain"],"test":[],"treatment":["a local dissection","coronary angioplasty","balloon angioplasty"],"problem_indices_start":[78,107],"problem_indices_end":[99,150],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10,42,161],"treatment_indices_end":[29,60,181]}
{"text":"in addition , on telemetry she developed complete heart block and hypotension requiring temporary pacing wire and then a permanent pacemaker implantation on 08-03-93 .","problem":["complete heart block","hypotension"],"test":["telemetry"],"treatment":["a permanent pacemaker implantation","temporary pacing wire"],"problem_indices_start":[41,66],"problem_indices_end":[61,77],"test_indices_start":[17],"test_indices_end":[26],"treatment_indices_start":[88,119],"treatment_indices_end":[109,153]}
{"text":"she developed congestive heart failure and required pressor support .","problem":["congestive heart failure"],"test":[],"treatment":["pressor support"],"problem_indices_start":[14],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[52],"treatment_indices_end":[67]}
{"text":"1. percutaneous transluminal coronary angioplasty and coronary atherectomy of the left anterior descending , 8-17-93 ,","problem":[],"test":[],"treatment":["coronary atherectomy of the left anterior descending","percutaneous transluminal coronary angioplasty"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,54],"treatment_indices_end":[49,106]}
{"text":"2. relook coronary angiogram , 08-18-93 .","problem":[],"test":["coronary angiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"therefore , directional coronary atherectomy was performed with an excellent angiographic outcome , and a less than 10% residual narrowing .","problem":["a less than 10% residual narrowing"],"test":[],"treatment":["directional coronary atherectomy"],"problem_indices_start":[104],"problem_indices_end":[138],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[44]}
{"text":"the patient is a 58 year old female with a history of parkinson 's disease for more than twenty years who presented to the gemenadentoolpai medical center with a revolving anterolateral wall myocardial infarction on 08-01-93 .","problem":["parkinson 's disease","a revolving anterolateral wall myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[54,165],"problem_indices_end":[79,217],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the circumflex artery had a minor 40% stenosis .","problem":["a minor 40% stenosis"],"test":[],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her past medical history is remarkable for a history of parkinson 's disease .","problem":["parkinson 's disease"],"test":[],"treatment":[],"problem_indices_start":[56],"problem_indices_end":[81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her hospital course was remarkable for ruling in for a myocardial infarction with a peak cpk of 9,379 units with a 5.9% mb fraction .","problem":["a myocardial infarction"],"test":["a peak cpk"],"treatment":["her hospital course"],"problem_indices_start":[53],"problem_indices_end":[76],"test_indices_start":[82],"test_indices_end":[92],"treatment_indices_start":[0],"treatment_indices_end":[19]}
{"text":"ecotrin 1 tablet po qd , captopril 6.25 mg po tid , k-dur 20 meq. po qd , lasix 20 mg po qd , isordil 10 mg po tid , sinemet 1\/2 tablet po bid , symmetrel 100 mg po bid , parloder 2.5mg po qd .","problem":[],"test":[],"treatment":["isordil","k-dur","ecotrin","captopril","sinemet","symmetrel","parloder","lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,25,52,74,94,117,145,171],"treatment_indices_end":[7,34,57,79,101,124,154,179]}
{"text":"her physical examination at the time of admission revealed a pleasant lady in no acute distress .","problem":["acute distress"],"test":["her physical examination"],"treatment":[],"problem_indices_start":[81],"problem_indices_end":[95],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her electrocardiogram revealed normal sinus rhythm , left atrial enlargement , left axis deviation , poor r-wave progression in v1 through v4 , consistent with marked clockwise rotation , cannot rule out an old anteroseptal wall myocardial infarction .","problem":["left atrial enlargement","left axis deviation","poor r-wave progression","an old anteroseptal wall myocardial infarction"],"test":["her electrocardiogram"],"treatment":[],"problem_indices_start":[53,79,101,204],"problem_indices_end":[76,98,124,250],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the left ventricular ejection fraction was estimated to 38% .","problem":[],"test":["the left ventricular ejection fraction"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[38],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the left anterior descending had a severe 80% proximal stenosis with a filling defect consistent with intraluminal thrombus .","problem":["intraluminal thrombus","a filling defect","a severe 80% proximal stenosis"],"test":[],"treatment":[],"problem_indices_start":[33,69,102],"problem_indices_end":[63,85,123],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was maintained on intravenous heparin and was brought back to the cardiac catheterization laboratory on 08-18-93 for a relook coronary angiography .","problem":[],"test":["a relook coronary angiography","the cardiac catheterization laboratory"],"treatment":["intravenous heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[66,121],"test_indices_end":[104,150],"treatment_indices_start":[22],"treatment_indices_end":[41]}
{"text":"coronary angiography demonstrated ongoing benefit of the initial coronary atherectomy .","problem":[],"test":["coronary angiography"],"treatment":["the initial coronary atherectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[53],"treatment_indices_end":[85]}
{"text":"specifically , there was no decrease in the initial gain that she achieved after directional atherectomy .","problem":[],"test":[],"treatment":["directional atherectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[81],"treatment_indices_end":[104]}
{"text":"the examination of the extremities showed no edema .","problem":["edema"],"test":["the examination of the extremities"],"treatment":[],"problem_indices_start":[45],"problem_indices_end":[50],"test_indices_start":[0],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her risk factors for coronary artery disease included a positive family history and an elevated cholesterol level .","problem":["a positive family history","coronary artery disease","an elevated cholesterol level","her risk factors"],"test":[],"treatment":[],"problem_indices_start":[0,21,54,84],"problem_indices_end":[16,44,79,113],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the examination the abdomen was benign .","problem":[],"test":["the examination the abdomen"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the main left coronary artery had a 20% stenosis .","problem":["a 20% stenosis"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has been under the care of dr. aalv manual and was referred here for further therapy .","problem":[],"test":[],"treatment":["further therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[73],"treatment_indices_end":[88]}
{"text":"the jugular venous pressure was elevated at 6 cm above the sternal angle .","problem":[],"test":["the jugular venous pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cine left ventriculogram revealed a dilated left ventricle with an area of anterolateral , apical , and septal akinesis .","problem":["a dilated left ventricle","an area of anterolateral , apical , and septal akinesis"],"test":["cine left ventriculogram"],"treatment":[],"problem_indices_start":[34,64],"problem_indices_end":[58,119],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she underwent cardiac catheterization on 8-15-93 and was found to have a left ventricular end diastolic pressure of 28 millimeters of mercury .","problem":[],"test":["cardiac catheterization","a left ventricular end diastolic pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14,71],"test_indices_end":[37,112],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was transferred in stable condition to the pasi for further rehabilitation therapy .","problem":[],"test":[],"treatment":["further rehabilitation therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[56],"treatment_indices_end":[86]}
{"text":"acute myocardial infarction .","problem":["acute myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there were non-specific st-t wave abnormalities .","problem":["non-specific st-t wave abnormalities"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was maintained on intravenous heparin .","problem":[],"test":[],"treatment":["intravenous heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30],"treatment_indices_end":[49]}
{"text":"acute myocardial infarction .","problem":["acute myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her electrocardiogram showed a new right bundle branch block and left anterior hemiblock .","problem":["a new right bundle branch block","left anterior hemiblock"],"test":["her electrocardiogram"],"treatment":[],"problem_indices_start":[29,65],"problem_indices_end":[60,88],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. coronary artery disease ,","problem":["coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there were prominent q-waves in avl , consistent with lateral myocardial infarction .","problem":["lateral myocardial infarction","prominent q-waves in avl"],"test":[],"treatment":[],"problem_indices_start":[11,54],"problem_indices_end":[35,83],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had a dominant right coronary artery with minor disease .","problem":["a dominant right coronary artery","minor disease"],"test":[],"treatment":[],"problem_indices_start":[8,46],"problem_indices_end":[40,59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the blood pressure was 120\/70 millimeters of mercury .","problem":[],"test":["the blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 8-17-93 , she was taken to the cardiac catheterization laboratory where she underwent percutaneous transluminal coronary angioplasty of the proximal left anterior descending .","problem":[],"test":[],"treatment":["percutaneous transluminal coronary angioplasty of the proximal left anterior descending"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[89],"treatment_indices_end":[176]}
{"text":"the patient was seen in consultation by the neurology department because of the history of parkinson 's disease .","problem":["parkinson 's disease"],"test":[],"treatment":[],"problem_indices_start":[91],"problem_indices_end":[116],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was transferred to the heaonboburg linpack grant medical center for consideration of coronary angioplasty .","problem":[],"test":[],"treatment":["coronary angioplasty"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[97],"treatment_indices_end":[117]}
{"text":"her pulse was regular at 80 beats per minute .","problem":[],"test":["her pulse"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the cardiac examination revealed anapical impulse in the fifth left intercostal space , left to mid clavicular line .","problem":["anapical impulse in the fifth left intercostal space"],"test":["the cardiac examination"],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[85],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. unstable angina ( postmyocardial infarction angina ) ,","problem":["unstable angina ( postmyocardial infarction angina )"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had no prior significant cardiac history and presented to her local medical doctor 's office with an episode of severe retrosternal chest pain .","problem":["severe retrosternal chest pain"],"test":[],"treatment":[],"problem_indices_start":[121],"problem_indices_end":[151],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. parkinson 's disease .","problem":["parkinson 's disease"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient tolerated the procedure well .","problem":[],"test":[],"treatment":["the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[35]}
{"text":"he was noted to be in rapid af on several episodes receiving 5 mg iv lopressor each time with improvement .","problem":["rapid af"],"test":[],"treatment":["5 mg iv lopressor"],"problem_indices_start":[22],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61],"treatment_indices_end":[78]}
{"text":"rectal normal tone , guaiac positive brown stool , no perirectal lesions or erythema .","problem":["guaiac positive brown stool","perirectal lesions","erythema"],"test":[],"treatment":[],"problem_indices_start":[21,54,76],"problem_indices_end":[48,72,84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood cultures drawn at the outside hospital grew out pseudomonas that was sensitive to imipenem and tobramycin .","problem":["pseudomonas"],"test":["blood cultures"],"treatment":["imipenem","tobramycin"],"problem_indices_start":[54],"problem_indices_end":[65],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[88,101],"treatment_indices_end":[96,111]}
{"text":"the plan is to continue the digoxin and to recheck an echocardiogram to assess his ejection fraction when he is clinically better .","problem":[],"test":["an echocardiogram","his ejection fraction"],"treatment":["the digoxin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[51,79],"test_indices_end":[68,100],"treatment_indices_start":[24],"treatment_indices_end":[35]}
{"text":"however , with increasing diuresis and improving septic pictures his o2 saturations have improved and he is now on nasal cannula and will be maintained on nasal cannula to keep his sat above 93% .","problem":["improving septic pictures"],"test":["his sat","his o2 saturations"],"treatment":["increasing diuresis","nasal cannula","nasal cannula"],"problem_indices_start":[39],"problem_indices_end":[64],"test_indices_start":[65,177],"test_indices_end":[83,184],"treatment_indices_start":[15,115,155],"treatment_indices_end":[34,128,168]}
{"text":"he was treated initially with ceftazidime and gentamicin but there was a question about the organism 's susceptibility from lab studies done at the outside hospital .","problem":["the organism 's susceptibility"],"test":["lab studies"],"treatment":["gentamicin","ceftazidime"],"problem_indices_start":[88],"problem_indices_end":[123],"test_indices_start":[129],"test_indices_end":[140],"treatment_indices_start":[30,46],"treatment_indices_end":[41,56]}
{"text":"pt 17.6 , ptt 48.7 , fibrinogen 686 , tt 39.2 .","problem":[],"test":["pt","tt","ptt","fibrinogen"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,21,38],"test_indices_end":[2,13,31,40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he has been maintained on tube feeds and that should be continued .","problem":[],"test":[],"treatment":["tube feeds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[36]}
{"text":"the patient is being maintained on digoxin for his paroxysmal atrial fibrillation .","problem":["his paroxysmal atrial fibrillation"],"test":[],"treatment":["digoxin"],"problem_indices_start":[47],"problem_indices_end":[81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[35],"treatment_indices_end":[42]}
{"text":"an mri was performed upon admission and showed an epidural mass at the right posterior lateral t9 to t12 area invading the neural foramina .","problem":["an epidural mass"],"test":["an mri"],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[63],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a workup done in de is not available at the time of this dictation .","problem":[],"test":["a workup"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was given stress steroids and was subsequently transferred to lorough medical center 's intensive care unit for further management .","problem":[],"test":[],"treatment":["stress steroids","further management"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,120],"treatment_indices_end":[28,138]}
{"text":"7) thrombocytopenia status post bone marrow transplant .","problem":["thrombocytopenia"],"test":[],"treatment":["bone marrow transplant"],"problem_indices_start":[3],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32],"treatment_indices_end":[54]}
{"text":"tylenol 650 mg po q4h p.r.n. , dulcolax 10 mg per rectum b.i.d. p.r.n. , decadron 5 mg iv q6h , digoxin 0.25 mg po q day , colace 100 mg po t.i.d. , florinef 0.1 mg po q day for presumed adrenal insufficiency , imipenem 500 mg iv q6h , insulin nph 60 units subcu q a.m. , insulin nph 20 units subcu q p.m. , insulin czi sliding scale regular , synthroid 125 mcg po q day , magnesium sliding scale , potassium sliding scale today , morphine sulfate iv p.r.n. dressing changes and breakthrough pain , carafate 1 gm po q.i.d. , tobramycin 200 mg iv q30h , vancomyin 1 mg iv q18h.","problem":["adrenal insufficiency","breakthrough pain"],"test":[],"treatment":["colace","magnesium sliding scale","imipenem","potassium sliding scale","morphine sulfate iv","synthroid","florinef","dulcolax","digoxin","insulin czi sliding scale regular","tylenol","tobramycin","decadron","dressing changes","carafate","insulin nph","vancomyin","insulin nph"],"problem_indices_start":[187,479],"problem_indices_end":[208,496],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,31,73,96,123,149,211,236,272,308,344,373,399,431,458,499,525,553],"treatment_indices_end":[7,39,81,103,129,157,219,247,283,341,353,396,422,450,474,507,535,562]}
{"text":"abdomen non-distended , positive bowel sounds , soft , non-tender , no hepatosplenomegaly or masses .","problem":["non-distended","hepatosplenomegaly","non-tender","masses"],"test":[],"treatment":[],"problem_indices_start":[8,55,71,93],"problem_indices_end":[21,65,89,99],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"positive for diabetes mellitus .","problem":["diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his pt and ptt are now normal , however , he continues to run a low platelet count .","problem":["a low platelet count"],"test":["his pt","ptt"],"treatment":[],"problem_indices_start":[62],"problem_indices_end":[82],"test_indices_start":[0,11],"test_indices_end":[6,14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was subsequently switched to imipenem and tobramycin and was maintained on those medications throughout the hospital course .","problem":[],"test":[],"treatment":["imipenem","those medications","tobramycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32,45,78],"treatment_indices_end":[40,55,95]}
{"text":"he has been on increasing doses of insulin receiving nph in the morning and night in addition to a czi sliding scale on a q6h basis .","problem":[],"test":[],"treatment":["nph","increasing doses of insulin","a czi sliding scale"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15,53,97],"treatment_indices_end":[42,56,116]}
{"text":"chest clear to auscultation with a few fine crackles at the left base .","problem":["a few fine crackles at the left base"],"test":["auscultation"],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[69],"test_indices_start":[15],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the organism grown at this institution was sensitive to imipenem , ceftazidime , amikacin , gentamicin , ciprofloxacin , tobramycin but was resistant to cefotetan , ceftriaxone , mezlocillin , bactrim , ampicillin , chloramphenicol , and sulbactam .","problem":["the organism"],"test":[],"treatment":["cefotetan","ceftriaxone","ciprofloxacin","gentamicin","mezlocillin","imipenem","tobramycin","ceftazidime","ampicillin","chloramphenicol","sulbactam","bactrim","amikacin"],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[56,67,81,92,105,121,153,165,179,193,203,216,238],"treatment_indices_end":[64,78,89,102,118,131,162,176,190,200,213,231,247]}
{"text":"on transfer include vancomycin , ceftazidime , gentamicin , solu cortef 100 mg q8h , lasix , synthroid , insulin , ms contin 60 mg b.i.d. , mso4 2 mg p.r.n. pain iv , dopamine 12 mcg per minute .","problem":["pain"],"test":[],"treatment":["lasix","gentamicin","solu cortef","vancomycin","synthroid","ceftazidime","ms contin","mso4","insulin","dopamine"],"problem_indices_start":[157],"problem_indices_end":[161],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20,33,47,60,85,93,105,115,140,167],"treatment_indices_end":[30,44,57,71,90,102,112,124,144,175]}
{"text":"there were cultures obtained seeping from the wound at retelk county medical center and those also grew out pseudomonas aeruginosa .","problem":["pseudomonas aeruginosa","the wound"],"test":["cultures"],"treatment":[],"problem_indices_start":[42,108],"problem_indices_end":[51,130],"test_indices_start":[11],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this bone marrow transplant did not produce remission and then he was treated with three cycles of vad subsequently .","problem":[],"test":[],"treatment":["this bone marrow transplant","three cycles of vad"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,83],"treatment_indices_end":[27,102]}
{"text":"he also complained of some fecal incontinence the day prior to admission without urinary incontinence .","problem":["some fecal incontinence","urinary incontinence"],"test":[],"treatment":[],"problem_indices_start":[22,81],"problem_indices_end":[45,101],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he initially required a face mask to keep his saturation above 90% .","problem":[],"test":["his saturation"],"treatment":["a face mask"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[42],"test_indices_end":[56],"treatment_indices_start":[22],"treatment_indices_end":[33]}
{"text":"5) plasmacytoma .","problem":["plasmacytoma"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at the time of presentation the patient denied headache , arm weakness , changes in vision , dysarthria , abdominal pain , nausea or vomiting , chest pain or shortness of breath .","problem":["dysarthria","chest pain","nausea","headache","vomiting","arm weakness","changes in vision","abdominal pain","shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[47,58,73,93,106,123,133,144,158],"problem_indices_end":[55,70,90,103,120,129,141,154,177],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the plan is to continue the supplemental insulin while he is on steroids and while his sugars remain high .","problem":[],"test":["his sugars"],"treatment":["steroids","the supplemental insulin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[83],"test_indices_end":[93],"treatment_indices_start":[24,64],"treatment_indices_end":[48,72]}
{"text":"neurological exam on admission revealed he was drowsy but easily arousable to voice , oriented to person , retelk county medical center , and date , able to say no but mildly inattentive during examination .","problem":["mildly inattentive","drowsy"],"test":["examination","neurological exam on admission"],"treatment":[],"problem_indices_start":[47,168],"problem_indices_end":[53,186],"test_indices_start":[0,194],"test_indices_end":[30,205],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest x-ray was without infiltrates , wand in good position .","problem":["infiltrates"],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[35],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , one day prior to admission the patient developed right lower extremity pain and could not walk secondary to the pain .","problem":["the pain","right lower extremity pain"],"test":[],"treatment":[],"problem_indices_start":[59,118],"problem_indices_end":[85,126],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was evidence of cord compression .","problem":["cord compression"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neck supple , carotids without bruits .","problem":["bruits"],"test":[],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he has had no significant episode of tachycardia or blood pressure alteration during the final days of hospitalization .","problem":["tachycardia","blood pressure alteration"],"test":[],"treatment":[],"problem_indices_start":[37,52],"problem_indices_end":[48,77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1) multiple myeloma .","problem":["multiple myeloma"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was treated with ceftazidime , gentamicin , and vancomycin and also was started on a dopamine drip for treatment of his sepsis .","problem":["his sepsis"],"test":[],"treatment":["gentamicin","ceftazidime","a dopamine drip","vancomycin"],"problem_indices_start":[119],"problem_indices_end":[129],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20,34,51,86],"treatment_indices_end":[31,44,61,101]}
{"text":"a swan was placed and initial readings were cvp of 6 , wedge pressure of 10 to 12 , cardiac index of 4.7 , and svr of 438 all consistent with a pseudomonas sepsis picture .","problem":["a pseudomonas sepsis picture"],"test":["cardiac index","wedge pressure","a swan","cvp","svr"],"treatment":[],"problem_indices_start":[142],"problem_indices_end":[170],"test_indices_start":[0,44,55,84,111],"test_indices_end":[6,47,69,97,114],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the plan is to complete a full course of imipenem and tobramycin for his pseudomonas cellulitis .","problem":["his pseudomonas cellulitis"],"test":[],"treatment":["imipenem","tobramycin"],"problem_indices_start":[69],"problem_indices_end":[95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[41,54],"treatment_indices_end":[49,64]}
{"text":"according to her scanty records , an mri of the spine showed diffuse spinal column involvement with lesions in t4 and t8 with no cord compression at that time .","problem":["diffuse spinal column involvement","lesions in t4 and t8","cord compression"],"test":["an mri of the spine"],"treatment":[],"problem_indices_start":[61,100,129],"problem_indices_end":[94,120,145],"test_indices_start":[34],"test_indices_end":[53],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his decadron dose was titrated down to 5 mg iv q6h on 12\/3\/94 .","problem":[],"test":[],"treatment":["his decadron dose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[17]}
{"text":"the tobramycin and imipenem were started on 11\/25\/94 .","problem":[],"test":[],"treatment":["imipenem","the tobramycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,19],"treatment_indices_end":[14,27]}
{"text":"of note , the patient has extreme pain with these dressing changes and requires parenteral morphine sulfate for pain control during dressing changes .","problem":["extreme pain","pain control during dressing changes"],"test":[],"treatment":["these dressing changes","parenteral morphine sulfate"],"problem_indices_start":[26,112],"problem_indices_end":[38,148],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[44,80],"treatment_indices_end":[66,107]}
{"text":"cardiac exam was regular s1 and s2 , no murmur .","problem":["murmur"],"test":["cardiac exam"],"treatment":[],"problem_indices_start":[40],"problem_indices_end":[46],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5) chronically low platelet count .","problem":["chronically low platelet count"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"as mentioned above he has a cord compression and is on steroids .","problem":["a cord compression"],"test":[],"treatment":["steroids"],"problem_indices_start":[26],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[55],"treatment_indices_end":[63]}
{"text":"he should also be encouraged to eat as much as possible orally in addition to this tube feeds and aspiration precaution should be maintained .","problem":[],"test":[],"treatment":["this tube feeds","aspiration precaution"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[78,98],"treatment_indices_end":[93,119]}
{"text":"in 08\/94 , the patient developed lower back pain .","problem":["lower back pain"],"test":[],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"about two weeks prior to admission the patient developed mid back pain , burning in nature with radiation around the right lower ribs .","problem":["mid back pain"],"test":[],"treatment":[],"problem_indices_start":[57],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"over the next 12 hours while in transit to the hospital , the patient 's right lower extremity became red , swollen , and increasingly painful .","problem":["red","swollen","increasingly painful"],"test":[],"treatment":[],"problem_indices_start":[107,113,127],"problem_indices_end":[110,120,147],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an mri without gadolinium done on 11\/20\/94 of the spine showed a right posterior lateral epidural mass extending from t9 to t12 .","problem":["a right posterior lateral epidural mass"],"test":["an mri without gadolinium"],"treatment":[],"problem_indices_start":[63],"problem_indices_end":[102],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2) paroxysmal atrial fibrillation .","problem":["paroxysmal atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the plan is to complete a full course of xrt to the spinal region for the plasmacytoma .","problem":["the plasmacytoma"],"test":[],"treatment":["xrt to the spinal region"],"problem_indices_start":[70],"problem_indices_end":[86],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[41],"treatment_indices_end":[65]}
{"text":"1) right lower extremity pseudomonas cellulitis .","problem":["right lower extremity pseudomonas cellulitis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's decadron dose was increased to 12 mg q day and he was also started on ms contin and radiation therapy was being planned and arranged at the petersly hospital and medical center .","problem":[],"test":[],"treatment":["ms contin","radiation therapy","the patient 's decadron dose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,90,104],"treatment_indices_end":[33,99,121]}
{"text":"he can be given intravenous lasix as needed for any evidence of respiratory compromise or increasing pulmonary edema .","problem":["respiratory compromise","increasing pulmonary edema"],"test":[],"treatment":["intravenous lasix"],"problem_indices_start":[64,90],"problem_indices_end":[86,116],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[33]}
{"text":"he was then treated with radiation therapy from t3 to t9 receiving 2500 cgy from 08\/94 to 09\/94 .","problem":[],"test":[],"treatment":["radiation therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25],"treatment_indices_end":[42]}
{"text":"these findings were consistent with the cord compression .","problem":["these findings","the cord compression"],"test":[],"treatment":[],"problem_indices_start":[0,36],"problem_indices_end":[14,56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's clinical situation was most consistent with a pseudomonas cellulitis and subsequent sepsis .","problem":["the patient 's clinical situation","a pseudomonas cellulitis","subsequent sepsis"],"test":[],"treatment":[],"problem_indices_start":[0,64,93],"problem_indices_end":[38,88,110],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"deep tendon reflexes were 2+ in the upper extremities , 1+ in the patella reflexes , no reflexes at the ankles , upgoing babinski toes bilaterally .","problem":["no reflexes at the ankles"],"test":["deep tendon reflexes","patella reflexes"],"treatment":[],"problem_indices_start":[85],"problem_indices_end":[110],"test_indices_start":[0,66],"test_indices_end":[20,82],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood cultures , urine culture , and ua were all done .","problem":[],"test":["ua","urine culture","blood cultures"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,17,37],"test_indices_end":[14,30,39],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was taken to huyychestleme health of in scoo , utah where he had a temperature of 99.9 , blood pressure 90\/50 , heart rate 128 , and o2 sat of 91% on room air .","problem":[],"test":["a temperature","heart rate","blood pressure","o2 sat"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[68,92,115,136],"test_indices_end":[81,106,125,142],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"these dressing changes are applied by applying the xeroform on betadine initially and then changing it with sterile dry bandages .","problem":[],"test":[],"treatment":["xeroform","these dressing changes","sterile dry bandages","betadine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,51,63,108],"treatment_indices_end":[22,59,71,128]}
{"text":"blood cultures drawn on admission subsequently grew pseudomonas aeruginosa .","problem":["pseudomonas aeruginosa"],"test":["blood cultures"],"treatment":[],"problem_indices_start":[52],"problem_indices_end":[74],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's lesion compressing his thoracic spine was never biopsied , however , the mri appearance does not seem to be infectious and is most consistent with plasmacytoma for which he is receiving the radiation therapy .","problem":["infectious","the patient 's lesion","plasmacytoma"],"test":["the mri"],"treatment":["the radiation therapy"],"problem_indices_start":[0,128,167],"problem_indices_end":[26,138,179],"test_indices_start":[89],"test_indices_end":[96],"treatment_indices_start":[206],"treatment_indices_end":[227]}
{"text":"his neurological exam remained stable with no evidence of increasing lower extremity edema .","problem":["increasing lower extremity edema"],"test":["his neurological exam"],"treatment":[],"problem_indices_start":[58],"problem_indices_end":[90],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he has had chronic bilateral lower extremity swelling since his transplant but the right lower extremity swelling was noticeably increased .","problem":["the right lower extremity swelling","chronic bilateral lower extremity swelling"],"test":[],"treatment":["his transplant"],"problem_indices_start":[11,79],"problem_indices_end":[53,113],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[60],"treatment_indices_end":[74]}
{"text":"motor exam normal tone , positive asterixis , no drift .","problem":["positive asterixis"],"test":["motor exam"],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[43],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an echocardiogram performed at the outside hospital while he was septic showed decreased global ef .","problem":["decreased global ef","septic"],"test":["an echocardiogram"],"treatment":[],"problem_indices_start":[65,79],"problem_indices_end":[71,98],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no csf density .","problem":["csf density"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has a poor nutritional status with hypoalbuminemia .","problem":["hypoalbuminemia","a poor nutritional status"],"test":[],"treatment":[],"problem_indices_start":[16,47],"problem_indices_end":[41,62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he has been in and out of atrial fibrillation and normal sinus rhythm .","problem":["atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his decadron dose will be slowly titrated down over time following his neurological exam closely .","problem":[],"test":["his neurological exam"],"treatment":["his decadron dose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[67],"test_indices_end":[88],"treatment_indices_start":[0],"treatment_indices_end":[17]}
{"text":"both of these responded to three day course of vitamin k 10 mg each day .","problem":[],"test":[],"treatment":["vitamin k"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47],"treatment_indices_end":[56]}
{"text":"he is being maintained with twice daily xeroform with betadine changes .","problem":[],"test":[],"treatment":["xeroform","betadine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40,54],"treatment_indices_end":[48,62]}
{"text":"heent exam atraumatic , no oral lesions .","problem":["oral lesions","atraumatic"],"test":["heent exam"],"treatment":[],"problem_indices_start":[11,27],"problem_indices_end":[21,39],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"thrombocytopenic inducing drugs should be avoided if possible on this patient .","problem":[],"test":[],"treatment":["thrombocytopenic inducing drugs"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[31]}
{"text":"extremities reveal the right lower extremity was tense , purple-red , swollen , and was warm from the knee to the ankle and extremely tender .","problem":["swollen","extremely tender","tense","purple-red"],"test":[],"treatment":[],"problem_indices_start":[49,57,70,124],"problem_indices_end":[54,67,77,140],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was evaluated by the surgery department and it is there feeling that there is no indication for surgical intervention \/ amputation at this time .","problem":[],"test":[],"treatment":["amputation","surgical intervention"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[99,123],"treatment_indices_end":[120,133]}
{"text":"there was pitting edema of both lower extremities but no evidence of cellulitis of the left lower extremity .","problem":["pitting edema of both lower extremities","cellulitis of the left lower extremity"],"test":[],"treatment":[],"problem_indices_start":[10,69],"problem_indices_end":[49,107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this has been evident since the time of his bone marrow transplant .","problem":[],"test":[],"treatment":["his bone marrow transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40],"treatment_indices_end":[66]}
{"text":"he also received several blood transfusions while here to maintain his hct around 30 .","problem":[],"test":["his hct"],"treatment":["several blood transfusions"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[67],"test_indices_end":[74],"treatment_indices_start":[17],"treatment_indices_end":[43]}
{"text":"the patient has had multiple myeloma since 1990 .","problem":["multiple myeloma"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3) plasmacytoma of t9 through t12 .","problem":["plasmacytoma of t9 through t12"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ua showed no white blood cells , positive granular casts .","problem":["positive granular casts"],"test":["ua"],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[56],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vancomycin was also added to his regimen on 11\/28\/94 and this was primarily to provide improved mrsa coverage as he continued to have erythema along the lateral right lower extremity .","problem":["erythema along the lateral right lower extremity"],"test":[],"treatment":["his regimen","improved mrsa coverage","vancomycin"],"problem_indices_start":[134],"problem_indices_end":[182],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,29,87],"treatment_indices_end":[10,40,109]}
{"text":"2) paroxysmal atrial fibrillation .","problem":["paroxysmal atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on admission revealed white blood cell count 4.2 , hct 27 , platelet count 28 .","problem":[],"test":["hct","white blood cell count","platelet count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22,51,60],"test_indices_end":[44,54,74],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8) elevated pt and ptt :","problem":["elevated pt and ptt"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was initially treated with dopamine which was subsequently weaned off after his sepsis improved .","problem":["his sepsis"],"test":[],"treatment":["dopamine"],"problem_indices_start":[88],"problem_indices_end":[98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39],"treatment_indices_end":[47]}
{"text":"6) failed autologous bone marrow transplant in 10\/92 .","problem":[],"test":[],"treatment":["failed autologous bone marrow transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[43]}
{"text":"8) multiple myeloma .","problem":["multiple myeloma"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"we have been transfusing him with platelets to keep his counts above 20,000 to reduce his bleeding risk .","problem":["his bleeding risk"],"test":["his counts"],"treatment":["platelets"],"problem_indices_start":[86],"problem_indices_end":[103],"test_indices_start":[52],"test_indices_end":[62],"treatment_indices_start":[34],"treatment_indices_end":[43]}
{"text":"he was initially treated with iv decadron 10 mg up front and then 6 mg q6h.","problem":[],"test":[],"treatment":["iv decadron"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30],"treatment_indices_end":[41]}
{"text":"in addition , the patient received a five day course of intravenous igg to improve infection control .","problem":[],"test":[],"treatment":["infection control","intravenous igg"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[56,83],"treatment_indices_end":[71,100]}
{"text":"6) poor nutritional status .","problem":["poor nutritional status"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he underwent an autologous bone marrow transplant in 10\/92 at petersly hospital and medical center .","problem":[],"test":[],"treatment":["an autologous bone marrow transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[49]}
{"text":"glucose 191 .","problem":[],"test":["glucose"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"question of penicillin and sulfa drugs leading to a rash .","problem":["a rash"],"test":[],"treatment":["penicillin","sulfa drugs"],"problem_indices_start":[50],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12,27],"treatment_indices_end":[22,38]}
{"text":"3) cord compression .","problem":["cord compression"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he also began to develop noticeably increasing bilateral lower extremity weakness and possibly numbness in the lower extremities .","problem":["numbness in the lower extremities","noticeably increasing bilateral lower extremity weakness"],"test":[],"treatment":[],"problem_indices_start":[25,95],"problem_indices_end":[81,128],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on admission showed a non-toxic appearing male with temperature 99.5 , blood pressure 82\/50 , heart rate 118 , respiratory rate 15 .","problem":[],"test":["respiratory rate","heart rate","blood pressure","temperature"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[52,71,94,111],"test_indices_end":[63,85,104,127],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7) hypothyroidism .","problem":["hypothyroidism"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he has been receiving radiation therapy to that area during the hospital stay .","problem":[],"test":[],"treatment":["radiation therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[39]}
{"text":"the patient has steroid induced diabetes mellitus .","problem":["steroid induced diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"as mentioned earlier he continues to have erythema tracking up his leg and up to his lateral thigh .","problem":["erythema"],"test":[],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the cause of this erythema is not know at this time but has not shown extensive progression .","problem":["this erythema"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4) chronic renal insufficiency .","problem":["chronic renal insufficiency"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he stated that he had difficulty rising from a chair .","problem":["difficulty rising from a chair"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he has been on decadron since 08\/94 .","problem":[],"test":[],"treatment":["decadron"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[23]}
{"text":"at that time he received total body irradiation of 1400 cgy .","problem":[],"test":[],"treatment":["total body irradiation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25],"treatment_indices_end":[47]}
{"text":"the patient has a plasmacytoma affecting the spine .","problem":["a plasmacytoma"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"magnesium 1.7 .","problem":[],"test":["magnesium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4) steroid induced diabetes mellitus .","problem":["steroid induced diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"during this hospitalization , pt was noted to have sinus bradycardia and pauses , associated with desaturations in the 70 's .","problem":["pauses","sinus bradycardia","desaturations in the 70 's"],"test":[],"treatment":[],"problem_indices_start":[51,73,98],"problem_indices_end":[68,79,129],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he will have outpt fitting at the sleep center in sabo .","problem":[],"test":[],"treatment":["outpt fitting"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[26]}
{"text":"simvastatin and niacin , vit. b-3","problem":[],"test":[],"treatment":["simvastatin","niacin","vit. b-3"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,16,25],"treatment_indices_end":[11,22,33]}
{"text":"wellbutrin ( bupropion hcl ) 150 mg po bid folate ( folic acid ) 1 mg po qd ativan ( lorazepam ) 1 mg po q12h x 1 days ativan ( lorazepam ) 1 mg po qhs x 7 days starting on 11\/5 mvi therapeutic w \/ minerals ( therap vits \/ minerals ) 1 tab po qd","problem":[],"test":[],"treatment":["ativan ( lorazepam )","folate ( folic acid )","mvi therapeutic w \/ minerals ( therap vits \/ minerals )","wellbutrin ( bupropion hcl )","ativan ( lorazepam )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,43,76,119,178],"treatment_indices_end":[28,64,96,139,233]}
{"text":"ett was negative for ischemia .","problem":["ischemia"],"test":["ett"],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[29],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"echo showed ef 45-50% , with mild dilatation and no significant valvular disease , and nl pap .","problem":["mild dilatation","significant valvular disease"],"test":["ef","echo"],"treatment":[],"problem_indices_start":[29,52],"problem_indices_end":[44,80],"test_indices_start":[0,12],"test_indices_end":[4,14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"fh , htn , tobacco .","problem":["htn"],"test":[],"treatment":[],"problem_indices_start":[5],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"presented w \/ epigastric pain , sob at work .","problem":["epigastric pain","sob"],"test":[],"treatment":[],"problem_indices_start":[14,32],"problem_indices_end":[29,35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"simvastatin and niacin , vit.","problem":[],"test":[],"treatment":["vit.","simvastatin","niacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,16,25],"treatment_indices_end":[11,22,29]}
{"text":"responsible after study for causing admission ) obstructive sleep apnea","problem":["obstructive sleep apnea"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"conditions , infections , complications , affecting treatment \/ stay htn tobacco etoh abuse sinus bradycardia","problem":["htn","sinus bradycardia"],"test":[],"treatment":[],"problem_indices_start":[69,92],"problem_indices_end":[72,109],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cpap at 5 was attempted , but pt did not tolerate this .","problem":[],"test":[],"treatment":["cpap"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[4]}
{"text":"indicated lisinopril 10 mg po qd nicotine patch ( nicotine ) 21 mg\/day tp q24h","problem":[],"test":[],"treatment":["nicotine patch ( nicotine )","lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10,33],"treatment_indices_end":[20,60]}
{"text":"firmert hospital 11\/6 at 9am scheduled , cialneinsisters hospital and medical center 11\/16 at 8:15pm scheduled , dr. condnort 12\/04 at 2pm scheduled , dr. lila spielbjaque 12\/01 at 1:50pm scheduled , no known allergies","problem":["known allergies"],"test":[],"treatment":[],"problem_indices_start":[203],"problem_indices_end":[218],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"indicated thiamine ( thiamine hcl ) 100 mg po qd simvastatin 40 mg po qhs","problem":[],"test":[],"treatment":["thiamine ( thiamine hcl )","simvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10,49],"treatment_indices_end":[35,60]}
{"text":"50 yo m from taheimpromong admitted w \/ cp for r \/ o mi .","problem":["mi","cp"],"test":[],"treatment":[],"problem_indices_start":[40,53],"problem_indices_end":[42,55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"r \/ o mi","problem":["mi"],"test":[],"treatment":[],"problem_indices_start":[6],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"has significant cardiac","problem":["significant cardiac"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"override added on 11\/03\/00 by twada , stasterl etheshi , m.d. on order for mvi therapeutic w \/ minerals po ( ref # 90299469 )","problem":[],"test":[],"treatment":["mvi therapeutic w \/ minerals po"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[75],"treatment_indices_end":[106]}
{"text":"b-3 reason for override :","problem":[],"test":[],"treatment":["b-3"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[3]}
{"text":"obstructive sleep apnea","problem":["obstructive sleep apnea"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given printed instructions for headache ( english ) .","problem":["headache"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"headache","problem":["headache"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"md evaluation , head ct","problem":[],"test":["head ct"],"treatment":["md evaluation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16],"test_indices_end":[23],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"migraines for 10 days","problem":["migraines"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following evaluation and treatment , the patient 's disposition at the end of the visit was admitted as an inpatient to oaksgekesser\/ memorial hospital .","problem":[],"test":["evaluation"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[20],"treatment_indices_start":[25],"treatment_indices_end":[34]}
{"text":"the patient 's preliminary admitting physician is brittsfyfeast , sher t and the preliminary diagnosis is s \/ sob .","problem":["sob"],"test":[],"treatment":[],"problem_indices_start":[115],"problem_indices_end":[118],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient presented with a chief complaint of sob .","problem":["sob"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"override added on 10\/01\/03 by kotejoasthoreuphkays , gai , m.d. on order for tylenol po 650 mg q4h ( ref # 85225311 )","problem":[],"test":[],"treatment":["tylenol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[77],"treatment_indices_end":[84]}
{"text":"tylenol ( acetaminophen ) 650 mg po q4h prn pain","problem":["pain"],"test":[],"treatment":["tylenol ( acetaminophen )"],"problem_indices_start":[44],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[25]}
{"text":"breech , multiple gestation ,","problem":["multiple gestation","breech"],"test":[],"treatment":[],"problem_indices_start":[0,9],"problem_indices_end":[6,27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"undelivered","problem":["undelivered"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"take with food milk of magnesia ( magnesium hydroxide ) 30 milliliters po bid prn constipation percocet 1-2 tab po q4h prn pain","problem":["constipation","pain"],"test":[],"treatment":["milk of magnesia ( magnesium hydroxide )","percocet"],"problem_indices_start":[82,123],"problem_indices_end":[94,127],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15,95],"treatment_indices_end":[55,103]}
{"text":"weight :","problem":[],"test":["weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sulfa , bactrim","problem":[],"test":[],"treatment":["bactrim","sulfa"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,8],"treatment_indices_end":[5,15]}
{"text":"acetaminophen and acetaminophen","problem":[],"test":[],"treatment":["acetaminophen","acetaminophen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,18],"treatment_indices_end":[13,31]}
{"text":"no observed abnormalities","problem":["observed abnormalities"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pregnancy","problem":["pregnancy"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"apgars 8,9","problem":[],"test":["apgars"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"colace ( docusate sodium ) 100 mg po bid ibuprofen 600 mg po q4h prn pain","problem":["pain"],"test":[],"treatment":["ibuprofen","colace ( docusate sodium )"],"problem_indices_start":[69],"problem_indices_end":[73],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,41],"treatment_indices_end":[26,50]}
{"text":"apgars 8,8","problem":[],"test":["apgars"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"acetaminophen and acetaminophen","problem":[],"test":[],"treatment":["acetaminophen","acetaminophen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,18],"treatment_indices_end":[13,31]}
{"text":"weight :","problem":[],"test":["weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"temperature 97.4 , heart rate 100 , blood pressure 142\/89 , and o2 saturation 94% on room air .","problem":[],"test":["heart rate","temperature","blood pressure","o2 saturation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,19,36,64],"test_indices_end":[11,29,50,77],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest ct showed bibasilar diffuse infiltrates , pcp was negative .","problem":["bibasilar diffuse infiltrates"],"test":["pcp","chest ct"],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[45],"test_indices_start":[0,48],"test_indices_end":[8,51],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sinus tachycardia at 100 .","problem":["sinus tachycardia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no nausea , vomiting , or diarrhea .","problem":["vomiting","nausea","diarrhea"],"test":[],"treatment":[],"problem_indices_start":[3,12,26],"problem_indices_end":[9,20,34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's differential diagnosis included initially a question of an atypical pneumonia or pcp .","problem":["pcp","an atypical pneumonia"],"test":[],"treatment":[],"problem_indices_start":[76,101],"problem_indices_end":[97,104],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he did drink alcohol three drinks per day , no withdrawal symptoms .","problem":["withdrawal symptoms"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he denied any fevers , chills , or night sweats .","problem":["fevers","chills","night sweats"],"test":[],"treatment":[],"problem_indices_start":[14,23,35],"problem_indices_end":[20,29,47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. bactrim double strength one tablet p.o. q.d. for pcp prophylaxis during his steroid course .","problem":[],"test":[],"treatment":["bactrim double strength","pcp prophylaxis","his steroid course"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,52,75],"treatment_indices_end":[26,67,93]}
{"text":"pneumonia","problem":["pneumonia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest exam reveals coarse rhonchi with some bibasilar crackles .","problem":["coarse rhonchi","some bibasilar crackles"],"test":["chest exam"],"treatment":[],"problem_indices_start":[19,39],"problem_indices_end":[33,62],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was continued on azithromycin and cefuroxime until bronchoscopy results were known , negative .","problem":[],"test":[],"treatment":["azithromycin","cefuroxime"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20,37],"treatment_indices_end":[32,47]}
{"text":"echocardiogram was checked to rule out chf , showed lvh and trace tr , ejection fraction of 60% without any pulmonary hypertension .","problem":["chf","pulmonary hypertension","trace tr","lvh"],"test":["echocardiogram","ejection fraction"],"treatment":[],"problem_indices_start":[39,52,60,108],"problem_indices_end":[42,55,68,130],"test_indices_start":[0,71],"test_indices_end":[14,88],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neuro exam was alert and oriented x 3 .","problem":[],"test":["neuro exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"thus initially he had been started on prednisone and bactrim , this was discontinued .","problem":[],"test":[],"treatment":["prednisone","bactrim"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38,53],"treatment_indices_end":[48,60]}
{"text":"in emergency room , he was noted to be afebrile with stable vital signs , was treated with iv fluids , azithromycin , and cefuroxime .","problem":[],"test":[],"treatment":["cefuroxime","azithromycin","iv fluids"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[91,103,122],"treatment_indices_end":[100,115,132]}
{"text":"he did note some weight loss over the past several months , though the amount was unknown .","problem":["some weight loss"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"multiple conversations were had with the patient as well as an interpreter stating the importance of not smoking and keeping flames away from his oxygen tank .","problem":[],"test":[],"treatment":["his oxygen tank"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[142],"treatment_indices_end":[157]}
{"text":"sister with bone cancer .","problem":["bone cancer"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ambulatory saturation was 82% on room air .","problem":[],"test":["ambulatory saturation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pulmonary consult was invited , initially the patient refused bronchoscopy , however , did agree to it during his hospital stay .","problem":[],"test":["bronchoscopy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[62],"test_indices_end":[74],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white blood cell count 11.2 , hematocrit 43.2 , and platelets 447,000 .","problem":[],"test":["platelets","hematocrit","white blood cell count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,30,52],"test_indices_end":[22,40,61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdominal exam revealed soft , nontender , and nondistended abdomen .","problem":[],"test":["abdominal exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was in his usual state of health until two months prior to admission when he began to notice shortness of breath on climbing flights of stairs .","problem":["shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[105],"problem_indices_end":[124],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the results were negative for micro , most likely diagnosis as per review of pathology is organizing pneumonia with possible diagnosis of boop and chronic inhalational injury was a possibility .","problem":["chronic inhalational injury","organizing pneumonia","boop","micro"],"test":["review of pathology"],"treatment":[],"problem_indices_start":[30,90,138,147],"problem_indices_end":[35,110,142,174],"test_indices_start":[67],"test_indices_end":[86],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he stated that this became worse over the last month until he was noted to be short of breath at rest .","problem":["short of breath"],"test":[],"treatment":[],"problem_indices_start":[78],"problem_indices_end":[93],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his electrolytes were repeated p.r.n.","problem":[],"test":["his electrolytes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his extremities were without cyanosis , clubbing , or edema .","problem":["edema","clubbing","cyanosis"],"test":[],"treatment":[],"problem_indices_start":[29,40,54],"problem_indices_end":[37,48,59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his ppd has been negative one year prior to admission , ppd was rechecked during this admission and was negative .","problem":[],"test":["his ppd","ppd"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,56],"test_indices_end":[7,59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was ruled out for tuberculosis with an induced sputum x 3 , which showed no afb .","problem":["afb","tuberculosis"],"test":["an induced sputum"],"treatment":[],"problem_indices_start":[21,79],"problem_indices_end":[33,82],"test_indices_start":[39],"test_indices_end":[56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no hepatosplenomegaly noted on abdominal exam .","problem":["hepatosplenomegaly"],"test":["abdominal exam"],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[30],"test_indices_start":[40],"test_indices_end":[54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient required supplemental oxygen to keep his oxygen saturation greater than 93% .","problem":[],"test":["his oxygen saturation"],"treatment":["supplemental oxygen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[49],"test_indices_end":[70],"treatment_indices_start":[21],"treatment_indices_end":[40]}
{"text":"sodium 139 , potassium 3.5 , chloride 103 , bicarbonate 25 , bun 9 , creatinine 0.9 , and glucose 83 .","problem":[],"test":["chloride","bun","creatinine","bicarbonate","potassium","glucose","sodium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,29,44,61,69,90],"test_indices_end":[6,22,37,55,64,79,97],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his skin was clear , without rashes .","problem":["rashes"],"test":[],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was discharged to home in satisfactory condition with home oxygen .","problem":[],"test":[],"treatment":["home oxygen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[66],"treatment_indices_end":[77]}
{"text":"1. prednisone 60 mg p.o. q.a.m.","problem":[],"test":[],"treatment":["prednisone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"he was told to call a doctor or come to the emergency room should he have any further troubles , breathing , chest pain , or fevers .","problem":["chest pain","any further troubles","fevers"],"test":[],"treatment":[],"problem_indices_start":[74,109,125],"problem_indices_end":[94,119,131],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 38-year-old gentleman , spanish-speaking , from the taheimpromong , with no significant past medical history , who presents with shortness of breath x 2 months as well as a dry cough x 1 month .","problem":["shortness of breath","a dry cough"],"test":[],"treatment":[],"problem_indices_start":[146,188],"problem_indices_end":[165,199],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent exam revealed sclerae to be injected .","problem":["sclerae"],"test":["heent exam"],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[27],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"shortness of breath .","problem":["shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he also states that he has had a dry and nonproductive cough for one month .","problem":["a dry and nonproductive cough"],"test":[],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he initially had refused hiv testing , however , was finally consented , hiv was noted to be negative .","problem":["hiv"],"test":["hiv testing"],"treatment":[],"problem_indices_start":[73],"problem_indices_end":[76],"test_indices_start":[25],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heart exam was regular rate and rhythm , tachycardic , with a flat jugular venous pressure .","problem":["a flat jugular venous pressure","tachycardic"],"test":["heart exam"],"treatment":[],"problem_indices_start":[41,60],"problem_indices_end":[52,90],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was treated with supportive medical therapy for his cough .","problem":["his cough"],"test":[],"treatment":["supportive medical therapy"],"problem_indices_start":[51],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[46]}
{"text":"general exam revealed a well-developed , well-nourished gentleman in no acute distress .","problem":["acute distress"],"test":["general exam"],"treatment":[],"problem_indices_start":[72],"problem_indices_end":[86],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no lymphadenopathy was noted in the neck , there was a question of right axillary lymphadenopathy .","problem":["right axillary lymphadenopathy","lymphadenopathy"],"test":[],"treatment":[],"problem_indices_start":[3,67],"problem_indices_end":[18,97],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was sent home with ldamc services to help with his medications as well as oxygen education .","problem":[],"test":[],"treatment":["his medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[50],"treatment_indices_end":[65]}
{"text":"diffuse interstitial process \/ consolidation .","problem":["consolidation","diffuse interstitial process"],"test":[],"treatment":[],"problem_indices_start":[0,31],"problem_indices_end":[28,44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lovenox .","problem":[],"test":[],"treatment":["lovenox"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"hepatitis serologies were negative .","problem":[],"test":["hepatitis serologies"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient presented with a chief complaint of cp sob .","problem":["sob","cp"],"test":[],"treatment":[],"problem_indices_start":[48,51],"problem_indices_end":[50,54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's preliminary admitting physician is dreissneigh , liru and the preliminary admitting diagnosis is cp , r \/ o mi .","problem":["mi","cp"],"test":[],"treatment":[],"problem_indices_start":[117,128],"problem_indices_end":[119,130],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following evaluation and treatment , the patient 's disposition at the end of the visit was admitted as an inpatient to ro woodma healthcare .","problem":[],"test":["evaluation"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[20],"treatment_indices_start":[25],"treatment_indices_end":[34]}
{"text":"pelvic exam","problem":[],"test":["pelvic exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"perianal and perivaginal pruritis","problem":["perianal and perivaginal pruritis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if tests are positive , follow up with your primary care doctor of gynecologist .","problem":["positive"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please call ( 994 ) 944-4238 in 2-3 days to obtain results of the lab tests that were ordered .","problem":[],"test":["the lab tests"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[62],"test_indices_end":[75],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"r \/ o hemmoroids","problem":["hemmoroids"],"test":[],"treatment":[],"problem_indices_start":[6],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"per the patient 's wishes , she was transferred to the windgo hospital for chemotherapy .","problem":[],"test":[],"treatment":["chemotherapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[80],"treatment_indices_end":[92]}
{"text":"there was no lymphadenopathy .","problem":["lymphadenopathy"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a specimen was obtained by fine needle aspiration and the pathology of this was consistent with adenocarcinoma .","problem":["adenocarcinoma"],"test":["the pathology","fine needle aspiration"],"treatment":[],"problem_indices_start":[96],"problem_indices_end":[110],"test_indices_start":[27,54],"test_indices_end":[49,67],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"calcium 9.1 .","problem":[],"test":["calcium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had an elective termination of her pregnancy on 1\/13\/91 .","problem":["her pregnancy"],"test":[],"treatment":["an elective termination"],"problem_indices_start":[43],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[39]}
{"text":"ahead ct scan revealed a metastatic lesion in the right vertex of the calvarium but no intracranial abnormalities .","problem":["a metastatic lesion","intracranial abnormalities"],"test":["ahead ct scan"],"treatment":[],"problem_indices_start":[23,87],"problem_indices_end":[42,113],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her ldh was 394 .","problem":[],"test":["her ldh"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac exam was tachycardic and regular , normal s1 and s2 .","problem":["tachycardic"],"test":["cardiac exam"],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[28],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a fine needle aspirate of this mass reportedly revealed giant cell tumor .","problem":["this mass","giant cell tumor"],"test":["a fine needle aspirate"],"treatment":[],"problem_indices_start":[26,56],"problem_indices_end":[35,72],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 12\/23 , she was seen by dr. stonge at bri health where a 3 x 7 cm left mid clavicular mass was noted .","problem":["a 3 x 7 cm left mid clavicular mass"],"test":[],"treatment":[],"problem_indices_start":[58],"problem_indices_end":[93],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her alkaline phosphatase was 1514 .","problem":[],"test":["her alkaline phosphatase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's low serum albumin is also contributing to her extensive edema .","problem":["the patient 's low serum albumin","her extensive edema"],"test":[],"treatment":[],"problem_indices_start":[0,62],"problem_indices_end":[37,81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"total bilirubin 3.0 , direct bilirubin of 2.0 .","problem":[],"test":["direct bilirubin","total bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,22],"test_indices_end":[15,38],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent exam was unremarkable .","problem":[],"test":["heent exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the abdominal and pelvic ct scans showed no suspicious gi masses , no pancreatic mass ; a 2 cm ovarian cyst .","problem":["pancreatic mass","suspicious gi masses","a 2 cm ovarian cyst"],"test":["the abdominal and pelvic ct scans"],"treatment":[],"problem_indices_start":[44,70,88],"problem_indices_end":[64,85,107],"test_indices_start":[0],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"serum markers were normal .","problem":[],"test":["serum markers"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"impending spinal cord compression .","problem":["impending spinal cord compression"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the pathology , unfortunately , revealed an aggressive adenocarcinoma ( micropapillary type ; mucin producing ) .","problem":["an aggressive adenocarcinoma"],"test":["the pathology"],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[69],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"total bilirubin was 2.1 .","problem":[],"test":["total bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the poor prognosis for the patient and child were discussed and after the patient decided to have an elective abortion , an abdominal ct scan was obtained which revealed diffuse metastatic lesions of the liverspine , ribs and most of the lymph nodes .","problem":["diffuse metastatic lesions of the liverspine , ribs and most of the lymph nodes"],"test":["an abdominal ct scan"],"treatment":["an elective abortion"],"problem_indices_start":[170],"problem_indices_end":[249],"test_indices_start":[121],"test_indices_end":[141],"treatment_indices_start":[98],"treatment_indices_end":[118]}
{"text":"subsequently , the mass progressively increased in size and the patient had developed significant discomfort in this region .","problem":["significant discomfort in this region","the mass"],"test":[],"treatment":[],"problem_indices_start":[15,86],"problem_indices_end":[23,123],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an abdominal and pelvic ct scan with iv contrast revealed bilateral pulmonary nodules and bilateral pleural effusions , extensive liver metastases , narrowing of the intra hepatic ivc and distention of the azygous system suggestive of ivc obstruction by liver metastases ; ascites ; multiple bony metastases ; and an isolated splenic metastases .","problem":["an isolated splenic metastases","bilateral pulmonary nodules","narrowing of the intra hepatic ivc","multiple bony metastases","distention of the azygous system","ivc obstruction","liver metastases","bilateral pleural effusions","extensive liver metastases","ascites"],"test":["an abdominal and pelvic ct scan with iv contrast"],"treatment":[],"problem_indices_start":[58,90,120,149,188,235,254,273,283,314],"problem_indices_end":[85,117,146,183,220,250,270,280,307,344],"test_indices_start":[0],"test_indices_end":[48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the review of the pathology from bri health confirmed a high grade adenocarcinoma .","problem":["a high grade adenocarcinoma"],"test":["the pathology"],"treatment":[],"problem_indices_start":[54],"problem_indices_end":[81],"test_indices_start":[14],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the ca-125 was still pending and alphafeto protein is still pending .","problem":[],"test":["alphafeto protein","the ca-125"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,33],"test_indices_end":[10,50],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she received three days of intravenous etidronate with normal saline diuresis and the serum calcium subsequently decreased to 9.0 .","problem":[],"test":["the serum calcium"],"treatment":["normal saline diuresis","intravenous etidronate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[82],"test_indices_end":[99],"treatment_indices_start":[27,55],"treatment_indices_end":[49,77]}
{"text":"the mri scan on admission revealed an impending cord compression at the level of t10 .","problem":["an impending cord compression"],"test":["the mri scan on admission"],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[64],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on admission included percocet for pain and multivitamins .","problem":["pain"],"test":[],"treatment":["multivitamins","percocet"],"problem_indices_start":[35],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,44],"treatment_indices_end":[30,57]}
{"text":"the work-up for the extent of the patient 's disease included mri scan of the cervical and thoracic spine which revealed multiple metastatic lesions in the vertebral bodies ; a t3 lesion extending from the body to the right neural for amina with foraminal obstruction .","problem":["foraminal obstruction","a t3 lesion","multiple metastatic lesions in the vertebral bodies","the patient 's disease"],"test":["the work-up","mri scan of the cervical and thoracic spine"],"treatment":[],"problem_indices_start":[30,126,180,251],"problem_indices_end":[57,177,191,272],"test_indices_start":[0,67],"test_indices_end":[11,110],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was initially told that this was a benign tumor and that it could simply be watched and definitively treated after the delivery of her baby .","problem":["a benign tumor"],"test":[],"treatment":["the delivery of her baby"],"problem_indices_start":[45],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[127],"treatment_indices_end":[151]}
{"text":"hypercalcemia :","problem":["hypercalcemia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lungs were clear to auscultation .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was then switched to po etidronate .","problem":[],"test":[],"treatment":["po etidronate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[33],"treatment_indices_end":[46]}
{"text":"it was felt that the patient 's extensive pulmonary metastases and bilateral pleural effusions resulted in increased work of respiration and a sensation of shortness of breath .","problem":["shortness of breath","increased work of respiration","bilateral pleural effusions","the patient 's extensive pulmonary metastases"],"test":[],"treatment":[],"problem_indices_start":[17,72,112,161],"problem_indices_end":[67,99,141,180],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has extensive hepatic metastases and by ct scan there is obstruction of the intrahepatic ivc .","problem":["obstruction of the intrahepatic ivc","extensive hepatic metastases"],"test":["ct scan"],"treatment":[],"problem_indices_start":[16,69],"problem_indices_end":[44,104],"test_indices_start":[52],"test_indices_end":[59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the hcg on admission was 30,710 and on 1\/19 was 805 .","problem":[],"test":["the hcg on admission"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ptt was 27.3 .","problem":[],"test":["ptt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ast was 89 .","problem":[],"test":["ast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sensation was intact to light touch .","problem":[],"test":["light touch"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24],"test_indices_end":[35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's father died at age 69 with metastatic prostate cancer .","problem":["metastatic prostate cancer"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[73],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on admission included an alt of 108 , ast of 286 .","problem":[],"test":["ast","an alt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22,38],"test_indices_end":[28,41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this prompted further staging work-up .","problem":[],"test":["further staging work-up"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14],"test_indices_end":[37],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she denied fevers , chills or sweats .","problem":["sweats","chills","fevers"],"test":[],"treatment":[],"problem_indices_start":[11,20,30],"problem_indices_end":[17,26,36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has not had any alcoholic beverages during this pregnancy .","problem":["this pregnancy"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there were no rales or wheezes .","problem":["wheezes","rales"],"test":[],"treatment":[],"problem_indices_start":[14,23],"problem_indices_end":[19,30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"skin exam revealed a right posterior parietal scalp nodle measuring 2 x 3 cm which was very firm .","problem":["a right posterior parietal scalp nodle"],"test":["skin exam"],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[57],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no obvious gior pancreatic tumor identified .","problem":["obvious gior pancreatic tumor"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at the time of discharge , the patient 's electrolytes were within normal limits .","problem":[],"test":["the patient 's electrolytes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[27],"test_indices_end":[59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient subsequently had a limited chest ct at bri health which showed diffuse bilateral pulmonary metastases , metastases to the sternum , rib , multiple spinal levels ; internal mammary lymphadenopathy .","problem":["internal mammary lymphadenopathy","diffuse bilateral pulmonary metastases","metastases to the sternum , rib , multiple spinal levels"],"test":["a limited chest ct"],"treatment":[],"problem_indices_start":[75,116,175],"problem_indices_end":[113,172,207],"test_indices_start":[29],"test_indices_end":[47],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's sister has a history of cervical cancer .","problem":["cervical cancer"],"test":[],"treatment":[],"problem_indices_start":[44],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was decided to have the patient 's medical and oncological issues managed at windgo hospital .","problem":["the patient 's medical and oncological issues"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[73],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood pressure was 98\/64 .","problem":[],"test":["blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had a very firm nodule at the vertex of her calvarium .","problem":["a very firm nodule"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on discharge included etidronate , 475 mg iv q day ; heparin , 5000 units subcutaneously b.i.d. ; decadron , 4 mg po q six hours ; ms contin , 45 mg po b.i.d. ; pepcid , 20 mg po b.i.d. ; senekot , one tablet po t.i.d. ; bronkosol , 0.25 cc q four hours .","problem":[],"test":[],"treatment":["decadron","etidronate","bronkosol","heparin","ms contin","pepcid","senekot"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,53,98,131,161,188,221],"treatment_indices_end":[32,60,106,140,167,195,230]}
{"text":"hypercalcemia .","problem":["hypercalcemia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"although the patient 's room air saturation was 96% during this admission , she subjectively complained of increased shortness of breath .","problem":["increased shortness of breath"],"test":["the patient 's room air saturation"],"treatment":[],"problem_indices_start":[112],"problem_indices_end":[141],"test_indices_start":[9],"test_indices_end":[48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had back pain on admission without any focal neurological signs .","problem":["back pain","any focal neurological signs"],"test":[],"treatment":[],"problem_indices_start":[16,47],"problem_indices_end":[25,75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has had no motor weakness , abnormal sensation , numbness , tingling or incontinence of bowel or bladder .","problem":["incontinence of bowel or bladder","abnormal sensation","tingling","motor weakness","numbness"],"test":[],"treatment":[],"problem_indices_start":[15,32,53,64,76],"problem_indices_end":[29,50,61,72,108],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the cea was less than 0.7 .","problem":[],"test":["the cea"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient presented with a serum calcium of 11.8 and an albumin of 2.3 on admission .","problem":[],"test":["a serum calcium","an albumin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[27,55],"test_indices_end":[42,65],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was mild lower thoracic tenderness .","problem":["mild lower thoracic tenderness"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no jugular venous distention .","problem":["jugular venous distention"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was transferred to nimaconwood valley hospital for management of her cancer and termination of the pregnancy .","problem":["the pregnancy","her cancer"],"test":[],"treatment":["termination","management"],"problem_indices_start":[77,107],"problem_indices_end":[87,120],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[63,92],"treatment_indices_end":[73,103]}
{"text":"work-up for the source of the primary tumor which is still unknown included a mammogram which identified no suspicious microcalcifications and no dominant masses .","problem":["dominant masses","the primary tumor","suspicious microcalcifications"],"test":["a mammogram","work-up"],"treatment":[],"problem_indices_start":[26,108,146],"problem_indices_end":[43,138,161],"test_indices_start":[0,76],"test_indices_end":[7,87],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was a 1 cm firm nodule in the right upper quadrant of the abdomen .","problem":["a 1 cm firm nodule"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 1\/5 , the patient underwent a local tumor debulking at bri health under local anesthesia .","problem":[],"test":[],"treatment":["local anesthesia","a local tumor debulking"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31,75],"treatment_indices_end":[54,91]}
{"text":"she was started on decadron and on 1\/17 began the first of ten radiation treatments to two fields ( t2 to t5 and t9 to t11 ) .","problem":[],"test":[],"treatment":["decadron","ten radiation treatments"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,59],"treatment_indices_end":[27,83]}
{"text":"over the past four weeks , the patient reported progressive shortness of breath and mid thoracic back pain .","problem":["mid thoracic back pain","progressive shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[48,84],"problem_indices_end":[79,106],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the abdomen was tympanitic and nontender .","problem":["nontender"],"test":[],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt was 12.9 .","problem":[],"test":["pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"back was without cva tenderness .","problem":["cva tenderness"],"test":[],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the liver was 11 cm by percussion .","problem":[],"test":["percussion"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[23],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no scapular tenderness .","problem":["scapular tenderness"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"per the patient 's wishes , dr. dalywoo droreite the windgo hospital was consulted for a second opinion regarding the management of her malignancy .","problem":["her malignancy"],"test":[],"treatment":["the management"],"problem_indices_start":[137],"problem_indices_end":[151],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[119],"treatment_indices_end":[133]}
{"text":"pulse 82 .","problem":[],"test":["pulse"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[5],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was a ii \/ vi systolic ejection murmur loudest at the left upper sternal border .","problem":["a ii \/ vi systolic ejection murmur"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hypoxia and shortness of breath :","problem":["hypoxia","shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[0,12],"problem_indices_end":[7,31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was a 1 cm firm nodule at the left upper thoracic region of the back between the midline and the scapula .","problem":["a 1 cm firm nodule at the left upper thoracic region"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hematocrit was 30.6 .","problem":[],"test":["hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"impending spinal cord compression :","problem":["impending spinal cord compression"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white blood cell count was 16.89 .","problem":[],"test":["white blood cell count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"intrauterine pregnancy at 23 weeks .","problem":["intrauterine pregnancy at 23 weeks"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dr. linke recommended chemotherapy with pfl .","problem":[],"test":[],"treatment":["chemotherapy with pfl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[43]}
{"text":"direct bilirubin was 1.4 .","problem":[],"test":["direct bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extremities revealed 1+ bipedal edema on admission .","problem":["1+ bipedal edema"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neurological examination revealed the patient to be alert and oriented times three .","problem":[],"test":["neurological examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 34-year-old female with a 22 week intrauterine pregnancy who was transferred from bri health with diffuse metastatic adenocarcinoma of unknown primary .","problem":["diffuse metastatic adenocarcinoma of unknown primary","a 22 week intrauterine pregnancy"],"test":[],"treatment":[],"problem_indices_start":[41,115],"problem_indices_end":[73,167],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"erica and basic cystic protein stains are still pending .","problem":[],"test":["erica and basic cystic protein stains"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[37],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"respiratory rate 20 .","problem":[],"test":["respiratory rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"metastatic adenocarcinoma of unknown primary .","problem":["metastatic adenocarcinoma of unknown primary"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this has resulted in marked bilateral lower extremity and presacral edema with ascites .","problem":["ascites","marked bilateral lower extremity and presacral edema"],"test":[],"treatment":[],"problem_indices_start":[21,79],"problem_indices_end":[73,86],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"calcium 11.8 .","problem":[],"test":["calcium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"subsequently , the mass continued to increase in size .","problem":["the mass"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hematocrit was 32.5 .","problem":[],"test":["hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an epidural mass was present at t10 which was extending from the lamina or spinous process anteriorly and almost compressing the spinal cord .","problem":["an epidural mass"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"alkaline phosphatase 1148 .","problem":[],"test":["alkaline phosphatase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"alt was 53 .","problem":[],"test":["alt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ldh 806 .","problem":[],"test":["ldh"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"deep tendon reflexes were 1-2+ and symmetric bilaterally .","problem":[],"test":["deep tendon reflexes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was in her usual state of excellent health until july of 1991 when she first noted a left clavicular mass .","problem":["a left clavicular mass"],"test":[],"treatment":[],"problem_indices_start":[95],"problem_indices_end":[117],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no egophony .","problem":["egophony"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ptt was 29.8 .","problem":[],"test":["ptt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a bone scan revealed increased uptake in the left chest wall , left anterior ribs four to six , and increased uptake in the left and right lateral skull in the area of the parotids .","problem":["increased uptake in the left chest wall , left anterior ribs four to six","increased uptake in the left and right lateral skull"],"test":["a bone scan"],"treatment":[],"problem_indices_start":[21,100],"problem_indices_end":[93,152],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt was 13.2 .","problem":[],"test":["pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no heave .","problem":["heave"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white blood cell count was 11.14 .","problem":[],"test":["white blood cell count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"inferior vena cava obstruction .","problem":["inferior vena cava obstruction"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there has been no gi or gu symptoms except for constipation .","problem":["constipation","gi or gu symptoms"],"test":[],"treatment":[],"problem_indices_start":[18,47],"problem_indices_end":[35,59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ivc obstruction :","problem":["ivc obstruction"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen was gravid .","problem":["gravid"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"albumin was 2.3 .","problem":[],"test":["albumin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"albumin 2.3 .","problem":[],"test":["albumin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pelvic exam revealed normal vulva , vagina normal , cervix normal , uterus anteverted , small , nontender .","problem":["nontender"],"test":["pelvic exam"],"treatment":[],"problem_indices_start":[96],"problem_indices_end":[105],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no masses or tenderness .","problem":["masses","tenderness"],"test":[],"treatment":[],"problem_indices_start":[3,13],"problem_indices_end":[9,23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"130\/82 and heart rate 80 .","problem":[],"test":["heart rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"clear to auscultation and percussion bilaterally .","problem":[],"test":["percussion","auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[9,26],"test_indices_end":[21,36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she did well and was admitted to the gyn service postoperatively because the patient had persistent pain .","problem":["persistent pain"],"test":[],"treatment":[],"problem_indices_start":[89],"problem_indices_end":[104],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. undesired fertility .","problem":["undesired fertility"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was extensively counseled regarding other methods of birth control and desired to proceed with definitive surgical therapy .","problem":[],"test":[],"treatment":["birth control","definitive surgical therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[57,99],"treatment_indices_end":[70,126]}
{"text":"the patient then underwent liposuction of her abdomen , inner thighs , hips , flanks , chest and arms with dr. chain .","problem":[],"test":[],"treatment":["liposuction of her abdomen , inner thighs , hips , flanks , chest and arms"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[101]}
{"text":"the patient is a 30 -year-old gravida iii , para ii who presented desiring definitive surgical sterilization .","problem":[],"test":[],"treatment":["definitive surgical sterilization"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[75],"treatment_indices_end":[108]}
{"text":"blood pressure :","problem":[],"test":["blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"height 5 ' 1 " , weight 138 lb.","problem":[],"test":["weight","height"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,27],"test_indices_end":[6,33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"motrin and percocet as needed .","problem":[],"test":[],"treatment":["percocet","motrin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,11],"treatment_indices_end":[6,19]}
{"text":"the patient was consented for both procedures and brought to the operating room .","problem":[],"test":[],"treatment":["both procedures"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30],"treatment_indices_end":[45]}
{"text":"on postoperative day #one , she was then stable with no complaints .","problem":["complaints"],"test":[],"treatment":[],"problem_indices_start":[56],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was done with falope rings .","problem":[],"test":[],"treatment":["falope rings"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[31]}
{"text":"the estimated blood loss was minimal and the patient received 600 cc. of intravenous fluid .","problem":["the estimated blood loss"],"test":[],"treatment":["intravenous fluid"],"problem_indices_start":[0],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[73],"treatment_indices_end":[90]}
{"text":"of note , the patient had a negative urine pregnancy test prior to the surgery .","problem":[],"test":[],"treatment":["the surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[67],"treatment_indices_end":[78]}
{"text":"soft , nontender , nondistended .","problem":["nondistended","nontender"],"test":[],"treatment":[],"problem_indices_start":[7,19],"problem_indices_end":[16,31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no history of sexually transmitted disease , no history of domestic violence .","problem":["sexually transmitted disease"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. undesired adiposity .","problem":["undesired adiposity"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"regular menses , on ortho-tri-cyclen .","problem":[],"test":[],"treatment":["ortho-tri-cyclen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[36]}
{"text":"appendectomy at the age of 14 , open .","problem":[],"test":[],"treatment":["appendectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"the patient was admitted to the operating room where she underwent an unremarkable laparoscopic tubal ligation .","problem":[],"test":[],"treatment":["an unremarkable laparoscopic tubal ligation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[67],"treatment_indices_end":[110]}
{"text":"1. ortho tri-cyclen .","problem":[],"test":[],"treatment":["ortho tri-cyclen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[19]}
{"text":"her foley was removed .","problem":[],"test":[],"treatment":["her foley"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"no masses .","problem":["masses"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"spontaneous vaginal delivery x 2 .","problem":["spontaneous vaginal delivery"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition , the patient desired liposuction of varying areas as well .","problem":[],"test":[],"treatment":["liposuction of varying areas"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[62]}
{"text":"she remained afebrile .","problem":["afebrile"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"eval","problem":[],"test":["eval"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if symptoms continue to be overwhelming return to v or call 1-903-263-5797","problem":["overwhelming","symptoms"],"test":[],"treatment":[],"problem_indices_start":[3,27],"problem_indices_end":[11,39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"continue w\/ risperdal per new psychiatrist","problem":[],"test":[],"treatment":["risperdal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[21]}
{"text":"ptsd","problem":["ptsd"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[4],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":".5 risperdal","problem":[],"test":[],"treatment":[".5 risperdal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"b and w and work w\/ therapist re: historical issues .","problem":[],"test":[],"treatment":["b and w"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"no calf tenderness .","problem":["calf tenderness"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cbc :","problem":[],"test":["cbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ekg showed atrial fibrillation , left axis deviation , lvh , nonspecific st-t changes either due to digitalis affect .","problem":["left axis deviation","atrial fibrillation","nonspecific st-t changes","lvh","digitalis affect"],"test":["ekg"],"treatment":[],"problem_indices_start":[11,33,55,61,100],"problem_indices_end":[30,52,58,85,116],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct scan of the renal area showed right hydronephrosis which extends to an asymmetrically thickened urinary bladder wall .","problem":["right hydronephrosis","an asymmetrically thickened urinary bladder wall"],"test":["ct scan of the renal area"],"treatment":[],"problem_indices_start":[33,71],"problem_indices_end":[53,119],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heart initially tachycardia , grade ii \/ vi systolic ejection murmur at the left sternal border .","problem":["tachycardia","grade ii \/ vi systolic ejection murmur at the left sternal border"],"test":[],"treatment":[],"problem_indices_start":[16,30],"problem_indices_end":[27,95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was noted to have elevated bun and creatinine .","problem":["elevated bun"],"test":["bun","creatinine"],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[33],"test_indices_start":[30,38],"test_indices_end":[33,48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"further evaluation of his renal failure showed that the patient has bilateral hydronephrosis , most likely obstructive uropathy due to prostate ca in the pelvic area .","problem":["prostate ca in the pelvic area","obstructive uropathy","his renal failure","bilateral hydronephrosis"],"test":["further evaluation"],"treatment":[],"problem_indices_start":[22,68,107,135],"problem_indices_end":[39,92,127,165],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however after the procedure , the patient 's hematocrit dropped to 24 and he was transfused two units of packed red blood cells .","problem":["the patient 's hematocrit dropped"],"test":[],"treatment":["two units of packed red blood cells","the procedure"],"problem_indices_start":[30],"problem_indices_end":[68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14,97],"treatment_indices_end":[27,132]}
{"text":"the specialist concluded that because the patient 's hematuria seemed to be stable and hematocrit to maintain at about 29-30 , there is no urgent need to do an arteriogram which may cause further damage to the patient 's kidney .","problem":["the patient 's hematuria","further damage to the patient 's kidney"],"test":["an arteriogram","hematocrit"],"treatment":[],"problem_indices_start":[38,193],"problem_indices_end":[67,237],"test_indices_start":[92,162],"test_indices_end":[102,176],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this 88-year-old male with history of prostate ca was admitted from an outside hospital secondary to persistent hematuria status post nephrostomy tube placement transferred to retelk county medical center for further management .","problem":["persistent hematuria","prostate ca"],"test":[],"treatment":["nephrostomy tube placement","further management"],"problem_indices_start":[38,101],"problem_indices_end":[49,121],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[134,209],"treatment_indices_end":[160,227]}
{"text":"the patient 's primary care physician , dr. tomedankell flowayles will manage the hospice issues .","problem":[],"test":[],"treatment":["the hospice"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[83],"treatment_indices_end":[94]}
{"text":"examination was limited because the patient speaks only portuguese .","problem":[],"test":["examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest examination showed some basilar crackles at the right lung base .","problem":["some basilar crackles at the right lung base"],"test":["chest examination"],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[69],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"clonidine 2.5 milligrams topical q. week , nitropaste 2 inches q.4h. , nilandron 50 milligrams p.o. q.d. , lupron , dulcolax p.r.n. , colace 100 milligrams p.o. b.i.d. , ferrous sulfate 300 milligrams p.o. b.i.d. , lansopiacole 15 milligrams p.o. q.d. , bethanechol 25 milligrams p.o. t.i.d.","problem":[],"test":[],"treatment":["bethanechol","colace","nitropaste","clonidine","dulcolax","lupron","ferrous sulfate","lansopiacole","nilandron"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,43,71,107,116,134,170,215,254],"treatment_indices_end":[9,53,80,113,124,140,185,227,265]}
{"text":"no palpitations , history of epigastric pain and body weight loss .","problem":["epigastric pain","body weight loss","palpitations"],"test":[],"treatment":[],"problem_indices_start":[3,29,49],"problem_indices_end":[15,44,65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"liver function test showed ast 21 , alkaline phosphatase 70 , total bilirubin 0.3 , total protein 6.5 , albumin 3.9 , globulin 2.6 .","problem":[],"test":["liver function test","globulin","alkaline phosphatase","ast","total protein","total bilirubin","albumin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,27,36,62,84,104,118],"test_indices_end":[19,30,56,77,97,111,126],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was discharged to home for hospice on march 8 , 1999 .","problem":[],"test":[],"treatment":["hospice"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39],"treatment_indices_end":[46]}
{"text":"no headache .","problem":["headache"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. metastatic prostate ca .","problem":["metastatic prostate ca"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt 11.9 , inr 1.0 , ptt 28.4 .","problem":[],"test":["inr","ptt","pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,20],"test_indices_end":[2,13,23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urology consultation thinks that cystoscopy would not add any benefit to the management and only would consider a right nephrostomy if renal function failed to improve .","problem":["renal function"],"test":["urology consultation"],"treatment":["a right nephrostomy","cystoscopy"],"problem_indices_start":[135],"problem_indices_end":[149],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[33,112],"treatment_indices_end":[43,131]}
{"text":"because of the increasing creatinine to 8.0 on february 28 , 1999 , a left nephrostomy tube was placed .","problem":["the increasing creatinine"],"test":[],"treatment":["a left nephrostomy tube"],"problem_indices_start":[11],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[68],"treatment_indices_end":[91]}
{"text":"chest x-ray showed no evidence of cardiomegaly .","problem":["cardiomegaly"],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[46],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was also given sodium bicarbonate to correct his metabolic acidosis .","problem":["his metabolic acidosis"],"test":[],"treatment":["sodium bicarbonate"],"problem_indices_start":[57],"problem_indices_end":[79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[45]}
{"text":"bethanechol 25 milligrams p.o. t.i.d. , clonidine 2.5 milligrams topical q. week , apply every sunday , colace 100 milligrams p.o. b.i.d. , haldol 0.5-1 milligrams p.o. q.6-8h. p.r.n. agitation , niferex 150 milligrams p.o. b.i.d. , nitroglycerin paste 2% , 2 inches topical q.8h. , prilosec 20 milligrams p.o. q.d. , senna tablets 2 tablets b.i.d. , sodium bicarbonate 650 milligrams p.o. t.i.d. for five days , proscar 5 milligrams p.o. q.d. , casodex 50 milligrams p.o. q.d. , nephrocaps 1 tablets p.o. q.d.","problem":["agitation"],"test":[],"treatment":["bethanechol","clonidine","senna tablets","nephrocaps","nitroglycerin paste","prilosec","sodium bicarbonate","niferex","proscar","haldol","colace","casodex"],"problem_indices_start":[184],"problem_indices_end":[193],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,40,104,140,196,233,283,318,351,413,446,480],"treatment_indices_end":[11,49,110,146,203,252,291,331,369,420,453,490]}
{"text":"he received transurethral resection of the prostate one year ago because of persistent urinary retention .","problem":["persistent urinary retention"],"test":[],"treatment":["transurethral resection of the prostate"],"problem_indices_start":[76],"problem_indices_end":[104],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[51]}
{"text":"no bone pain .","problem":["bone pain"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mucous membranes slightly dry .","problem":["mucous membranes slightly dry"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a long discussion amongst the specialist , nephrology , urology , interventional radiology , primary oncology as well with the family lead to the conclusion that conservative management may give the patient more comfort than crisis treatment in this well advanced prostate ca .","problem":["this well advanced prostate ca"],"test":[],"treatment":["crisis treatment","conservative management"],"problem_indices_start":[245],"problem_indices_end":[275],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[162,225],"treatment_indices_end":[185,241]}
{"text":"acute renal failure .","problem":["acute renal failure"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"homan 's sign negative .","problem":[],"test":["homan 's sign"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no thyromegaly .","problem":["thyromegaly"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. anemia .","problem":["anemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"home with hospice .","problem":[],"test":[],"treatment":["hospice"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10],"treatment_indices_end":[17]}
{"text":"after admission , the patient was treated conservatively to correct his electrolyte and metabolic acidosis .","problem":["his electrolyte and metabolic acidosis"],"test":[],"treatment":[],"problem_indices_start":[68],"problem_indices_end":[106],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cpk was tracked , but was totally normal .","problem":[],"test":["cpk"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after transfusion , the patient 's hematocrit rose to 37.7 on the day of discharge .","problem":[],"test":["the patient 's hematocrit"],"treatment":["transfusion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[50],"treatment_indices_start":[6],"treatment_indices_end":[17]}
{"text":"he continued to pass about 1500-2000 cc of urine a day and his renal function improved slowly with creatinine decreased to 4.2 on the day of discharge .","problem":[],"test":["creatinine","his renal function"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[59,99],"test_indices_end":[77,109],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his hematocrit increased to about 30 , but he continued to have hematuria and his renal function only improved very slowly .","problem":["hematuria"],"test":["his hematocrit","his renal function"],"treatment":[],"problem_indices_start":[64],"problem_indices_end":[73],"test_indices_start":[0,78],"test_indices_end":[14,96],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on admission the patient 's biochemistry showed sodium of 140 , potassium 4.0 , chloride 107 , bicarb 14 , bun 63 , creatinine 5.8 , blood sugar 133 .","problem":[],"test":["creatinine","bicarb","bun","blood sugar","potassium","sodium","chloride"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[53,69,85,100,112,121,138],"test_indices_end":[59,78,93,106,115,131,149],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4) prostate ca .","problem":["prostate ca"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"prostate cancer and renal failure","problem":["renal failure","prostate cancer"],"test":[],"treatment":[],"problem_indices_start":[0,20],"problem_indices_end":[15,33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"prostate specific antigen increased from 77.9 to 88 , and the patient also had urinary incontinence and body weight loss .","problem":["body weight loss","urinary incontinence"],"test":["prostate specific antigen"],"treatment":[],"problem_indices_start":[79,104],"problem_indices_end":[99,120],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"temperature 95.4 , pulse 120 , blood pressure 150\/80 , respiratory rate 24 , 95% on room air .","problem":[],"test":["respiratory rate","temperature","blood pressure","pulse"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,19,31,55],"test_indices_end":[11,24,45,71],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"wbc 8.4 , hematocrit 32.6 , platelet count 194,000 .","problem":[],"test":["hematocrit","platelet count","wbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,28],"test_indices_end":[3,20,42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. obstructive uropathy , status post left nephrostomy .","problem":["status post left nephrostomy","obstructive uropathy"],"test":[],"treatment":[],"problem_indices_start":[3,26],"problem_indices_end":[23,54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a mass like thickening of the urinary bladder suggestive of either detrusor hypertrophy or possibly tumor .","problem":["a mass like thickening of the urinary bladder","tumor","detrusor hypertrophy"],"test":[],"treatment":[],"problem_indices_start":[0,67,100],"problem_indices_end":[45,87,105],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he also received kayexalate for hyperkalemia .","problem":["hyperkalemia"],"test":[],"treatment":["kayexalate"],"problem_indices_start":[32],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17],"treatment_indices_end":[27]}
{"text":"during this admission , the patient also developed atrial fibrillation with ventricular rate of about 70-80 .","problem":["atrial fibrillation"],"test":["ventricular rate"],"treatment":[],"problem_indices_start":[51],"problem_indices_end":[70],"test_indices_start":[76],"test_indices_end":[92],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bun was 34 and creatinine was 2.6 , up from his baseline of 1.0 .","problem":[],"test":["creatinine","bun"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,15],"test_indices_end":[3,25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had constipation with dysuria , but no fever or chills .","problem":["fever","constipation","dysuria","chills"],"test":[],"treatment":[],"problem_indices_start":[16,34,51,60],"problem_indices_end":[28,41,56,66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mr. prehekote is an 88-year-old portuguese speaking only male who was diagnosed with adenocarcinoma of the prostate in 1998 .","problem":["adenocarcinoma of the prostate"],"test":[],"treatment":[],"problem_indices_start":[85],"problem_indices_end":[115],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"history of present illness :","problem":["present illness"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the ct scan showed a cavitary lung lesion in the right lower lobe compatible with metastatic or septic embolus .","problem":["a cavitary lung lesion in the right lower lobe","septic embolus"],"test":["the ct scan"],"treatment":[],"problem_indices_start":[19,96],"problem_indices_end":[65,110],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was given blood transfusion , two units when his hematocrit dropped to 29.4 .","problem":[],"test":["his hematocrit"],"treatment":["blood transfusion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[48],"test_indices_end":[62],"treatment_indices_start":[13],"treatment_indices_end":[30]}
{"text":"5. gastroesophageal reflux disease .","problem":["gastroesophageal reflux disease"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on admission , the patient was a frail looking elderly male lying in bed in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[79],"problem_indices_end":[93],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"allergies :","problem":["allergies"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3) anemia .","problem":["anemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"due to the persistent blood in the urine , he was transferred from eifro medical center to the retelk county medical center for angiographic studies to rule out any vascular injuries .","problem":["the persistent blood in the urine","vascular injuries"],"test":["angiographic studies"],"treatment":[],"problem_indices_start":[7,165],"problem_indices_end":[40,182],"test_indices_start":[128],"test_indices_end":[148],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no beta blockers were given .","problem":[],"test":[],"treatment":["beta blockers"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"no lung infiltrate .","problem":["lung infiltrate"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ck enzymes 146 .","problem":[],"test":["ck enzymes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dr. lucreamull discussed the patient 's clinical status and overall situation with the patient 's family and the family decided that mr. prehekote could return home with hospice .","problem":[],"test":[],"treatment":["hospice"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[180],"treatment_indices_end":[187]}
{"text":"traced pitting edema .","problem":["traced pitting edema"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no chest pain .","problem":["chest pain"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2) gastroesophageal reflux disease .","problem":["gastroesophageal reflux disease"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no cyanosis and no clubbing .","problem":["cyanosis","clubbing"],"test":[],"treatment":[],"problem_indices_start":[3,19],"problem_indices_end":[11,27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"significant problems :","problem":["significant problems"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no cough .","problem":["cough"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"isocoric cataract bilaterally .","problem":["isocoric cataract bilaterally"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no oral ulcers .","problem":["oral ulcers"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1) hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after that , he was on lupron and nilandron hormone therapy .","problem":[],"test":[],"treatment":["lupron","nilandron hormone therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23,34],"treatment_indices_end":[29,59]}
{"text":"the patient was admitted on february 23 , 1999 to eifro medical center because of failure to thrive and decreased hematocrit .","problem":["failure to thrive","decreased hematocrit"],"test":[],"treatment":[],"problem_indices_start":[82,104],"problem_indices_end":[99,124],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"troponin i on the second day of admission was 1.18 .","problem":[],"test":["troponin i"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"peripheral pulses were very strong and bounding .","problem":[],"test":["peripheral pulses"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient presented with a chief complaint of af-resolved .","problem":["af-resolved"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following evaluation and treatment , the patient 's disposition at the end of the visit was treated and released .","problem":[],"test":["evaluation"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[20],"treatment_indices_start":[25],"treatment_indices_end":[34]}
{"text":"due to difficult ambulation , the patient developed a small ulcer in the sacral area , which was treated with duoderm dressing .","problem":["difficult ambulation","a small ulcer in the sacral area"],"test":[],"treatment":["duoderm dressing"],"problem_indices_start":[7,52],"problem_indices_end":[27,84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[110],"treatment_indices_end":[126]}
{"text":"further cultures from sputum and urine revealed yeast sensitive to diflucan , which was administered shortly after .","problem":["yeast"],"test":["further cultures from sputum and urine"],"treatment":["diflucan"],"problem_indices_start":[48],"problem_indices_end":[53],"test_indices_start":[0],"test_indices_end":[38],"treatment_indices_start":[67],"treatment_indices_end":[75]}
{"text":"note , please draw blood for vancomycin levels on 25 may 1998 , before the next dose , to get the trough level .","problem":[],"test":["vancomycin levels","the trough level"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[29,94],"test_indices_end":[46,110],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"elavil by mouth 15 mg every night , dulcolax rectally 10 mg once a day , tegretol by mouth 100 mg twice a day , benadryl by mouth 25 mg three times a day , colace by mouth 200 mg twice a day , vasotec by mouth 10 mg twice a day , eoc \/ loc p.r.\/p.o. one each once a day as needed for constipation , lasix by mouth 80 mg every morning , insulin regular according to insulin scale , synthroid by mouth 25 mcg once a day , maalox plus extra strength by mouth 15 ml every six hours as needed for indigestion , milk of magnesia by mouth 30 ml once a day as needed for constipation , asacol by mouth 400 mg every morning , asacol 800 mg every night , lopressor by mouth 25 mg twice a day , miracle cream topically on skin once a day , nystatin swish and swallow by mouth 5 ml four times a day , percocet by mouth one tab every four hours as needed for pain , and vancomycin by infusion 1 gm every 18 hours ; instructions in 250 ml slow iv infusion over one hour .","problem":["indigestion","constipation","pain","constipation"],"test":[],"treatment":["maalox plus extra strength","tegretol","benadryl","lasix","slow iv infusion","colace","asacol","miracle cream","eoc \/ loc","nystatin swish and swallow","asacol","vancomycin","vasotec","insulin","magnesia","synthroid","lopressor","percocet","elavil","dulcolax"],"problem_indices_start":[284,492,563,846],"problem_indices_end":[296,503,575,850],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,36,73,112,156,193,230,299,336,381,420,514,578,617,645,684,729,789,857,925],"treatment_indices_end":[6,44,81,120,162,200,239,304,343,390,446,522,584,623,654,697,755,797,867,941]}
{"text":"vancomycin levels should be checked every third day for four to six weeks , according to imd .","problem":[],"test":["vancomycin levels"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"insulin-dependent diabetes mellitus , lymphoma as above , ulcerative colitis , melanoma status post excision in right upper extremity , hypertension , hypothyroidism , congestive heart failure , and coronary artery disease with bypass grafting .","problem":["coronary artery disease","melanoma","hypertension","lymphoma","hypothyroidism","congestive heart failure","ulcerative colitis","insulin-dependent diabetes mellitus"],"test":[],"treatment":["bypass grafting","excision in right upper extremity"],"problem_indices_start":[0,38,58,79,136,151,168,199],"problem_indices_end":[35,46,76,87,148,165,192,222],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[100,228],"treatment_indices_end":[133,243]}
{"text":"status post cholecystectomy , lumbar diskectomy , and tonsillectomy with adenoidectomy .","problem":[],"test":[],"treatment":["lumbar diskectomy","cholecystectomy","tonsillectomy","adenoidectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12,30,54,73],"treatment_indices_end":[27,47,67,86]}
{"text":"of note , the patient is status post lymphoma with treatment of chemotherapy and radiation six years ago , and is an insulin-dependent diabetic .","problem":["status post lymphoma","an insulin-dependent diabetic"],"test":[],"treatment":["chemotherapy","radiation"],"problem_indices_start":[25,114],"problem_indices_end":[45,143],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[64,81],"treatment_indices_end":[76,90]}
{"text":"due to the persistent fevers , the patient underwent vancomycin desensitization in the surgical intensive care unit followed by a change of antibiotics to vancomycin and levofloxacin .","problem":["the persistent fevers"],"test":[],"treatment":["a change of antibiotics","vancomycin","levofloxacin","vancomycin desensitization"],"problem_indices_start":[7],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[53,128,155,170],"treatment_indices_end":[79,151,165,182]}
{"text":"she is now coming for surgical treatment , wound debridement , and possible wound closure with bilateral pectoralis flap .","problem":[],"test":[],"treatment":["wound closure with bilateral pectoralis flap","surgical treatment","wound debridement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,43,76],"treatment_indices_end":[40,60,120]}
{"text":"she underwent coronary artery bypass graft times two with saphenous vein graft on 29 march 1998 .","problem":[],"test":[],"treatment":["coronary artery bypass graft","saphenous vein graft"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14,58],"treatment_indices_end":[42,78]}
{"text":"because of expected long term antibiotic administration , a picc line was placed and the patient was prepared for transfer back to fo hospital .","problem":[],"test":[],"treatment":["a picc line","expected long term antibiotic administration"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[11,58],"treatment_indices_end":[55,69]}
{"text":"the patient was admitted with a blood pressure of 140\/80 , temperature 101.3 , pulse 84 , and respiratory rate 22 .","problem":[],"test":["respiratory rate","blood pressure","temperature","pulse"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[32,59,79,94],"test_indices_end":[46,70,84,110],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"elavil 50 mg p.o. q.h.s. , coated aspirin 325 mg p.o. p.day , tegretol 100 mg p.o. b.i.d. , ancef 1 gm iv q.12h. times seven days , vasotec 5 mg p.o. q.day , synthroid 0.025 mg p.o. q.day , asacol 400 mg q.a.m. and 800 mg q.p.m. , lopressor 25 mg p.o. b.i.d. , prilosec 20 mg p.o. q.day , and insulin 70\/30 26 units in the morning and 12 units at night .","problem":[],"test":[],"treatment":["synthroid","prilosec","coated aspirin","vasotec","ancef","lopressor","asacol","elavil","tegretol","insulin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,27,62,92,132,158,190,231,261,293],"treatment_indices_end":[6,41,70,97,139,167,196,240,269,300]}
{"text":"nizatidine by mouth 150 mg twice a day , insulin 70\/30 human injection under skin 12 units every night , insulin 70\/30 human injection subcutaneous 26 units every morning , lovenox injection under skin 40 mg once a day , and levofloxacin by mouth 250 mg once a day .","problem":[],"test":[],"treatment":["levofloxacin","nizatidine","lovenox","insulin","insulin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,41,105,173,225],"treatment_indices_end":[10,48,112,180,237]}
{"text":"she is status post left knee replacement and status post multiple prior surgeries and reconstruction of the knee .","problem":[],"test":[],"treatment":["reconstruction of the knee","multiple prior surgeries","left knee replacement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,57,86],"treatment_indices_end":[40,81,112]}
{"text":"the patient was switched to ampicillin , gentamicin , and clindamycin , according to the culture , enterococci and staphylococcus in the wound .","problem":["enterococci","the wound","staphylococcus"],"test":["the culture"],"treatment":["ampicillin","gentamicin","clindamycin"],"problem_indices_start":[99,115,133],"problem_indices_end":[110,129,142],"test_indices_start":[85],"test_indices_end":[96],"treatment_indices_start":[28,41,58],"treatment_indices_end":[38,51,69]}
{"text":"the patient is obese with unremarkable physical examination except for a systolic murmur , i \/ vi and erythema over the sternal wound and upper third .","problem":["obese","i \/ vi and erythema over the sternal wound","a systolic murmur"],"test":[],"treatment":[],"problem_indices_start":[15,71,91],"problem_indices_end":[20,88,133],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no purulence or discharge noted .","problem":["purulence","discharge"],"test":[],"treatment":[],"problem_indices_start":[13,26],"problem_indices_end":[22,35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 10 may 1998 , she underwent sternal wound debridement and closure , performed by dr. falccouette and dr. shuffzeln .","problem":[],"test":[],"treatment":["sternal wound debridement and closure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31],"treatment_indices_end":[68]}
{"text":"as a small complication , the patient opened a left ankle wound post saphenous vein harvest , which persists up until now and is of a size 2 x 1 cm .","problem":["a small complication","a left ankle wound"],"test":[],"treatment":["saphenous vein harvest"],"problem_indices_start":[3,45],"problem_indices_end":[23,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[69],"treatment_indices_end":[91]}
{"text":"keep vancomycin trough between 10-20 , but not less due to desensitization .","problem":["desensitization"],"test":["vancomycin trough"],"treatment":[],"problem_indices_start":[59],"problem_indices_end":[74],"test_indices_start":[5],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sternal wound infection .","problem":["sternal wound infection"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"erythromycin , vancomycin , and bacitracin .","problem":[],"test":[],"treatment":["vancomycin","erythromycin","bacitracin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,15,32],"treatment_indices_end":[12,25,42]}
{"text":"the patient was placed on iv antibiotics , ancef 1 gm q.8h.","problem":[],"test":[],"treatment":["ancef","iv antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,43],"treatment_indices_end":[40,48]}
{"text":"the patient is a 74-year-old woman , well known to the cardiac surgery service , readmitted from glasmif\/putdi health network with sternal wound infection .","problem":["sternal wound infection"],"test":[],"treatment":[],"problem_indices_start":[131],"problem_indices_end":[154],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has been previously hospitalized on 12 april 1998 for the same diagnosis .","problem":["the same diagnosis"],"test":[],"treatment":[],"problem_indices_start":[58],"problem_indices_end":[76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the wound had a beefy red cellulitic area surrounding an open area , blanching to touch .","problem":["a beefy red cellulitic area","the wound"],"test":[],"treatment":[],"problem_indices_start":[0,14],"problem_indices_end":[9,41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"external wound infections","problem":["external wound infections"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on postoperative day two the patient was noted to have some swelling in her left lower extremity and this was felt to be a hematoma secondary to her pvr cuff .","problem":["a hematoma","some swelling in her left lower extremity"],"test":["her pvr cuff"],"treatment":[],"problem_indices_start":[55,121],"problem_indices_end":[96,131],"test_indices_start":[145],"test_indices_end":[157],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"small posterior tibial occlusion on the distal calf and a small peroneal goes down to the ankle .","problem":["small posterior tibial occlusion on the distal calf","a small peroneal"],"test":[],"treatment":[],"problem_indices_start":[0,56],"problem_indices_end":[51,72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"significant for guillain-barr syndrome , lupus , status post multiple decubiti , peripheral vascular disease , status post right total knee replacement and status post cholecystectomy , status post hysterectomy , status post goiter and left lung fibrosis , status post methicillin resistant staphylococcus aureus pneumonia .","problem":["goiter","lupus","multiple decubiti","peripheral vascular disease","methicillin resistant staphylococcus aureus pneumonia","guillain-barr syndrome","left lung fibrosis"],"test":[],"treatment":["hysterectomy","cholecystectomy","right total knee replacement"],"problem_indices_start":[16,41,61,81,225,236,269],"problem_indices_end":[38,46,78,108,231,254,322],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[123,168,198],"treatment_indices_end":[151,183,210]}
{"text":"trental 400 milligrams t.i.d. , cytotec 100 milligrams t.i.d. , ativan 2 milligrams q.h.s. darvon 65 milligrams two q.i.d , relafen 500 milligrams b.i.d , vitamin e , prilosec 20 milligrams once a day , zantac 150 milligrams b.i.d , lasix 120 milligrams every other day prn edema .","problem":["edema"],"test":[],"treatment":["cytotec","prilosec","ativan","lasix","darvon","vitamin e","trental","relafen","zantac"],"problem_indices_start":[274],"problem_indices_end":[279],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,32,64,91,124,155,167,203,233],"treatment_indices_end":[7,39,70,97,131,164,175,209,238]}
{"text":"the patient is allergic ampicillin , tylenol , clinoril , biaxin , codeine , sulfa and aminophylline .","problem":["allergic"],"test":[],"treatment":["ampicillin","aminophylline","biaxin","codeine","clinoril","tylenol","sulfa"],"problem_indices_start":[15],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24,37,47,58,67,77,87],"treatment_indices_end":[34,44,55,64,74,82,100]}
{"text":"her hematocrit was 26.8 and she was transfused 1 unit of packed red blood cells .","problem":[],"test":["her hematocrit"],"treatment":["packed red blood cells"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[57],"treatment_indices_end":[79]}
{"text":"her pain resolved after surgery and she has been doing well since , although at baseline now she is minimally ambulatory from bed to commode .","problem":["her pain","minimally ambulatory"],"test":[],"treatment":["surgery"],"problem_indices_start":[0,100],"problem_indices_end":[8,120],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[31]}
{"text":"abdomen , soft , non-tender , non-distended , normal active bowel sounds .","problem":["non-tender","non-distended"],"test":[],"treatment":[],"problem_indices_start":[17,30],"problem_indices_end":[27,43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was discharged with po keflex that she was to take for the next ten days .","problem":[],"test":[],"treatment":["po keflex"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[33]}
{"text":"the ulcer was managed conservatively at har hospital by dr. holes with silvadene b.i.d. lower extremity non-invasive study obtained at that time showed poor distal right extremity perfusion .","problem":["poor distal right extremity perfusion","the ulcer"],"test":["lower extremity non-invasive study"],"treatment":["silvadene"],"problem_indices_start":[0,152],"problem_indices_end":[9,189],"test_indices_start":[88],"test_indices_end":[122],"treatment_indices_start":[71],"treatment_indices_end":[80]}
{"text":"her angiography showed a right proximal popliteal occlusion , anterior tibial dominant foot vessel .","problem":["a right proximal popliteal occlusion","anterior tibial dominant foot vessel"],"test":["her angiography"],"treatment":[],"problem_indices_start":[23,62],"problem_indices_end":[59,98],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"non-healing ulcer on the right leg .","problem":["non-healing ulcer on the right leg"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is mild amount of surrounding erythema and the patient was started on ancef at that time .","problem":["surrounding erythema"],"test":[],"treatment":["ancef"],"problem_indices_start":[24],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[76],"treatment_indices_end":[81]}
{"text":"this patient is an seventy eight year old female with history of peripheral vascular disease who is status post above knee to fem pop bypass graft with 6 millimeter ptfe .","problem":["peripheral vascular disease"],"test":[],"treatment":["6 millimeter ptfe","above knee to fem pop bypass graft"],"problem_indices_start":[65],"problem_indices_end":[92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[112,152],"treatment_indices_end":[146,169]}
{"text":"for the past couple of months the patient has had a non-healing right dorsal foot ulcer which has been increasing in size and started as a pin hole and she does not recollect any trauma , as similar small ulcers developed on the left foot as well around the same time , but that has subsequently healed .","problem":["any trauma","a non-healing right dorsal foot ulcer","a pin hole","similar small ulcers"],"test":[],"treatment":[],"problem_indices_start":[50,137,175,191],"problem_indices_end":[87,147,185,211],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was afebrile , her vital signs were stable .","problem":[],"test":["her vital signs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extremities on the right , she has a ii+ femoral , no distal pulses beyond that .","problem":["distal pulses"],"test":[],"treatment":[],"problem_indices_start":[54],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has just finished a ten day course of ciprofloxacin .","problem":[],"test":[],"treatment":["ciprofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[42],"treatment_indices_end":[55]}
{"text":"the area of erythema on her left leg enlarged slightly and the patient was placed on vancomycin for several days after which time her erythema again began to decrease .","problem":["erythema on her left leg","her erythema"],"test":[],"treatment":["vancomycin"],"problem_indices_start":[12,130],"problem_indices_end":[36,142],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[85],"treatment_indices_end":[95]}
{"text":"she is status post angiography today .","problem":[],"test":["angiography"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she is afebrile , her vital signs are stable .","problem":[],"test":["her vital signs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[18],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she does have rest pain in the right foot and ankle .","problem":["rest pain in the right foot and ankle"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on a rectal examination she is guaiac negative , no masses and no gluteal ulcers or decubiti .","problem":["masses","decubiti","gluteal ulcers"],"test":["a rectal examination"],"treatment":[],"problem_indices_start":[52,66,84],"problem_indices_end":[58,80,92],"test_indices_start":[3],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has on her right ankle anteriorly a four centimeter ulcer with necrotic base .","problem":["a four centimeter ulcer with necrotic base"],"test":[],"treatment":[],"problem_indices_start":[38],"problem_indices_end":[80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was referred back to dr. pop for the possibility of a revascularization procedure .","problem":[],"test":[],"treatment":["a revascularization procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[64],"treatment_indices_end":[93]}
{"text":"this operation was performed for two months of increased rest pain .","problem":["increased rest pain"],"test":[],"treatment":["this operation"],"problem_indices_start":[47],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[14]}
{"text":"lungs decreased breath sounds at bilateral bases with minimal expiratory crackles on the right .","problem":["decreased breath sounds at bilateral bases","minimal expiratory crackles on the right"],"test":[],"treatment":[],"problem_indices_start":[6,54],"problem_indices_end":[48,94],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"proventil inhaler via nebulizers 0.5 milligrams with atrovent .","problem":[],"test":[],"treatment":["proventil inhaler via nebulizers","atrovent"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,53],"treatment_indices_end":[32,61]}
{"text":"she denies any fevers or chills .","problem":["chills","fevers"],"test":[],"treatment":[],"problem_indices_start":[15,25],"problem_indices_end":[21,31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had wounds which were clean , dry and intact and the patient was stable from a respiratory standpoint using her respirator at night .","problem":["wounds"],"test":[],"treatment":["her respirator"],"problem_indices_start":[8],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[112],"treatment_indices_end":[126]}
{"text":"neck , she has ii+ bilateral carotids , no bruits , no jugular venous distention .","problem":["jugular venous distention","bruits"],"test":[],"treatment":[],"problem_indices_start":[43,55],"problem_indices_end":[49,80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on the left she has a ii+ femoral and ii+ popliteal , no distal pulses beyond that .","problem":["distal pulses"],"test":[],"treatment":[],"problem_indices_start":[57],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient required an additional blood transfusion during her hospital stay as her hematocrit had decreased to 27 on postoperative day three .","problem":[],"test":["her hematocrit"],"treatment":["an additional blood transfusion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[81],"test_indices_end":[95],"treatment_indices_start":[21],"treatment_indices_end":[52]}
{"text":"prednisone 5 every other day , alternating with ten every other day .","problem":[],"test":[],"treatment":["prednisone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"the patient was admitted and taken to the operating room on the following day and she underwent a right fem to below knee popliteal bypass graft using a six millimeter ring ptfe .","problem":[],"test":[],"treatment":["a right fem to below knee popliteal bypass graft","a six millimeter ring ptfe"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[96,151],"treatment_indices_end":[144,177]}
{"text":"right fem to below knee pop bypass graft .","problem":[],"test":[],"treatment":["right fem to below knee pop bypass graft"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[40]}
{"text":"didronel 1 q day which has been on hold .","problem":[],"test":[],"treatment":["didronel"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"minimal surrounding erythema .","problem":["minimal surrounding erythema"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient presented with a chief complaint of sob .","problem":["sob"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following triage , the patient left without being seen .","problem":[],"test":["triage"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ms. lenkpruskihkooglekih is a 63-year-old lady with a history of frequent premature ventricular contractions and infrequent short runs of non-sustained ventricular tachycardia ( one four-beat run ) in 1991 , for which several antiarrhythmic agents including propranolol , quinidine , procainamide , tenormin , norpace , corgard , and flecainide were used , but were stopped because of intolerance .","problem":["intolerance","infrequent short runs of non-sustained ventricular tachycardia","frequent premature ventricular contractions"],"test":[],"treatment":["corgard","tenormin","norpace","quinidine","propranolol","flecainide","procainamide"],"problem_indices_start":[65,113,385],"problem_indices_end":[108,175,396],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[258,272,284,299,310,320,334],"treatment_indices_end":[269,281,296,307,317,327,344]}
{"text":"there was no evidence of left ventricular hypertrophy or asymmetric septal hypertrophy , which had been an issue that had been raised on an echocardiogram in ownra cin , new mexico on 12\/06\/96 .","problem":["asymmetric septal hypertrophy","left ventricular hypertrophy"],"test":["an echocardiogram"],"treatment":[],"problem_indices_start":[25,57],"problem_indices_end":[53,86],"test_indices_start":[137],"test_indices_end":[154],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at that time , she had clear coronary arteries on coronary angiography and an ejection fraction greater than 50% .","problem":[],"test":["an ejection fraction","coronary angiography"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[50,75],"test_indices_end":[70,95],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has been on coumadin since and has continued to have occasional palpitations and mild shortness of breath .","problem":["mild shortness of breath","occasional palpitations"],"test":[],"treatment":["coumadin"],"problem_indices_start":[57,85],"problem_indices_end":[80,109],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[24]}
{"text":"includes a history of hypertension ; multinodular goiter ; subtotal thyroidectomy .","problem":["hypertension","multinodular goiter"],"test":[],"treatment":["subtotal thyroidectomy"],"problem_indices_start":[22,37],"problem_indices_end":[34,56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[59],"treatment_indices_end":[81]}
{"text":"she did well off antiarrhythmic agents until october of this year when she was noted to have atrial fibrillation with a rapid ventricular rate after several days of decreased exercise tolerance .","problem":["atrial fibrillation","decreased exercise tolerance","a rapid ventricular rate"],"test":[],"treatment":["antiarrhythmic agents"],"problem_indices_start":[93,118,165],"problem_indices_end":[112,142,193],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17],"treatment_indices_end":[38]}
{"text":"the patient was discharged to home on amiodarone 200 mg daily on 12\/29\/96 .","problem":[],"test":[],"treatment":["amiodarone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[48]}
{"text":"a 12-lead electrocardiogram showed atrial fibrillation with a qt interval of .46 seconds .","problem":["atrial fibrillation"],"test":["a 12-lead electrocardiogram"],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[54],"test_indices_start":[0],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"history of multinodular goiter ; history of hypertension ; history of subtotal thyroidectomy .","problem":["multinodular goiter","hypertension"],"test":[],"treatment":["subtotal thyroidectomy"],"problem_indices_start":[11,44],"problem_indices_end":[30,56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[70],"treatment_indices_end":[92]}
{"text":"the patient was started on propafenone 300 mg three times a day and underwent an attempt at electrical cardioversion after seven doses of this .","problem":[],"test":[],"treatment":["propafenone","electrical cardioversion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,92],"treatment_indices_end":[38,116]}
{"text":"an electrocardiogram showed no evidence of qt prolongation prior to discharge , and pulmonary function tests will be performed before the patient goes home today .","problem":["qt prolongation"],"test":["pulmonary function tests","an electrocardiogram"],"treatment":[],"problem_indices_start":[43],"problem_indices_end":[58],"test_indices_start":[0,84],"test_indices_end":[20,108],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a complete blood count , electrolytes , bun and creatinine were within normal limits .","problem":[],"test":["electrolytes","creatinine","a complete blood count","bun"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,25,40,48],"test_indices_end":[22,37,43,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the propafenone was stopped , and the patient was changed to amiodarone 400 mg t.i.d. , which was continued for two days .","problem":[],"test":[],"treatment":["amiodarone","propafenone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4,61],"treatment_indices_end":[15,71]}
{"text":"include cardizem cd 180 mg daily ; monopril 10 mg daily ; digoxin .25 mg daily ; and lasix 40 mg every other day .","problem":[],"test":[],"treatment":["lasix","cardizem cd","monopril","digoxin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[8,35,58,85],"treatment_indices_end":[19,43,65,90]}
{"text":"to quinidine , procardia , and sulfa antibiotics .","problem":[],"test":[],"treatment":["procardia","quinidine","sulfa antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,15,31],"treatment_indices_end":[12,24,48]}
{"text":"there were diffuse st segment and t-wave abnormalities , which were nonspecific .","problem":["diffuse st segment and t-wave abnormalities"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"atrial fibrillation .","problem":["atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition , she will return to this hospital in early february for repeat attempt at electrical cardioversion on amiodarone .","problem":[],"test":[],"treatment":["amiodarone","electrical cardioversion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[87,115],"treatment_indices_end":[111,125]}
{"text":"on examination , blood pressure was 200\/100 ; heart rate 120 per minute ( atrial fibrillation ) .","problem":["atrial fibrillation"],"test":["blood pressure","examination","heart rate"],"treatment":[],"problem_indices_start":[74],"problem_indices_end":[93],"test_indices_start":[3,17,46],"test_indices_end":[14,31,56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no peripheral edema .","problem":["peripheral edema"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she will continue her coumadin until then and arrangements for her readmission can be made through dr. iceca rhaltkaaispehbreun 's office here .","problem":[],"test":[],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[30]}
{"text":"an echocardiogram was performed , which showed completely normal left ventricular systolic function with an ejection fraction calculated at .74 .","problem":[],"test":["an echocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"inr was elevated at 2.5 .","problem":[],"test":["inr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"electrical cardioversion .","problem":[],"test":[],"treatment":["electrical cardioversion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"other than the addition of amiodarone 200 mg daily , will be the same as her admission medications .","problem":[],"test":[],"treatment":["amiodarone","her admission medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,73],"treatment_indices_end":[37,98]}
{"text":"she was started on coumadin and had a failed attempt at dc electrical cardioversion on 11\/16\/96 .","problem":[],"test":[],"treatment":["coumadin","dc electrical cardioversion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,56],"treatment_indices_end":[27,83]}
{"text":"the abdominal examination was benign .","problem":[],"test":["the abdominal examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"atrial fibrillation .","problem":["atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was noted to be anxious .","problem":["anxious"],"test":[],"treatment":[],"problem_indices_start":[28],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no neck vein distension or carotid bruits .","problem":["carotid bruits","neck vein distension"],"test":[],"treatment":[],"problem_indices_start":[13,37],"problem_indices_end":[33,51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he received rx for potassium to help with cramps .","problem":["cramps"],"test":[],"treatment":["rx","potassium"],"problem_indices_start":[42],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12,19],"treatment_indices_end":[14,28]}
{"text":"pt 's labs were checked , he was seen by neurology , and he received a spine mri which was negative .","problem":[],"test":["a spine mri","pt 's labs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,74],"test_indices_end":[15,85],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"advised to contact pain service for repeat injections , f \/ u with neurology , explore pt , massage therapy .","problem":[],"test":[],"treatment":["massage therapy","repeat injections","pt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36,87,92],"treatment_indices_end":[53,89,107]}
{"text":"back pain\/ mechanical fall","problem":["mechanical fall","back pain\/"],"test":[],"treatment":[],"problem_indices_start":[0,11],"problem_indices_end":[10,26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"k-dur 20meq po qd","problem":[],"test":[],"treatment":["k-dur"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"the patient was given printed instructions for back pain ( english ) .","problem":["back pain"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"body shaking","problem":["body shaking"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. motrin 400 mg p.o. b.i.d. p.r.n. pain .","problem":["pain"],"test":[],"treatment":["motrin"],"problem_indices_start":[36],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"she is to be maintained on metoprolol for blood pressure control and the restarting of her ace inhibitor is to be decided by her primary care physician .","problem":[],"test":[],"treatment":["metoprolol","her ace inhibitor","blood pressure control"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,42,87],"treatment_indices_end":[37,64,104]}
{"text":"transverse colectomy for tumor .","problem":["tumor"],"test":[],"treatment":["transverse colectomy"],"problem_indices_start":[25],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[20]}
{"text":"1. tylenol 650 mg p.o. q.4.h. p.r.n. pain .","problem":["pain"],"test":[],"treatment":["tylenol"],"problem_indices_start":[37],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"when she was taking clear liquids , her pain medication was switched to p.o. pain regimen with good affect .","problem":[],"test":[],"treatment":["her pain medication","p.o. pain regimen","clear liquids"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20,36,72],"treatment_indices_end":[33,55,89]}
{"text":"4. halcion 0.25 mg p.o. at night .","problem":[],"test":[],"treatment":["halcion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"for blood pressure control she was maintained on metoprolol at the request of her primary care physician and enalapril was discontinued .","problem":[],"test":[],"treatment":["metoprolol","blood pressure control","enalapril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4,49,109],"treatment_indices_end":[26,59,118]}
{"text":"with the help of physical therapy the patient was ambulated and on postoperative seven , with the patient tolerating a post surgical soft diet and with pain well controlled on oral pain medications , she was discharged to rehabilitation facility .","problem":["pain"],"test":[],"treatment":["physical therapy","oral pain medications","a post surgical soft diet"],"problem_indices_start":[152],"problem_indices_end":[156],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17,117,176],"treatment_indices_end":[33,142,197]}
{"text":"abdomen is soft , nontender , and nondistended .","problem":["nontender","nondistended"],"test":[],"treatment":[],"problem_indices_start":[18,34],"problem_indices_end":[27,46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heart is regular without murmurs , rubs , or gallops .","problem":["rubs","gallops","murmurs"],"test":[],"treatment":[],"problem_indices_start":[25,35,45],"problem_indices_end":[32,39,52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"premarin vaginal once a month , enalapril , tylenol , vitamins , and halcion at night .","problem":[],"test":[],"treatment":["tylenol","premarin vaginal","halcion","vitamins","enalapril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,32,44,54,69],"treatment_indices_end":[16,41,51,62,76]}
{"text":"she has also had some discomfort in her left lower abdomen and notes diarrhea every 4-5 days .","problem":["diarrhea","some discomfort in her left lower abdomen"],"test":[],"treatment":[],"problem_indices_start":[17,69],"problem_indices_end":[58,77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. dulcolax 10 to 20 mg pr b.i.d. p.r.n. constipation .","problem":["constipation"],"test":[],"treatment":["dulcolax"],"problem_indices_start":[41],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"she is to also call the office if she has any fever greater than 101 , bleeding from the surgical wounds , or pus from the wounds .","problem":["bleeding from the surgical wounds","pus from the wounds","fever greater than 101"],"test":[],"treatment":[],"problem_indices_start":[46,71,110],"problem_indices_end":[68,104,129],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cholecystectomy in 1994 , colonoscopy 2004 , status post tonsillectomy , status post appendectomy , status post orif of left wrist , status post left ear surgery , nsvd x5 , and hypertension .","problem":["hypertension"],"test":[],"treatment":["appendectomy","left ear surgery","colonoscopy","nsvd","orif of left wrist","cholecystectomy","tonsillectomy"],"problem_indices_start":[178],"problem_indices_end":[190],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,26,57,85,112,145,164],"treatment_indices_end":[15,37,70,97,130,161,168]}
{"text":"her vital signs are stable .","problem":[],"test":["her vital signs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"history of diverticulitis , status post cholecystectomy , status post appendectomy , and hypertension .","problem":["diverticulitis","hypertension"],"test":[],"treatment":["cholecystectomy","appendectomy"],"problem_indices_start":[11,89],"problem_indices_end":[25,101],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40,70],"treatment_indices_end":[55,82]}
{"text":"she was maintained on an epidural and pca for pain control .","problem":["pain control"],"test":[],"treatment":["an epidural","pca"],"problem_indices_start":[46],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,38],"treatment_indices_end":[33,41]}
{"text":"she says that her appetite is good and has noted no weight loss .","problem":["weight loss"],"test":[],"treatment":[],"problem_indices_start":[52],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"baseline blood pressure of 144\/61 , heart rate of 73 , and oxygen saturation of 96% on room air .","problem":[],"test":["heart rate","baseline blood pressure","oxygen saturation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,36,59],"test_indices_end":[23,46,76],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is an 84-year-old woman with a history of diverticulitis who was found to have colon cancer on colonoscopy , which was performed in march of 2004 .","problem":["colon cancer","diverticulitis"],"test":["colonoscopy"],"treatment":[],"problem_indices_start":[54,91],"problem_indices_end":[68,103],"test_indices_start":[107],"test_indices_end":[118],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient tolerated the procedure well and there are no complications .","problem":["complications"],"test":[],"treatment":["the procedure"],"problem_indices_start":[58],"problem_indices_end":[71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[35]}
{"text":"the patient reports a history of bloating and flatulence as well as increased fatigue .","problem":["flatulence","increased fatigue","bloating"],"test":[],"treatment":[],"problem_indices_start":[33,46,68],"problem_indices_end":[41,56,85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her extremities are without edema and are warm .","problem":["edema"],"test":[],"treatment":[],"problem_indices_start":[28],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lungs are clear to auscultation bilaterally .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was consented for surgery and on the day of admission was taken to the operating room for transverse colectomy for tumor .","problem":["tumor"],"test":[],"treatment":["transverse colectomy","surgery"],"problem_indices_start":[127],"problem_indices_end":[132],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30,102],"treatment_indices_end":[37,122]}
{"text":"2. metoprolol 25 mg p.o. b.i.d.","problem":[],"test":[],"treatment":["metoprolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"an invasive moderately differentiated adenocarcinoma was noted in the transverse colon at 80 cm .","problem":["an invasive moderately differentiated adenocarcinoma"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was kept npo initially and her diet was slowly advanced as tolerated .","problem":[],"test":[],"treatment":["npo"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[16]}
{"text":"she is a pleasant well appearing elderly woman in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[53],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"colon cancer .","problem":["colon cancer"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on exam she is afebrile .","problem":["afebrile"],"test":["exam"],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[23],"test_indices_start":[3],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. senna 2 tablets p.o. b.i.d.","problem":[],"test":[],"treatment":["senna"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there has been interval improvement in left basilar atelectasis .","problem":["left basilar atelectasis"],"test":[],"treatment":[],"problem_indices_start":[39],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"htn ventral hernia right nephrectomy s\/p right facial plating","problem":["ventral hernia","htn"],"test":[],"treatment":["right facial plating","right nephrectomy"],"problem_indices_start":[0,4],"problem_indices_end":[3,18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,41],"treatment_indices_end":[36,61]}
{"text":"htn elev. chol. right facial droop with metal plate secondary to gsw to face right nephrectomy","problem":["htn","right facial droop","gsw","elev. chol."],"test":[],"treatment":["metal plate","face right nephrectomy"],"problem_indices_start":[0,4,16,65],"problem_indices_end":[3,15,34,68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40,72],"treatment_indices_end":[51,94]}
{"text":"no spontaneous echo contrast is seen in the body of the left atrium .","problem":["spontaneous echo contrast"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cath at kindred\/north shore today showed 80% lm lesion with normal lad , cx , rca .","problem":["80% lm lesion"],"test":["cath"],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[54],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"previously reported interstitial edema has resolved .","problem":["interstitial edema"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"echo prior to scheduled cath showed mild lvh , inferior hk , ef 40% , mild mr , mild lae .","problem":["mild mr","inferior hk","mild lae","mild lvh"],"test":["ef","scheduled cath","echo"],"treatment":[],"problem_indices_start":[36,47,70,80],"problem_indices_end":[44,58,77,88],"test_indices_start":[0,14,61],"test_indices_end":[4,28,63],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"61 yo african-american-hispanic male had abnormal ekg found as part of pre-op eval. for ventral hernia repair .","problem":["abnormal ekg"],"test":["pre-op eval."],"treatment":["ventral hernia repair"],"problem_indices_start":[41],"problem_indices_end":[53],"test_indices_start":[71],"test_indices_end":[83],"treatment_indices_start":[88],"treatment_indices_end":[109]}
{"text":"status post coronary bypass surgery .","problem":[],"test":[],"treatment":["coronary bypass surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[35]}
{"text":"chief complaint: recent mild angina with exertion","problem":["recent mild angina"],"test":[],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mg - 2.1","problem":[],"test":["mg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"had subsequent abnormal stress test and pefusion imaging showed ef 38% with perfusion defects .","problem":["perfusion defects","abnormal stress test"],"test":["ef","pefusion imaging"],"treatment":[],"problem_indices_start":[15,76],"problem_indices_end":[35,93],"test_indices_start":[40,64],"test_indices_end":[56,66],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"admitted directly to or from ambulance transfer and underwent cabg x3 with dr. howard on 06-13 .","problem":[],"test":[],"treatment":["cabg"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[62],"treatment_indices_end":[66]}
{"text":"two view chest , 2017-06-17","problem":[],"test":["two view chest"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"trace mr , ai as described .","problem":["ai","trace mr"],"test":[],"treatment":[],"problem_indices_start":[0,11],"problem_indices_end":[8,13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there has been removal of a swan-ganz catheter and placement of a right internal jugular vascular catheter , with the tip terminating in the proximal right atrium just below the junction with the superior vena cava .","problem":[],"test":[],"treatment":["a right internal jugular vascular catheter","a swan-ganz catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,64],"treatment_indices_end":[46,106]}
{"text":"urean - 25* creat - 1.0 k - 3.9","problem":[],"test":["urean","creat","k"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,12,24],"test_indices_end":[5,17,25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. rosuvastatin 20 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["rosuvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"emergency cabg x 3 ( 2017-06-13 )( lima to lad , svg to ramus , svg to om )","problem":[],"test":[],"treatment":["svg to om","svg to ramus","lima to lad","emergency cabg"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,35,49,64],"treatment_indices_end":[14,46,61,73]}
{"text":"8. furosemide 20 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ) for 7 days .","problem":[],"test":[],"treatment":["furosemide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"cad","problem":["cad"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient recorded as having no known allergies to drugs","problem":["known allergies"],"test":[],"treatment":["drugs"],"problem_indices_start":[30],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49],"treatment_indices_end":[54]}
{"text":"pt - 13.6* ptt - 33.3 inr ( pt ) - 1.2*","problem":[],"test":["ptt","pt","pt","inr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,11,22,28],"test_indices_end":[2,14,25,30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-06-17 05:14am blood","problem":[],"test":["blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. docusate sodium 100 mg capsule sig : one ( 1 ) capsule po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"2017-06-17 05:14am blood","problem":[],"test":["blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the aortic valve leaflets are mildly thickened .","problem":["mildly thickened"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"trace aortic regurgitation is seen .","problem":["trace aortic regurgitation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-06-14 02:06am blood","problem":[],"test":["blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-06-13 08:05pm blood","problem":[],"test":["blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is mild symmetric left ventricular hypertrophy with normal cavity size .","problem":["mild symmetric left ventricular hypertrophy"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"wbc - 9.4 rbc - 3.61* hgb - 10.4* hct - 29.9* mcv - 83 mch - 28.8 mchc - 34.8 rdw - 14.3 plt ct - 154","problem":[],"test":["hgb","rdw","plt ct","wbc","mchc","rbc","mcv","mch","hct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,22,34,46,55,66,78,89],"test_indices_end":[3,13,25,37,49,58,70,81,95],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the mitral valve leaflets are mildly thickened .","problem":["mildly thickened"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no mass or vegetation is seen on the mitral valve .","problem":["mass","vegetation"],"test":[],"treatment":[],"problem_indices_start":[3,11],"problem_indices_end":[7,21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no pericardial effusion .","problem":["pericardial effusion"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right basilar atelectasis has slightly worsened .","problem":["right basilar atelectasis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no aortic valve stenosis .","problem":["aortic valve stenosis"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"trivial mitral regurgitation is seen .","problem":["trivial mitral regurgitation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"preserved lv systolic function on phenylephrine .","problem":[],"test":[],"treatment":["phenylephrine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[47]}
{"text":"2017-06-14 02:06am blood","problem":[],"test":["blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lvef now 50% .","problem":[],"test":["lvef"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"transferred in urgently for cabg with dr. howard .","problem":[],"test":[],"treatment":["cabg"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28],"treatment_indices_end":[32]}
{"text":"plt ct - 154","problem":[],"test":["plt ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hct - 25.2*","problem":[],"test":["hct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ventral hernia","problem":["ventral hernia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bisoprolol 5 mg daily crestor 20 mg daily","problem":[],"test":[],"treatment":["crestor","bisoprolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,22],"treatment_indices_end":[10,29]}
{"text":"there are simple atheroma in the descending thoracic aorta .","problem":["simple atheroma"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"foley removed on pod #2 and had scattered rales with temp 101.2 .","problem":["scattered rales"],"test":["temp"],"treatment":["foley"],"problem_indices_start":[32],"problem_indices_end":[47],"test_indices_start":[53],"test_indices_end":[57],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"there are simple atheroma in the aortic arch .","problem":["simple atheroma"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"afebrile the next day and pacing wires removed without incident .","problem":["afebrile"],"test":[],"treatment":["pacing wires"],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[38]}
{"text":"i certify that i was present for this procedure in compliance with hcfa regulations .","problem":[],"test":[],"treatment":["this procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[33],"treatment_indices_end":[47]}
{"text":"there are simple atheroma in the ascending aorta .","problem":["simple atheroma"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no left ventricular aneurysm is seen .","problem":["left ventricular aneurysm"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there are simple atheroma in the aortic root .","problem":["simple atheroma"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"severe systolic htn also noted .","problem":["severe systolic htn"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the right ventricular cavity is mildly dilated .","problem":["mildly dilated"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"resting regional wall motion abnormalities include mild inferior hypokinesis .","problem":["mild inferior hypokinesis","resting regional wall motion abnormalities"],"test":[],"treatment":[],"problem_indices_start":[0,51],"problem_indices_end":[42,76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"discharge instructions : may shower , no bathing or swimming for 1 month no creams , lotions or powders to any incisions no driving for 1 month no lifting > 10 # for 10 weeks","problem":["any incisions"],"test":[],"treatment":["creams","powders","lotions"],"problem_indices_start":[107],"problem_indices_end":[120],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[76,85,96],"treatment_indices_end":[82,92,103]}
{"text":"there is mild symmetric left ventricular hypertrophy .","problem":["mild symmetric left ventricular hypertrophy"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no ventricular septal defect .","problem":["ventricular septal defect"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is mild regional left ventricular systolic dysfunction .","problem":["mild regional left ventricular systolic dysfunction"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"overall left ventricular systolic function is mildly depressed .","problem":["mildly depressed"],"test":["overall left ventricular systolic function"],"treatment":[],"problem_indices_start":[46],"problem_indices_end":[62],"test_indices_start":[0],"test_indices_end":[42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no masses or vegetations are seen on the aortic valve .","problem":["vegetations","masses"],"test":[],"treatment":[],"problem_indices_start":[3,13],"problem_indices_end":[9,24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no atrial septal defect is seen by 2d or color doppler .","problem":["atrial septal defect"],"test":["color doppler","2d"],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[35,41],"test_indices_end":[37,54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. oxycodone-acetaminophen 5-325 mg tablet sig : 1-2 tablets po every 4-6 hours as needed for pain .","problem":["pain"],"test":[],"treatment":["oxycodone-acetaminophen"],"problem_indices_start":[94],"problem_indices_end":[98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[26]}
{"text":"2. potassium chloride 10 meq capsule , sustained release sig : two ( 2 ) capsule , sustained release po q12h ( every 12 hours ) for 7 days .","problem":[],"test":[],"treatment":["potassium chloride"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[21]}
{"text":"4. ranitidine hcl 150 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["ranitidine hcl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[17]}
{"text":"no mass\/thrombus is seen in the left atrium or left atrial appendage .","problem":["mass\/thrombus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hctz 25 mg daily lisinopril 40 mg daily","problem":[],"test":[],"treatment":["lisinopril","hctz"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,17],"treatment_indices_end":[4,27]}
{"text":"5. aspirin 81 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po daily ( daily ) .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"no spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage .","problem":["thrombus","spontaneous echo contrast"],"test":[],"treatment":[],"problem_indices_start":[3,32],"problem_indices_end":[28,40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the left atrium is mildly dilated .","problem":["mildly dilated"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"transferred to the csru in stable condition on phenylephrine and propofol drips .","problem":[],"test":[],"treatment":["propofol drips","phenylephrine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47,65],"treatment_indices_end":[60,79]}
{"text":"2017-06-15 02:02pm blood","problem":[],"test":["blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extubated early the next morning and chest tubes removed .","problem":[],"test":[],"treatment":["chest tubes"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37],"treatment_indices_end":[48]}
{"text":"persistent pleural effusions .","problem":["persistent pleural effusions"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. vascular catheter tip terminates in proximal right atrium .","problem":[],"test":[],"treatment":["vascular catheter tip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[24]}
{"text":"2. bibasilar minor atelectasis , worse on the right and improved on the left .","problem":["bibasilar minor atelectasis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gentle diuresis and beta blockade started , and he was transferred to the floor to begin increasing his activity level .","problem":[],"test":[],"treatment":["gentle diuresis","beta blockade"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,20],"treatment_indices_end":[15,33]}
{"text":"bilateral pleural effusions are unchanged .","problem":["bilateral pleural effusions"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. metoprolol tartrate 25 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["metoprolol tartrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"no nausea , vomiting , diaphoresis .","problem":["vomiting","diaphoresis","nausea"],"test":[],"treatment":[],"problem_indices_start":[3,12,23],"problem_indices_end":[9,20,34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given asa , plavix , heparin drip x 24 hours , nitro drip , atorvastatin , metoprolol , and lisinopril .","problem":[],"test":[],"treatment":["asa","plavix","heparin drip","lisinopril","atorvastatin","metoprolol","nitro drip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,28,37,63,76,91,108],"treatment_indices_end":[25,34,49,73,88,101,118]}
{"text":"ck ( cpk ) - 627* ck-mb - 55* mb indx - 8.8* ctropnt - 4.46*","problem":[],"test":["ck-mb","ck","cpk","ctropnt","mb indx"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,5,18,30,45],"test_indices_end":[2,8,23,37,52],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mchc - 35.3* rdw - 14.8 plt ct - 214","problem":[],"test":["mchc","rdw","plt ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,24],"test_indices_end":[4,16,30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"they did an ecg at bridgewater state hospital rehab which demonstarted new st depressions in v1-v4 .","problem":["new st depressions in v1-v4"],"test":["an ecg"],"treatment":[],"problem_indices_start":[71],"problem_indices_end":[98],"test_indices_start":[9],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ck ( cpk ) - 1288* ck-mb - 158* mb indx - 12.3* ctropnt - 6.88*","problem":[],"test":["ctropnt","ck-mb","ck","cpk","mb indx"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,5,19,32,48],"test_indices_end":[2,8,24,39,55],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 91 yo woman with h\/o htn who came from bridgewater state hospital rehab with substernal chest pain after exercise .","problem":["substernal chest pain","htn"],"test":[],"treatment":[],"problem_indices_start":[38,94],"problem_indices_end":[41,115],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-10-07 07:30am blood","problem":[],"test":["blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"wbc - 13.8* rbc - 3.39* hgb - 10.7* hct - 30.2* mcv - 89 mch - 31.5","problem":[],"test":["mch","mcv","hct","hgb","rbc","wbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,12,24,36,48,57],"test_indices_end":[3,15,27,39,51,60],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"glucose - 120* urean - 30* creat - 1.2* na - 134 k - 4.2 cl - 100 hco3 - 25","problem":[],"test":["glucose","hco3","k","cl","creat","na","urean"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,15,27,40,49,57,66],"test_indices_end":[7,20,32,42,50,59,70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on presentation to providence behavioral health hospital amanda , her vitals were hr 68 , bp 142\/68 , rr 28 , o2 sat 100% ra .","problem":[],"test":["her vitals","hr","bp","rr","o2 sat"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[66,82,90,102,110],"test_indices_end":[76,84,92,104,116],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"90 year-old woman with h\/o of htn p\/w substernal chest pain shortly after exercise at nursing home , with ekg showing st depressions in v1-v4 and troponin 0.07.","problem":["htn","st depressions in v1-v4","substernal chest pain"],"test":["ekg","troponin"],"treatment":[],"problem_indices_start":[30,38,118],"problem_indices_end":[33,59,141],"test_indices_start":[106,146],"test_indices_end":[109,154],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-10-06 04:47pm blood","problem":[],"test":["blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ck ( cpk ) - 1471* ck-mb - 207* mb indx - 14.1* ctropnt - 6.00*","problem":[],"test":["mb indx","ctropnt","cpk","ck-mb","ck"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,5,19,32,48],"test_indices_end":[2,8,24,39,55],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"likely nstemi .","problem":["nstemi"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she received asa 81 mg x 2 and nitro sl x 2 with partial relief at nursing home .","problem":[],"test":[],"treatment":["asa","nitro sl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,31],"treatment_indices_end":[16,39]}
{"text":"the patient 's family refused coronary artery catheterization .","problem":[],"test":[],"treatment":["coronary artery catheterization"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30],"treatment_indices_end":[61]}
{"text":"her metoprolol dose was increased from 25 mg po bid to 50 mg po bid then 75 mg po tid .","problem":[],"test":[],"treatment":["her metoprolol dose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[19]}
{"text":"an echo showed that she had preserved ef and no wall motion abnormalities .","problem":["wall motion abnormalities"],"test":["an echo"],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[73],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on hospital day 2 she experienced atrial fibrillation with hr in the 140s .","problem":["atrial fibrillation"],"test":["hr"],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[53],"test_indices_start":[59],"test_indices_end":[61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her chest pain was controlled with morphine .","problem":["her chest pain"],"test":[],"treatment":["morphine"],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[35],"treatment_indices_end":[43]}
{"text":"calcium - 8.7 phos - 2.5* mg - 2.1","problem":[],"test":["phos","mg","calcium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,14,26],"test_indices_end":[7,18,28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her sbp remained in the 160s-170s on hospital day 1 and she was gently diuresed .","problem":[],"test":["her sbp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she should also continue on lipitor and lisinopril .","problem":[],"test":[],"treatment":["lisinopril","lipitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28,40],"treatment_indices_end":[35,50]}
{"text":"chest pain","problem":["chest pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"labs on discharge 2015-10-08 08:35am","problem":[],"test":["labs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blindness 02-26 macular degeneration","problem":["macular degeneration","blindness"],"test":[],"treatment":[],"problem_indices_start":[0,16],"problem_indices_end":[9,36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"we decided given her age that she would not be a good candidate for cardioversion for her afib nor would she be a good candidate for coumadin .","problem":["her afib"],"test":[],"treatment":["coumadin","cardioversion"],"problem_indices_start":[86],"problem_indices_end":[94],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[68,133],"treatment_indices_end":[81,141]}
{"text":"* leukocytosis- she developed mild elevated wbc .","problem":["mild elevated wbc","leukocytosis-"],"test":[],"treatment":[],"problem_indices_start":[2,30],"problem_indices_end":[15,47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"r ankle fx 2002","problem":["r ankle fx"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ua had 12-14","problem":[],"test":["ua"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she can be given prn lasix for weight gain or shortness of breath .","problem":["weight gain","shortness of breath"],"test":[],"treatment":["lasix"],"problem_indices_start":[31,46],"problem_indices_end":[42,65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[26]}
{"text":"hearing difficulty","problem":["hearing difficulty"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bilateral crackles at bases and midlungs , elevated jvp , trace bilateral ankle edema , and cxr with diffuse opacities suggest possible pulmonary edema , likely secondary to acute mi .","problem":["bilateral crackles at bases and midlungs","elevated jvp","trace bilateral ankle edema","acute mi","pulmonary edema","diffuse opacities"],"test":["cxr"],"treatment":[],"problem_indices_start":[0,43,58,101,136,174],"problem_indices_end":[40,55,85,118,151,182],"test_indices_start":[92],"test_indices_end":[95],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiology discussed cath however , patient 's family turned down .","problem":[],"test":["cath"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[21],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she should have her chem 7 checked next week given the start of her new meds .","problem":[],"test":["her chem 7"],"treatment":["her new meds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16],"test_indices_end":[26],"treatment_indices_start":[64],"treatment_indices_end":[76]}
{"text":"htn","problem":["htn"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she experienced no respiratory difficulty during the hospital stay .","problem":["respiratory difficulty"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"will also need lft 's checked in 3-6 months .","problem":[],"test":["lft 's"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[15],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"t 97.8 , hr 53 , bp 156\/58 , rr 16 , o2 sat 94% on 2.5 l","problem":[],"test":["rr","o2 sat","bp","t","hr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,9,17,29,37],"test_indices_end":[1,11,19,31,43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her o2 sat was stable at 94-97% on 2.5l of supplemental o2 .","problem":[],"test":["her o2 sat"],"treatment":["supplemental o2"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[43],"treatment_indices_end":[58]}
{"text":"her cxr prior to discharge showed mild pulm edema and thus was given 40 of lasix prior to going to rehab .","problem":["mild pulm edema"],"test":["her cxr"],"treatment":["lasix"],"problem_indices_start":[34],"problem_indices_end":[49],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[75],"treatment_indices_end":[80]}
{"text":"her bp remained stable .","problem":[],"test":["her bp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"therefore we will continue rate control with metoprolol this can be titrated if needed , and aspirin and plavix for anti-coagulation .","problem":[],"test":[],"treatment":["aspirin","anti-coagulation","plavix","metoprolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[45,93,105,116],"treatment_indices_end":[55,100,111,132]}
{"text":"s\/p hysterectomy","problem":[],"test":[],"treatment":["hysterectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[16]}
{"text":"ekg showed sinus brady , with old lad and new st depressions in v1-v4 .","problem":["sinus brady","old lad and new st depressions in v1-v4"],"test":["ekg"],"treatment":[],"problem_indices_start":[11,30],"problem_indices_end":[22,69],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tylenol prn lisinopril 5 mg po qd protonix 20 mg po qd artifical tears bid metoprolol 25 mg po bid","problem":[],"test":[],"treatment":["metoprolol","artifical tears","lisinopril","tylenol","protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,12,34,55,75],"treatment_indices_end":[7,22,42,70,85]}
{"text":"2. docusate sodium 100 mg capsule sig : one ( 1 ) capsule po bid ( 2 times a day ) as needed for constipation .","problem":["constipation"],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[97],"problem_indices_end":[109],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"exam was notable for rrr with no murmur , bibasilar crackles , guaiac negative .","problem":["bibasilar crackles","murmur"],"test":["guaiac","exam"],"treatment":[],"problem_indices_start":[33,42],"problem_indices_end":[39,60],"test_indices_start":[0,63],"test_indices_end":[4,69],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. senna 8.6 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ) as needed .","problem":[],"test":[],"treatment":["senna"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"she received asa , nitro sl then gtt , morphine , metoprolol , and heparin gtt .","problem":[],"test":[],"treatment":["heparin gtt","metoprolol","morphine","nitro sl","asa"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,19,39,50,67],"treatment_indices_end":[16,27,47,60,78]}
{"text":"she has a culture pending which needs to be followed up at the nursing home and treated if positive .","problem":["positive"],"test":["a culture"],"treatment":[],"problem_indices_start":[91],"problem_indices_end":[99],"test_indices_start":[8],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was initially started on bactrim , but this was stopped as she was afebrile .","problem":["afebrile"],"test":[],"treatment":["bactrim"],"problem_indices_start":[71],"problem_indices_end":[79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[36]}
{"text":"wbc 's , few bacteria .","problem":["few bacteria"],"test":["wbc 's"],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[21],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. clopidogrel 75 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["clopidogrel"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"trace ankle edema bilaterally","problem":["trace ankle edema bilaterally"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. aspirin 325 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"nad , awake , alert , blind , able to hear loud voices at l ear","problem":["nad","blind"],"test":[],"treatment":[],"problem_indices_start":[0,22],"problem_indices_end":[3,27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"soft , nt , nd , bs present , no masses","problem":["masses","nt","nd"],"test":[],"treatment":[],"problem_indices_start":[7,12,33],"problem_indices_end":[9,14,39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. polyvinyl alcohol 1.4 % drops sig : 1-2 drops ophthalmic bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["polyvinyl alcohol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[20]}
{"text":"wbc - 11.4* rbc - 3.61* hgb - 11.4* hct - 32.6* mcv - 90 mch - 31.7","problem":[],"test":["hgb","wbc","rbc","mch","mcv","hct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,12,24,36,48,57],"test_indices_end":[3,15,27,39,51,60],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. pantoprazole 40 mg tablet , delayed release ( e.c. ) sig : 0.5 tablet , delayed release ( e.c. ) po q24h ( every 24 hours ) .","problem":[],"test":[],"treatment":["pantoprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"5. atorvastatin 80 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["atorvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"10. acetaminophen 325 mg tablet sig : two ( 2 ) tablet po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["acetaminophen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[17]}
{"text":"jvp 11 cm","problem":[],"test":["jvp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. metoprolol tartrate 25 mg tablet sig : three ( 3 ) tablet po tid ( 3 times a day ) .","problem":[],"test":[],"treatment":["metoprolol tartrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"reg rate , nl s1 & s2 , no m\/r\/g","problem":["m\/r\/g"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her hr decreased to 70s-80s .","problem":[],"test":["her hr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. lisinopril 10 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"12. lasix 40 mg tablet sig : one ( 1 ) tablet po once a day as needed for shortness of breath or wheezing :","problem":["shortness of breath","wheezing"],"test":[],"treatment":["lasix"],"problem_indices_start":[74,97],"problem_indices_end":[93,105],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[9]}
{"text":"crackles at base and mid-lungs bilaterally","problem":["crackles at base and mid-lungs bilaterally"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"11. maalox 225-200 mg\/5 ml suspension sig : five ( 5 ) ml po every six ( 6 ) hours as needed for indigestion .","problem":["indigestion"],"test":[],"treatment":["maalox"],"problem_indices_start":[97],"problem_indices_end":[108],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"glucose - 124* urean - 30* creat - 1.3* na - 137 k - 4.2 cl - 102 hco3 - 27","problem":[],"test":["na","creat","urean","hco3","cl","k","glucose"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,15,27,40,49,57,66],"test_indices_end":[7,20,32,42,50,59,70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"can give 40 lasix po if having any weight gain or shortness of breath .","problem":["weight gain","shortness of breath"],"test":[],"treatment":["lasix"],"problem_indices_start":[35,50],"problem_indices_end":[46,69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[17]}
{"text":"atrial fibrillation","problem":["atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mchc - 35.1* rdw - 14.7 plt ct - 281","problem":[],"test":["mchc","plt ct","rdw"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,24],"test_indices_end":[4,16,30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient without chest pain , heart rate and bp stable .","problem":["chest pain"],"test":["heart rate","bp"],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[26],"test_indices_start":[29,44],"test_indices_end":[39,46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"htn","problem":["htn"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please take all medications as instructed .","problem":[],"test":[],"treatment":["all medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[27]}
{"text":"sinus brady @ 48 bpm , lad , lvh , rbbb , q wave in i , st depressions in v1-v4 , st elevation in iii , avf , twi in iii , v5 .","problem":["rbbb","st depressions in v1-v4","q wave in i","st elevation in iii","avf","twi in iii","lvh","sinus brady"],"test":[],"treatment":[],"problem_indices_start":[0,29,35,42,56,82,104,110],"problem_indices_end":[11,32,39,53,79,101,107,120],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if the patient experiences any chest pain , shortness of breath , nausea , vomiting , fevers , chills , please return to the emergency room .","problem":["chest pain","shortness of breath","vomiting","nausea","fevers","chills"],"test":[],"treatment":[],"problem_indices_start":[31,44,66,75,86,95],"problem_indices_end":[41,63,72,83,92,101],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has been started on several new medications which are important to protect her heart .","problem":[],"test":[],"treatment":["several new medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[47]}
{"text":"angap - 12","problem":[],"test":["angap"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[5],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ck ( cpk ) - 42 ctropnt - 0.07*","problem":[],"test":["ck","cpk","ctropnt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,5,16],"test_indices_end":[2,8,23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after returning to her room she w noted sscp without radiation .","problem":["sscp"],"test":[],"treatment":[],"problem_indices_start":[40],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"troponin was 0.07 .","problem":[],"test":["troponin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ekg :","problem":[],"test":["ekg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"transferred to ccu for further management and observation .","problem":[],"test":[],"treatment":["further management"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[41]}
{"text":"nstemi","problem":["nstemi"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lvef >70% , la 6.1 cm , no regional wall motion abnormality .","problem":["regional wall motion abnormality"],"test":["la","lvef"],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[59],"test_indices_start":[0,12],"test_indices_end":[4,14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"echo :","problem":[],"test":["echo"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-10-05 09:00pm blood","problem":[],"test":["blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac enzymes","problem":[],"test":["cardiac enzymes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"angap - 13","problem":[],"test":["angap"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[5],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cxr 10-07 :","problem":[],"test":["cxr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is slight worsening of the still mild pulmonary edema .","problem":["the still mild pulmonary edema","slight worsening"],"test":[],"treatment":[],"problem_indices_start":[9,29],"problem_indices_end":[25,59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no pneumothorax .","problem":["pneumothorax"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"small right pleural effusion is stable .","problem":["small right pleural effusion"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was initially maintained on intravenous fluids only and when his respiratory distress resolved he was transitioned to enteral feeds .","problem":["his respiratory distress"],"test":[],"treatment":["intravenous fluids","enteral feeds"],"problem_indices_start":[73],"problem_indices_end":[97],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40,130],"treatment_indices_end":[58,143]}
{"text":"he is due to have his state screen sent today .","problem":[],"test":["his state screen"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[18],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. apnea and bradycardia of prematurity .","problem":["prematurity","bradycardia","apnea"],"test":[],"treatment":[],"problem_indices_start":[3,13,28],"problem_indices_end":[8,24,39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"feeds at discharge are pe-20 currently at 120 cc per kg per day due to advance 15 cc per kg per day to a total of 150 cc per kg per day .","problem":[],"test":[],"treatment":["pe-20","feeds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,23],"treatment_indices_end":[5,28]}
{"text":"2. rule out sepsis , off antibiotics .","problem":["sepsis"],"test":[],"treatment":["antibiotics"],"problem_indices_start":[12],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25],"treatment_indices_end":[36]}
{"text":"caffeine 12 mg pg q day. he has not had his 06-10 dose .","problem":[],"test":[],"treatment":["caffeine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"the patient has not had an cmed examination or hearing test .","problem":[],"test":["cmed examination","hearing test"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[27,47],"test_indices_end":[43,59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"before this age , the family and other caregivers should be considered for immunization against influenza to protect the infant .","problem":["influenza"],"test":[],"treatment":["immunization"],"problem_indices_start":[96],"problem_indices_end":[105],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[75],"treatment_indices_end":[87]}
{"text":"the patient was initially started on nasal prong cpap at 6 and required additional oxygen to 35% .","problem":[],"test":[],"treatment":["additional oxygen","nasal prong cpap"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37,72],"treatment_indices_end":[53,89]}
{"text":"1. prematurity at 30-6\/7 weeks .","problem":["prematurity"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however by 24 hours he transitioned to low-flow nasal cannula and on day of life five transitioned to room air where he currently remains .","problem":[],"test":[],"treatment":["low-flow nasal cannula"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39],"treatment_indices_end":[61]}
{"text":"he was noted to have an erythematous perianal rash and for this was started on nystatin powder .","problem":["an erythematous perianal rash"],"test":[],"treatment":["nystatin powder"],"problem_indices_start":[21],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[79],"treatment_indices_end":[94]}
{"text":"with the initiation of caffeine therapy the patient has had no more apnea or bradycardic events .","problem":["apnea","bradycardic events"],"test":[],"treatment":["caffeine therapy"],"problem_indices_start":[68,77],"problem_indices_end":[73,95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[39]}
{"text":"influenza vaccination should be considered annually in the fall for preterm infants with chronic lung disease once they reach six months of age .","problem":["chronic lung disease"],"test":[],"treatment":["influenza vaccination"],"problem_indices_start":[89],"problem_indices_end":[109],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[21]}
{"text":"he was noted to have some apnea and bradycardic spells of prematurity and was therefore started on caffeine .","problem":["some apnea","bradycardic spells of prematurity"],"test":[],"treatment":["caffeine"],"problem_indices_start":[21,36],"problem_indices_end":[31,69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[99],"treatment_indices_end":[107]}
{"text":"the abdomen was benign , flat , nontender , nondistended , no hepatosplenomegaly .","problem":["nontender","nondistended","hepatosplenomegaly"],"test":[],"treatment":[],"problem_indices_start":[32,44,62],"problem_indices_end":[41,56,80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. with chronic lung disease .","problem":["chronic lung disease"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the neurological examination was appropriate for age with normal tone and strength and appropriate reflexes .","problem":[],"test":["the neurological examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his most recent bilirubin was 6.6 on day of life six , the day of discharge , and his phototherapy was discontinued. he will need a rebound bilirubin level in am .","problem":[],"test":["a rebound bilirubin level","his most recent bilirubin"],"treatment":["his phototherapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,130],"test_indices_end":[25,155],"treatment_indices_start":[82],"treatment_indices_end":[98]}
{"text":"synagis rsv prophylaxis should be considered from october through april for infants who meet any of the following criteria :","problem":[],"test":[],"treatment":["synagis rsv prophylaxis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[23]}
{"text":"he developed physiologic hyperbilirubinemia ( peak bili 8.6\/0.3 on 06-08 , dol3 ) for which he was treated with a single phototherapy .","problem":["physiologic hyperbilirubinemia"],"test":["peak bili"],"treatment":["a single phototherapy"],"problem_indices_start":[13],"problem_indices_end":[43],"test_indices_start":[46],"test_indices_end":[55],"treatment_indices_start":[112],"treatment_indices_end":[133]}
{"text":"na 145 , k 4.3 , cl 110 , tco2 25 .","problem":[],"test":["tco2","cl","k","na"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,9,17,26],"test_indices_end":[2,10,19,30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the morning of admission the mother developed vaginal bleeding and fetal bradycardia was noted .","problem":["vaginal bleeding","fetal bradycardia"],"test":[],"treatment":[],"problem_indices_start":[46,67],"problem_indices_end":[62,84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hips were stable without clunk .","problem":["clunk"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his admission complete blood count was notable for a white count of 11.8 , 25 polys and no bands .","problem":["bands"],"test":["25 polys","his admission complete blood count","a white count"],"treatment":[],"problem_indices_start":[91],"problem_indices_end":[96],"test_indices_start":[0,51,75],"test_indices_end":[34,64,83],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was given bag mask ventilation with good response .","problem":[],"test":[],"treatment":["bag mask ventilation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[33]}
{"text":"the skin was without lesions .","problem":["lesions"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the infant emerged limp and without spontaneous respiratory effort .","problem":["spontaneous respiratory effort","limp"],"test":[],"treatment":[],"problem_indices_start":[19,36],"problem_indices_end":[23,66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rpr nonreactive , rubella immune .","problem":["rubella"],"test":["rpr"],"treatment":[],"problem_indices_start":[18],"problem_indices_end":[25],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hematocrit was 45 , platelet count 270 .","problem":[],"test":["hematocrit","platelet count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,20],"test_indices_end":[10,34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the cardiovascular examination revealed s1 and s2 regular , no murmurs , 2+ femoral pulses .","problem":["murmurs"],"test":["the cardiovascular examination","2+ femoral pulses","s1","s2"],"treatment":[],"problem_indices_start":[63],"problem_indices_end":[70],"test_indices_start":[0,40,47,73],"test_indices_end":[30,42,49,90],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"o+ , hepatitis b surface antigen negative ,","problem":[],"test":["hepatitis b surface antigen"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[5],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. feeding immaturity .","problem":["feeding immaturity"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the pregnancy was unremarkable until 2015-06-01 when the mother presented to shriner 's hospital for crippled children for increased blood pressure and proteinuria .","problem":["increased blood pressure","proteinuria"],"test":[],"treatment":[],"problem_indices_start":[123,152],"problem_indices_end":[147,163],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. hyperbilirubinemia .","problem":["hyperbilirubinemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neck was supple without masses or defects .","problem":["defects","masses"],"test":[],"treatment":[],"problem_indices_start":[24,34],"problem_indices_end":[30,41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood culture was sent but he was never started on antibiotics .","problem":[],"test":["blood culture"],"treatment":["antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[51],"treatment_indices_end":[62]}
{"text":"she was transferred to charles river hospital and was treated with magnesium sulfate and betamethasone .","problem":[],"test":[],"treatment":["magnesium sulfate","betamethasone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[67,89],"treatment_indices_end":[84,102]}
{"text":"the patient is a 1,770 gram male infant born by stat cesarean section for fetal bradycardia at 30-6\/7 weeks gestation to a 29-year-old gravida 3 , para 0 now 1 mother .","problem":["fetal bradycardia"],"test":[],"treatment":["stat cesarean section"],"problem_indices_start":[74],"problem_indices_end":[91],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48],"treatment_indices_end":[69]}
{"text":"apgar scores were 6 at one minute and 8 at five minutes .","problem":[],"test":["apgar scores"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the lungs were coarse bilaterally with moderate retractions .","problem":["coarse bilaterally","moderate retractions"],"test":[],"treatment":[],"problem_indices_start":[15,39],"problem_indices_end":[33,59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"last set of electrolytes on 06-08 , dol3 :","problem":[],"test":["last set of electrolytes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the blood culture remained sterile .","problem":[],"test":["the blood culture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was in mild to moderate respiratory distress .","problem":["mild to moderate respiratory distress"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the morning of transfer his iv came out so he has just been advanced to 120 cc per kg per day of pe-20 and his tolerating these pg feedings without difficulty .","problem":[],"test":[],"treatment":["these pg feedings","his iv","pe-20"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24,97,122],"treatment_indices_end":[30,102,139]}
{"text":"therefore , a stat cesarean section was performed .","problem":[],"test":[],"treatment":["a stat cesarean section"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[35]}
{"text":"go to an emergency room if you experience symptoms including , but not necessarily limited to : new and continuing nausea , vomiting , fevers ( >101.5 f ) , chills , or shortness of breath .","problem":["chills","fevers","new and continuing nausea","vomiting","shortness of breath","symptoms"],"test":[],"treatment":[],"problem_indices_start":[42,96,124,135,157,169],"problem_indices_end":[50,121,132,141,163,188],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. mitochondrial myopathy .","problem":["mitochondrial myopathy"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"justin searle a 60-year-old man with a long history of chronic prostatitis status post two transurethral resection of the prostate procedures in 2007 and 1998 .","problem":["chronic prostatitis"],"test":[],"treatment":["two transurethral resection of the prostate"],"problem_indices_start":[55],"problem_indices_end":[74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[87],"treatment_indices_end":[130]}
{"text":"2. supraventricular tachycardia ( on a beta blocker ) .","problem":["supraventricular tachycardia"],"test":[],"treatment":["a beta blocker"],"problem_indices_start":[3],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37],"treatment_indices_end":[51]}
{"text":"turp","problem":[],"test":[],"treatment":["turp"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[4]}
{"text":"patient tolerated procedure on 2018-03-05 and was transferred to","problem":[],"test":[],"treatment":["procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[27]}
{"text":"he also has a diagnosis of interstitial cystitis and more significantly has a history of coronary artery disease with a recent catheterization , supraventricular tachycardia , and a progressive mitochondrial myopathy .","problem":["supraventricular tachycardia","coronary artery disease","interstitial cystitis","a progressive mitochondrial myopathy"],"test":["a recent catheterization"],"treatment":[],"problem_indices_start":[27,89,145,180],"problem_indices_end":[48,112,173,216],"test_indices_start":[118],"test_indices_end":[142],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was started on pyridium .","problem":[],"test":[],"treatment":["pyridium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[26]}
{"text":"interstitial cystitis","problem":["interstitial cystitis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"plt count - 257#","problem":[],"test":["plt count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"icu for 24hr post-op cardiac monitoring .","problem":[],"test":["cardiac monitoring"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[21],"test_indices_end":[39],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sulfonamides \/ penicillins \/ tetracyclines \/ azithromycin \/ iodine \/ shellfish \/ ace inhibitors \/ ciprofloxacin","problem":[],"test":[],"treatment":["tetracyclines","sulfonamides","ace inhibitors","iodine","azithromycin","ciprofloxacin","penicillins"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,15,29,45,60,81,98],"treatment_indices_end":[12,26,42,57,66,95,111]}
{"text":"wbc - 7.5 rbc - 5.09 hgb - 15.4 hct - 43.7 mcv - 86","problem":[],"test":["hgb","mcv","hct","wbc","rbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,21,32,43],"test_indices_end":[3,13,24,35,46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please take an over the counter stool softener such as colace or a gentle laxative such as milk of magnesia if you experience constipation .","problem":["constipation"],"test":[],"treatment":["an over the counter stool softener","a gentle laxative","colace","milk of magnesia"],"problem_indices_start":[126],"problem_indices_end":[138],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12,55,65,91],"treatment_indices_end":[46,61,82,107]}
{"text":"no driving while taking pain medications .","problem":[],"test":[],"treatment":["pain medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[40]}
{"text":"catheter was removed .","problem":[],"test":[],"treatment":["catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"narcotics can cause constipation .","problem":["constipation"],"test":[],"treatment":["narcotics"],"problem_indices_start":[20],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"mch - 30.2 mchc - 35.2* rdw - 13.6","problem":[],"test":["mchc","mch","rdw"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,11,24],"test_indices_end":[3,15,27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"proceed to the er\/ew\/monica if your wound becomes red , swollen , warm , or produces pus .","problem":["swollen","red","warm","your wound","pus"],"test":[],"treatment":[],"problem_indices_start":[31,50,56,66,85],"problem_indices_end":[41,53,63,70,88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. simethicone 80 mg tablet , chewable sig : 0.5-1 tablet , chewable po qid ( 4 times a day ) as needed for indigestion\/gas pain .","problem":["indigestion\/gas pain"],"test":[],"treatment":["simethicone"],"problem_indices_start":[108],"problem_indices_end":[128],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"chronic prostatitis","problem":["chronic prostatitis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. ezetimibe 10 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["ezetimibe"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"twi 's in iii , v1 .","problem":["twi"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. atorvastatin calcium 20 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["atorvastatin calcium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[23]}
{"text":"1. hydroxyzine hcl 10 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["hydroxyzine hcl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"abd : soft , +distension with tympany , no hsm , hyperactive bs","problem":["tympany","hyperactive bs","hsm","+distension"],"test":[],"treatment":[],"problem_indices_start":[13,30,43,49],"problem_indices_end":[24,37,46,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on hd2 , cardiac clearance was obtained by dr. sanchez .","problem":[],"test":["cardiac clearance"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[9],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chronic prostatitis","problem":["chronic prostatitis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. history of orthostasis with tilt table testing done in the past .","problem":["orthostasis"],"test":["tilt table testing"],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[25],"test_indices_start":[31],"test_indices_end":[49],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. phenazopyridine hcl 100 mg tablet sig : one ( 1 ) tablet po tid ( 3 times a day ) for 3 days .","problem":[],"test":[],"treatment":["phenazopyridine hcl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"ext : no c\/c\/e","problem":["c\/c\/e"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. hyoscyamine sulfate 0.125 mg tablet sig : one ( 1 ) tablet po qid ( 4 times a day ) .","problem":[],"test":[],"treatment":["hyoscyamine sulfate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"6. atenolol 100 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["atenolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"1. coronary artery disease ( s\/p stents to lad and 3rd om )","problem":["coronary artery disease"],"test":[],"treatment":["stents to lad and 3rd om"],"problem_indices_start":[3],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[33],"treatment_indices_end":[57]}
{"text":"5. aluminum-magnesium hydroxide 225-200 mg\/5 ml suspension sig : 15-30 mls po qid ( 4 times a day ) as needed for indigestion .","problem":["indigestion"],"test":[],"treatment":["aluminum-magnesium hydroxide"],"problem_indices_start":[114],"problem_indices_end":[125],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[31]}
{"text":"7. pericarditis .","problem":["pericarditis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"glucose - 94 urea n - 22* creat - 1.4* sodium - 142","problem":[],"test":["sodium","creat","glucose","urea n"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,26,39],"test_indices_end":[7,19,31,45],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"potassium - 5.9* chloride - 108 total co2 - 23 anion gap - 17","problem":[],"test":["potassium","anion gap","total co2","chloride"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,17,32,47],"test_indices_end":[9,25,41,56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rrr , no m\/r\/g","problem":["m\/r\/g"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"leave the steri strips on until they begin to peel , then you may remove them. staples and stitches will remain until your follow-up appointment .","problem":[],"test":[],"treatment":["staples","the steri strips","stitches"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6,79,91],"treatment_indices_end":[22,86,99]}
{"text":"father had mi at 42","problem":["mi"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you may remove your dressings 2 days after your surgery if they were not removed in the hospital .","problem":[],"test":[],"treatment":["your surgery","your dressings"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15,43],"treatment_indices_end":[29,55]}
{"text":"continue taking your home medications unless otherwise contraindicated and follow up with pcp .","problem":[],"test":[],"treatment":["your home medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[37]}
{"text":"mother died of mi at 76","problem":["mi"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nad","problem":["nad"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"calcium - 9.7 phosphate - 3.9 magnesium - 1.9","problem":[],"test":["magnesium","calcium","phosphate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,14,30],"test_indices_end":[7,23,39],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt - 12.2 ptt - 23.8 inr ( pt ) - 0.9","problem":[],"test":["pt","ptt","inr ( pt )"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,21],"test_indices_end":[2,13,31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he has had symptoms of dribbling , stress incontinence , hematuria , but has no dysuria .","problem":["dribbling","symptoms","stress incontinence","hematuria","dysuria"],"test":[],"treatment":[],"problem_indices_start":[11,23,35,57,80],"problem_indices_end":[19,32,54,66,87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ecg :","problem":[],"test":["ecg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nsr at 62 , nl axis , nl intervals , q waves in iii , avr , v1 .","problem":["q waves in iii"],"test":["nsr","avr ,","v1"],"treatment":[],"problem_indices_start":[37],"problem_indices_end":[51],"test_indices_start":[0,54,60],"test_indices_end":[3,59,62],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you may take showers ( no baths ) after your dressings have been removed from your wounds .","problem":["your wounds"],"test":[],"treatment":["your dressings"],"problem_indices_start":[78],"problem_indices_end":[89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40],"treatment_indices_end":[54]}
{"text":"9. hypercholesterolemia .","problem":["hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if you experience clear drainage from your wounds , cover them with a clean dressing and stop showering until the drainage subsides for at least 2 days .","problem":["clear drainage","the drainage","your wounds"],"test":[],"treatment":["a clean dressing"],"problem_indices_start":[18,38,110],"problem_indices_end":[32,49,122],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[68],"treatment_indices_end":[84]}
{"text":"10. gastrointestinal bleed","problem":["gastrointestinal bleed"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. status post transurethral resection of prostate times two ( in 2007 and 1998 ) .","problem":[],"test":[],"treatment":["transurethral resection of prostate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[50]}
{"text":"6. interstitial cystitis .","problem":["interstitial cystitis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no complications .","problem":["complications"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"estimated blood loss of 300 cc .","problem":["estimated blood loss"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the percutaneous endoscopic gastrostomy was unsuccessful , and the procedure was converted to an open gastrostomy tube which then proceeded without complications .","problem":["complications"],"test":[],"treatment":["the procedure","an open gastrostomy tube","the percutaneous endoscopic gastrostomy"],"problem_indices_start":[148],"problem_indices_end":[161],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,63,94],"treatment_indices_end":[39,76,118]}
{"text":"the flap was pink with a strong doppler signal .","problem":[],"test":["a strong doppler signal"],"treatment":["the flap"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[23],"test_indices_end":[46],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"he was sedated and ventilated by his tracheostomy 6 cuff shiley tube .","problem":[],"test":[],"treatment":["his tracheostomy 6 cuff shiley tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[33],"treatment_indices_end":[68]}
{"text":"the plastic team then took over for reconstruction consisting of radial forearm free flap to floor of mouth .","problem":[],"test":[],"treatment":["reconstruction","radial forearm free flap"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36,65],"treatment_indices_end":[50,89]}
{"text":"he was placed on unasyn 3 grams iv q.6h.","problem":[],"test":[],"treatment":["iv","unasyn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17,32],"treatment_indices_end":[23,34]}
{"text":"frozen section sent to pathology revealing invasive squamous cell carcinoma .","problem":["invasive squamous cell carcinoma"],"test":["frozen section"],"treatment":[],"problem_indices_start":[43],"problem_indices_end":[75],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no complications .","problem":["complications"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"total intravenous fluids of 7300 cc .","problem":[],"test":[],"treatment":["total intravenous fluids"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"3. bilateral supraomohyoid neck dissection .","problem":[],"test":[],"treatment":["bilateral supraomohyoid neck dissection"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[42]}
{"text":"4. resection of floor of mouth tumor .","problem":["mouth tumor"],"test":[],"treatment":["resection"],"problem_indices_start":[25],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"g-tube was to gravity , foley to gravity , left radial a-line .","problem":[],"test":[],"treatment":["left radial a-line","foley","g-tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,24,43],"treatment_indices_end":[6,29,61]}
{"text":"tomato ( causing anaphylaxis ) and tetanus shot .","problem":["anaphylaxis"],"test":[],"treatment":["tetanus shot"],"problem_indices_start":[17],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[35],"treatment_indices_end":[47]}
{"text":"he had three westwood-pocasset drains - two in the neck and one in his right arm .","problem":[],"test":[],"treatment":["westwood-pocasset drains"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[37]}
{"text":"polypectomy in 2011 , tooth extraction ( all ) in 1980 , and hernia in 1977 .","problem":["hernia"],"test":[],"treatment":["tooth extraction","polypectomy"],"problem_indices_start":[61],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,22],"treatment_indices_end":[11,38]}
{"text":"in addition , the patient was prepared for an attempted percutaneous endoscopic gastrostomy tube .","problem":[],"test":[],"treatment":["an attempted percutaneous endoscopic gastrostomy tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[43],"treatment_indices_end":[96]}
{"text":"urine output of 900 cc .","problem":[],"test":["urine output"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was weaned from ventilation on postoperative day one to pressure support ventilation and then to spontaneous breathing on postoperative day two .","problem":[],"test":[],"treatment":["ventilation","pressure support ventilation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,59],"treatment_indices_end":[30,87]}
{"text":"postoperative laboratories revealed sodium was 134 , potassium was 4.1 , chloride was 102 , bicarbonate was 28 , blood urea nitrogen was 18 , creatinine was 0.8 , and glucose was 148 .","problem":[],"test":["sodium","chloride","potassium","postoperative laboratories","creatinine","bicarbonate","blood urea nitrogen","glucose"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,36,53,73,92,113,142,167],"test_indices_end":[26,42,62,81,103,132,152,174],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"triamterene\/hydrochlorothiazide 37.5\/25 mg one tablet by mouth once daily and lorazepam 1 mg three times daily as needed ( for anxiety ) .","problem":["anxiety"],"test":[],"treatment":["triamterene\/hydrochlorothiazide","lorazepam"],"problem_indices_start":[127],"problem_indices_end":[134],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,78],"treatment_indices_end":[31,87]}
{"text":"tube feedings were started 48 hours after the procedure .","problem":[],"test":[],"treatment":["tube feedings","the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,42],"treatment_indices_end":[13,55]}
{"text":"in addition , he received metoprolol q.4.h. , a regular insulin sliding scale , and adequate gastrointestinal prophylaxis with protonix .","problem":[],"test":[],"treatment":["a regular insulin sliding scale","protonix","metoprolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,46,127],"treatment_indices_end":[36,77,135]}
{"text":"nothing by mouth initially with morphine as needed for pain and ativan around the clock for delirium tremens prophylaxis .","problem":["pain"],"test":[],"treatment":["delirium tremens prophylaxis","morphine","ativan"],"problem_indices_start":[55],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32,64,92],"treatment_indices_end":[40,70,120]}
{"text":"his westwood-pocasset output for postoperative day one on the left was 60 , right neck 93 , in the arm 20 .","problem":[],"test":["his westwood-pocasset output"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. diagnostic laryngoscopy and biopsy .","problem":[],"test":["diagnostic laryngoscopy","biopsy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3,31],"test_indices_end":[26,37],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. tracheostomy .","problem":[],"test":[],"treatment":["tracheostomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"he underwent flap checks every 15 minutes initially with a dextran infusion .","problem":[],"test":["flap checks"],"treatment":["a dextran infusion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13],"test_indices_end":[24],"treatment_indices_start":[57],"treatment_indices_end":[75]}
{"text":"complete blood count revealed white count was 5.4 , hematocrit was 31.3 , and platelets were 160 .","problem":[],"test":["hematocrit","platelets","complete blood count","white count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,30,52,78],"test_indices_end":[20,41,62,87],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his tracheostomy was changed to a 6 cuffless shiley on 2016-11-26 and sutures in place with a 3-0 silk .","problem":[],"test":[],"treatment":["his tracheostomy","sutures","a 3-0 silk","a 6 cuffless shiley"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,32,70,92],"treatment_indices_end":[16,51,77,102]}
{"text":"the patient tolerated this procedure well .","problem":[],"test":[],"treatment":["this procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[36]}
{"text":"his tube feedings were advanced .","problem":[],"test":[],"treatment":["his tube feedings"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[17]}
{"text":"alt was 14 , ast was 31 , alkaline phosphatase was 42 , total bilirubin was 0.9 , albumin was 2.2 .","problem":[],"test":["ast","alkaline phosphatase","alt","total bilirubin","albumin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,26,56,82],"test_indices_end":[3,16,46,71,89],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the westwood-pocasset in his right arm was removed on 2016-11-25 .","problem":[],"test":[],"treatment":["the westwood-pocasset in his right arm"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[38]}
{"text":"the cuff on his tracheostomy tube was put down on 11-23 , postoperative day two which he tolerated well with minimal secretions and a strong adequate cough .","problem":["minimal secretions"],"test":[],"treatment":["his tracheostomy tube"],"problem_indices_start":[109],"problem_indices_end":[127],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[33]}
{"text":"lopressor 5 intravenously q.4.h.","problem":[],"test":[],"treatment":["lopressor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"tracheostomy tube in good position .","problem":[],"test":[],"treatment":["tracheostomy tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[17]}
{"text":"no pneumothorax .","problem":["pneumothorax"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"magnesium was 2.2 .","problem":[],"test":["magnesium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a chest x-ray postoperatively showed clear lung fields .","problem":[],"test":["a chest x-ray"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"calcium was 7.6 .","problem":[],"test":["calcium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he continued with pulmonary toilet and q.2h. flap checks .","problem":[],"test":["q.2h. flap checks"],"treatment":["pulmonary toilet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[39],"test_indices_end":[56],"treatment_indices_start":[18],"treatment_indices_end":[34]}
{"text":"cmed csru and plastic surgery flap checks , tracheostomy care , and westwood-pocasset management.","problem":[],"test":["flap checks"],"treatment":["westwood-pocasset management.","tracheostomy care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[30],"test_indices_end":[41],"treatment_indices_start":[44,68],"treatment_indices_end":[61,97]}
{"text":"medications per gastrostomy tube on postoperative day one .","problem":[],"test":[],"treatment":["medications","gastrostomy tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,16],"treatment_indices_end":[11,32]}
{"text":"includes hypertension and chronic obstructive pulmonary disease .","problem":["chronic obstructive pulmonary disease","hypertension"],"test":[],"treatment":[],"problem_indices_start":[9,26],"problem_indices_end":[21,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"flap checks carried out q.2h. initially in the surgical intensive care unit showing positive biphasic doppler signals .","problem":["positive biphasic doppler signals"],"test":["flap checks"],"treatment":[],"problem_indices_start":[84],"problem_indices_end":[117],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nebulizers as needed , weaning from ventilation .","problem":[],"test":[],"treatment":["nebulizers","ventilation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,36],"treatment_indices_end":[10,47]}
{"text":"he underwent a joint procedure by otolaryngology and plastic surgery .","problem":[],"test":[],"treatment":["a joint procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[30]}
{"text":"foley catheter for strict monitoring of ins and outs .","problem":[],"test":["strict monitoring of ins and outs"],"treatment":["foley catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[52],"treatment_indices_start":[0],"treatment_indices_end":[14]}
{"text":"he was admitted on 2016-11-21 following his surgery .","problem":[],"test":[],"treatment":["his surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40],"treatment_indices_end":[51]}
{"text":"he presented on 2016-11-21 for resection .","problem":[],"test":[],"treatment":["resection"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31],"treatment_indices_end":[40]}
{"text":"pathology was reviewed revealing invasive squamous cell carcinoma .","problem":["invasive squamous cell carcinoma"],"test":["pathology"],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[65],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"unasyn for antibiotic coverage .","problem":[],"test":[],"treatment":["antibiotic coverage","unasyn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,11],"treatment_indices_end":[6,30]}
{"text":"mr. jackson is a 63-year-old male with squamous cell carcinoma of the floor of mouth ( stage t2 n0 ) that was biopsied by his dentist .","problem":["stage t2 n0","squamous cell carcinoma"],"test":[],"treatment":[],"problem_indices_start":[39,87],"problem_indices_end":[62,98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hematocrit stable .","problem":[],"test":["hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hearing was diminished for conversational speech .","problem":["diminished"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no evidence of developing hydrocephalus , which was a concern due to the surrounding edema , and possible suppression of the fourth ventricle .","problem":["the surrounding edema","developing hydrocephalus","suppression of the fourth ventricle"],"test":[],"treatment":[],"problem_indices_start":[25,79,116],"problem_indices_end":[49,100,151],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"power was mildly diminished in the finger extensors and hand intrinsics on the left , otherwise , power was full throughout .","problem":["mildly diminished in the finger extensors"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"light touch was subjectively abnormal on both sides of the face .","problem":["subjectively abnormal"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"speech was fluent but slow , and there was long response latencies before she would initiate speech .","problem":["long response latencies","slow"],"test":[],"treatment":[],"problem_indices_start":[22,43],"problem_indices_end":[26,66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neurologically , she was awoken from sleep by voice , cooperative , but mildly drowsy .","problem":["mildly drowsy"],"test":[],"treatment":[],"problem_indices_start":[72],"problem_indices_end":[85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she developed an ear ache , for which she saw her primary care physician , evelyn was prescribed cortisone drops .","problem":["an ear ache"],"test":[],"treatment":["cortisone drops"],"problem_indices_start":[14],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[97],"treatment_indices_end":[112]}
{"text":"gait was wide based , very unsteady , veering to the left and to the right .","problem":["very unsteady","wide based"],"test":[],"treatment":[],"problem_indices_start":[9,22],"problem_indices_end":[19,35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she became more alert during the remainder of the exam .","problem":[],"test":["the exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[46],"test_indices_end":[54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was decreased excursion of the right mouth and flattening of the right nasolabial fold ( mild ) .","problem":["decreased excursion of the right mouth","flattening of the right nasolabial fold ( mild )"],"test":[],"treatment":[],"problem_indices_start":[10,53],"problem_indices_end":[48,101],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has had several prior bleeding events and presented with a subacute bleed in the mid to lower pons .","problem":["a subacute bleed in the mid to lower pons","several prior bleeding events"],"test":[],"treatment":[],"problem_indices_start":[12,61],"problem_indices_end":[41,102],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mrs. wisniewski is a 45 - year-old woman with a strong family history of cavernous angiomas .","problem":["cavernous angiomas"],"test":[],"treatment":[],"problem_indices_start":[73],"problem_indices_end":[91],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was a mild left pronator drift .","problem":["a mild left pronator drift"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiovascular exam revealed a regular rate and rhythm with no murmurs , rubs or gallops .","problem":["murmurs","gallops","rubs"],"test":["cardiovascular exam"],"treatment":[],"problem_indices_start":[63,73,81],"problem_indices_end":[70,77,88],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had sustained gaze holding nystagmus in both horizontal directions .","problem":["sustained gaze holding nystagmus"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. gabapentin 100 mg po t.i.d. for paresthesias .","problem":["paresthesias"],"test":[],"treatment":["gabapentin"],"problem_indices_start":[35],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"there was no rotary component .","problem":["rotary component"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. familial cavernous hemangiomas , status post a subacute pontine hemorrhage .","problem":["familial cavernous hemangiomas","a subacute pontine hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[3,48],"problem_indices_end":[33,77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has had at least two bleeding episodes in the past , mostly described as being accompanied by generalized weakness .","problem":["generalized weakness","at least two bleeding episodes"],"test":[],"treatment":[],"problem_indices_start":[12,98],"problem_indices_end":[42,118],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had a mildly widened right palpable fissure .","problem":["a mildly widened right palpable fissure"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen soft , nontender and distended .","problem":["distended","nontender"],"test":[],"treatment":[],"problem_indices_start":[15,29],"problem_indices_end":[24,38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she retropulsed and would have pitched backwards without the assistance of the examiner .","problem":["retropulsed"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her hearing got progressively worse and the sound of static increased .","problem":["progressively worse","the sound of static"],"test":[],"treatment":[],"problem_indices_start":[16,40],"problem_indices_end":[35,59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. zantac 150 mg po b.i.d.","problem":[],"test":[],"treatment":["zantac"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"extremities showed no edema .","problem":["edema"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she otherwise had normal spontaneous movements and facial expression and did not appear to be abulic .","problem":["abulic"],"test":[],"treatment":[],"problem_indices_start":[94],"problem_indices_end":[100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. colace 100 mg po b.i.d.","problem":[],"test":[],"treatment":["colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"she was never on an anticonvulsant due to her former beliefs as n. derk scientist .","problem":[],"test":[],"treatment":["an anticonvulsant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17],"treatment_indices_end":[34]}
{"text":"2. severe gait ataxia .","problem":["severe gait ataxia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was seen again by primary care physician , roderick since she had complaints of dizziness , as well as a new complaint of decreased hearing and the sensation of static in her ears , meniere 's disease was considered .","problem":["decreased hearing","static in her ears","dizziness","meniere 's disease"],"test":[],"treatment":[],"problem_indices_start":[84,126,165,186],"problem_indices_end":[93,143,183,204],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. prednisone taper completed .","problem":[],"test":[],"treatment":["prednisone taper"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[19]}
{"text":"she was very fatigued .","problem":["very fatigued"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her physical examination remained relatively unchanged , with resolution of the subtle left hand weakness and right facial weakness .","problem":["right facial weakness","the subtle left hand weakness"],"test":["her physical examination"],"treatment":[],"problem_indices_start":[76,110],"problem_indices_end":[105,131],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"therefore , it was recommended that she have aggressive physical therapy at an acute rehabilitation center .","problem":[],"test":[],"treatment":["aggressive physical therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[45],"treatment_indices_end":[72]}
{"text":"we will arrange to have a copy of the mri scans sent to him .","problem":[],"test":["the mri scans"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[34],"test_indices_end":[47],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was relatively central in location , with only a slight right-sided predominance .","problem":["a slight right-sided predominance"],"test":[],"treatment":[],"problem_indices_start":[53],"problem_indices_end":[86],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mra of the brain was unremarkable .","problem":[],"test":["mra of the brain"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her gait remained severely ataxic , likely secondary to sensory deafferentation , as well as involvement of crossing pontine cerebellar fibers .","problem":["severely ataxic","sensory deafferentation","crossing pontine cerebellar fibers"],"test":[],"treatment":[],"problem_indices_start":[18,56,108],"problem_indices_end":[33,79,142],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no areas of restricted diffusion to indicate infarction .","problem":["areas of restricted diffusion","infarction"],"test":[],"treatment":[],"problem_indices_start":[13,55],"problem_indices_end":[42,65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"follow-up ct was obtained the second day of admission .","problem":[],"test":["follow-up ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was a large focus of subacute blood products in the mid to low pons suggesting recent hemorrhage into a cavernous angioma .","problem":["subacute blood products in the mid to low pons","recent hemorrhage into a cavernous angioma"],"test":[],"treatment":[],"problem_indices_start":[27,85],"problem_indices_end":[73,127],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white blood cell count 7.8 with 86% polymorphonuclear cells , 11.1 lymphocytes , hemoglobin 14.3 , hematocrit 40.5 , mcv 88 , inr 1.0 , ptt 24.7 , pt 12.3 , platelet count 295,000 , glucose 81 , bun 15 , creatinine 0.8 , sodium 142 , potassium 4.2 , chloride 104 , co2 26 , calcium 9.3 , phosphate 4.8 , magnesium 2.3 .","problem":[],"test":["pt","co2","potassium","chloride","hematocrit","calcium","phosphate","hemoglobin","platelet count","polymorphonuclear cells","inr","lymphocytes","mcv","creatinine","ptt","white blood cell count","glucose","bun","magnesium","sodium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,36,67,81,99,117,126,136,147,157,182,195,204,221,234,250,265,274,288,304],"test_indices_end":[22,59,78,91,109,120,129,139,149,171,189,198,214,227,243,258,268,281,297,313],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"notable for multiple cavernous hemangiomas .","problem":["multiple cavernous hemangiomas"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"finger tapping and rapid alternating movements were slow on the left and she had trouble isolating individual finger movements .","problem":["slow on the left","trouble isolating individual finger movements"],"test":["rapid alternating movements","finger tapping"],"treatment":[],"problem_indices_start":[52,81],"problem_indices_end":[68,126],"test_indices_start":[0,19],"test_indices_end":[14,46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"these were seen best in gradient echocardiogram images .","problem":[],"test":["gradient echocardiogram images"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24],"test_indices_end":[54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mri of the brain revealed multiple foci susceptibility artifact within the brain .","problem":["multiple foci susceptibility artifact within the brain"],"test":["mri of the brain"],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[80],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was mostly described as feeling unsteady on her feet .","problem":["unsteady on her feet"],"test":[],"treatment":[],"problem_indices_start":[37],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no communication >.......< in the visualized vessels and the angiomas .","problem":["angiomas"],"test":[],"treatment":[],"problem_indices_start":[71],"problem_indices_end":[79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she made mistakes with position sense , roughly at chance level with both great toes and the left first finger , position sense in the right limb seems preserved .","problem":["mistakes with position sense"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this unsteady gait progressed , and then she subsequently started to develop a pins and needle feeling in the face , hands and feet bilaterally .","problem":["this unsteady gait","a pins and needle feeling in the face , hands and feet bilaterally"],"test":[],"treatment":[],"problem_indices_start":[0,77],"problem_indices_end":[18,143],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a few days later she complained of dizziness .","problem":["dizziness"],"test":[],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no dysarthria .","problem":["dysarthria"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was given an oral prednisone taper .","problem":[],"test":[],"treatment":["an oral prednisone taper"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[38]}
{"text":"she had bilateral upgoing toes .","problem":["bilateral upgoing toes"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at an outside hospital , head ct revealed a 1.5 cm diameter hyperdense mass in the pons , slightly off center to the right .","problem":["a 1.5 cm diameter hyperdense mass in the pons"],"test":["head ct"],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[87],"test_indices_start":[25],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no evidence of any special neglect .","problem":["any special neglect"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in general , she was a thin well-appearing woman in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[55],"problem_indices_end":[69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has had at least two generalized seizures in the past , but she has not had one since she was 26 years old .","problem":["at least two generalized seizures"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sclera were anicteric .","problem":["anicteric"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"respiratory rate 14 .","problem":[],"test":["respiratory rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mrs. wisniewski is a 45-year-old woman with multiple familial cavernous hemangiomas .","problem":["multiple familial cavernous hemangiomas"],"test":[],"treatment":[],"problem_indices_start":[44],"problem_indices_end":[83],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pulse 60 .","problem":[],"test":["pulse"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[5],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood pressure 120\/80 .","problem":[],"test":["blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"temperature 99.2 .","problem":[],"test":["temperature"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"strong maternal history of hemangiomas .","problem":["hemangiomas"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was some mild surrounding edema .","problem":["some mild surrounding edema"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"prednisone taper as above .","problem":[],"test":[],"treatment":["prednisone taper"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"there was no significant change in size of the subacute pontine hemorrhage .","problem":["the subacute pontine hemorrhage","significant change in size"],"test":[],"treatment":[],"problem_indices_start":[13,43],"problem_indices_end":[39,74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"reflexes were brisk in the legs with 4-5 beats of clonus at the ankles bilaterally .","problem":["clonus at the ankles bilaterally"],"test":["reflexes"],"treatment":[],"problem_indices_start":[50],"problem_indices_end":[82],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there are also tiny foci artifact within the cerebellum and base of the pons .","problem":["tiny foci artifact within the cerebellum and base of the pons"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was a larger area of susceptibility artifact in the left temporal lobe , right frontal lobe , and the splenius of the corpus collasum .","problem":["susceptibility artifact in the left temporal lobe , right frontal lobe , and the splenius of the corpus collasum"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[139],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was mild finger-to-nose dysmetria on the left .","problem":["mild finger-to-nose dysmetria on the left"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was mild enhancement of the pontine hemorrhagic mass but none elsewhere .","problem":["mild enhancement of the pontine hemorrhagic mass"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was initially admitted to cmed for resection and repair of this left facial lesion .","problem":["this left facial lesion"],"test":[],"treatment":["resection","repair"],"problem_indices_start":[62],"problem_indices_end":[85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38,52],"treatment_indices_end":[47,58]}
{"text":"he tolerated the procedure well with no complications except postoperatively , his voice was hoarse .","problem":["hoarse","complications"],"test":[],"treatment":["the procedure"],"problem_indices_start":[40,93],"problem_indices_end":[53,99],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[26]}
{"text":"minimal bleeding .","problem":["minimal bleeding"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head , eyes , ears , nose and throat , polypoid lesion just inferior to the left zygoma , elevated superiorly , with visible bone .","problem":["visible bone","polypoid lesion"],"test":[],"treatment":[],"problem_indices_start":[39,117],"problem_indices_end":[54,129],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he is being discharged to rehabilitation to follow up for xrt given the fact that his pathology revealed squamous cell cancer extending deep to the margin as well as positive level ii nodes .","problem":["squamous cell cancer","positive level ii nodes"],"test":["his pathology"],"treatment":["xrt"],"problem_indices_start":[105,166],"problem_indices_end":[125,189],"test_indices_start":[82],"test_indices_end":[95],"treatment_indices_start":[58],"treatment_indices_end":[61]}
{"text":"on examination , he is afebrile .","problem":["afebrile"],"test":["examination"],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[31],"test_indices_start":[3],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dr. navarrete has been e-mailed and his secretary contacted for as soon as possible appointment for xrt follow up .","problem":[],"test":[],"treatment":["xrt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[100],"treatment_indices_end":[103]}
{"text":"4. aeroseb .","problem":[],"test":[],"treatment":["aeroseb"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"foley was also discontinued .","problem":[],"test":[],"treatment":["foley"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"urology also followed him and kept him on antibiotics until postoperative day #7 at which point antibiotics were discontinued .","problem":[],"test":[],"treatment":["antibiotics","antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[42,96],"treatment_indices_end":[53,107]}
{"text":"this revealed some supraglottic edema which revealed with time , without further intervention .","problem":["some supraglottic edema"],"test":[],"treatment":["further intervention"],"problem_indices_start":[14],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[73],"treatment_indices_end":[93]}
{"text":"on scoping him he had significant supraglottic edema .","problem":["significant supraglottic edema"],"test":["scoping"],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[52],"test_indices_start":[3],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was followed by plastic surgery for his split thickness skin graft and his bolster was discontinued on postoperative day #5 with good take up of his skin graft .","problem":[],"test":[],"treatment":["his bolster","his split thickness skin graft","his skin graft"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39,74,148],"treatment_indices_end":[69,85,162]}
{"text":"he then went to the operating room on 2016-03-14 where he had resection of the left face squamous cell cancer by dr. langhorne and split thickness and full thickness skin grafting of the defects on 2016-03-14 .","problem":["the left face squamous cell cancer","the defects"],"test":[],"treatment":["resection","split thickness and full thickness skin grafting"],"problem_indices_start":[75,183],"problem_indices_end":[109,194],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[62,131],"treatment_indices_end":[71,179]}
{"text":"he was kept in the unit for observation of his airway and b.i.d. laryngoscopy .","problem":[],"test":["observation of his airway","laryngoscopy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[28,65],"test_indices_end":[53,77],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he went to the operating room on 2016-03-10 with urology for hematuria where he had a cystoscopy transurethral resection of prostate placement .","problem":["hematuria"],"test":[],"treatment":["a cystoscopy transurethral resection of prostate placement"],"problem_indices_start":[61],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[84],"treatment_indices_end":[142]}
{"text":"elderly man , somewhat cachectic .","problem":["somewhat cachectic"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his past medical history is significant for prostate cancer , benign prostatic hypertrophy , hypothyroidism , status post radiation for non hodgkin 's lymphoma , chronic painless hematuria , degenerative joint disease and history of a murmur .","problem":["benign prostatic hypertrophy","prostate cancer","degenerative joint disease","chronic painless hematuria","a murmur","non hodgkin 's lymphoma","hypothyroidism"],"test":[],"treatment":["radiation"],"problem_indices_start":[44,62,93,136,162,191,233],"problem_indices_end":[59,90,107,159,188,217,241],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[122],"treatment_indices_end":[131]}
{"text":"nontender , nondistended .","problem":["nontender","nondistended"],"test":[],"treatment":[],"problem_indices_start":[0,12],"problem_indices_end":[9,24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"clear to auscultation .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[9],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. proscar .","problem":[],"test":[],"treatment":["proscar"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"vital signs , stable .","problem":[],"test":["vital signs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. ancef .","problem":[],"test":[],"treatment":["ancef"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"last colonoscopy , five years ago .","problem":[],"test":["colonoscopy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[5],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no exudate .","problem":["exudate"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. levothyroxine .","problem":[],"test":[],"treatment":["levothyroxine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"2. lasix .","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"dementia .","problem":["dementia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is an 85 year old man initially admitted to the plastic surgery service for evaluation of a left facial mass .","problem":["a left facial mass"],"test":["evaluation"],"treatment":[],"problem_indices_start":[95],"problem_indices_end":[113],"test_indices_start":[81],"test_indices_end":[91],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he also had consults from urology for his hematuria as well as medicine preoperatively and cmed ccu .","problem":["his hematuria"],"test":[],"treatment":[],"problem_indices_start":[38],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"postop course c\/b right upper extremity dvt and postop afib .","problem":["postop afib","right upper extremity dvt"],"test":[],"treatment":[],"problem_indices_start":[18,48],"problem_indices_end":[43,59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"over the next several days the patient was maintained on argatrobanwhile coumadin therapy was initiated .","problem":[],"test":[],"treatment":["coumadin therapy","argatrobanwhile"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[57,73],"treatment_indices_end":[72,89]}
{"text":"? sleep apnea","problem":["sleep apnea"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt - 15.0 * ptt - 107.1 * inr ( pt )- 1.3 *","problem":[],"test":["ptt","pt","inr ( pt )-"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,12,26],"test_indices_end":[2,15,37],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"s\/p 2 surgs. for spermatocele","problem":["spermatocele"],"test":[],"treatment":["2 surgs."],"problem_indices_start":[17],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"in er c\/o dyspnea and was noted to have mental status changes .","problem":["dyspnea","mental status changes"],"test":[],"treatment":[],"problem_indices_start":[10,40],"problem_indices_end":[17,61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"calcium - 8.8 phosphate - 3.9 magnesium - 2.4","problem":[],"test":["magnesium","phosphate","calcium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,14,30],"test_indices_end":[7,23,39],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cv : rrr s1-s2 , no murmur .","problem":["murmur"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"keflex \/ heparin agents","problem":[],"test":[],"treatment":["heparin agents","keflex"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,9],"treatment_indices_end":[6,23]}
{"text":"htn","problem":["htn"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cv:rrr s1-s2 , no mrg","problem":["mrg"],"test":[],"treatment":[],"problem_indices_start":[18],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"post-op afib","problem":["post-op afib"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"glucose - 193 * urea n - 23 * creat - 1.2 sodium - 138 potassium - 4.6 chloride - 101 total co2 - 21 * anion gap - 21 *","problem":[],"test":["creat","glucose","anion gap","total co2","urea n","potassium","sodium","chloride"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,30,42,55,71,86,103],"test_indices_end":[7,22,35,48,64,79,95,112],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdm : soft nt \/ nd \/ nabs","problem":["nt","nd"],"test":[],"treatment":[],"problem_indices_start":[12,17],"problem_indices_end":[14,19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ext : warm well perfused no cce","problem":["cce"],"test":[],"treatment":[],"problem_indices_start":[28],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdm : soft , nt\/nd\/nabs","problem":["nt\/nd\/nabs"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"then referred to er for tx","problem":[],"test":[],"treatment":["tx"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[26]}
{"text":"wbc - 13.3 *# rbc - 3.45 * hgb - 10.6 * hct - 30.5 * mcv - 88 mch - 30.6 mchc - 34.7 rdw - 12.7","problem":[],"test":["mcv","hgb","hct","mchc","rdw","rbc","wbc","mch"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,14,27,40,53,62,73,85],"test_indices_end":[3,17,30,43,56,65,77,88],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"seasonal allergies","problem":["seasonal allergies"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"discharge pe","problem":[],"test":["discharge pe"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"renal calculi","problem":["renal calculi"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ext : + distal pulses , no edema","problem":["edema"],"test":["distal pulses"],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[32],"test_indices_start":[8],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"amiodarone 200 '","problem":[],"test":[],"treatment":["amiodarone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"vs : t 99 hr 68 bp 113\/72 rr 18 sat 98% ra","problem":[],"test":["bp","vs","hr","t","rr","sat"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,5,10,16,26,32],"test_indices_end":[2,6,12,18,28,35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vs : hr 103 bp 162\/69 rr 14 sat 92% ra","problem":[],"test":["bp","hr","rr","vs","sat"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,5,12,22,28],"test_indices_end":[2,7,14,24,31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. amoxicillin-pot clavulanate 875-125 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ) for 10 days .","problem":[],"test":[],"treatment":["amoxicillin-pot clavulanate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[30]}
{"text":"non-contributory for premature cad ; father had mi in his 70 's","problem":["mi","premature cad"],"test":[],"treatment":[],"problem_indices_start":[21,48],"problem_indices_end":[34,50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lopressor 50 \"","problem":[],"test":[],"treatment":["lopressor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"blood wbc - 12.9 * rbc - 3.37 * hgb - 10.4 * hct - 29.4 * mcv - 87 mch - 30.8 mchc - 35.3 * rdw - 13.3 plt ct - 345","problem":[],"test":["hgb","rbc","blood wbc","mch","hct","mcv","mchc","rdw","plt ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,19,32,45,58,67,78,92,103],"test_indices_end":[9,22,35,48,61,70,82,95,109],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. metoprolol tartrate 50 mg tablet sig :one ( 1 ) tablet po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["metoprolol tartrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"2. atorvastatin 10 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["atorvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"chief complaint : pt sent to er after routine f\/u for ue dvt with vascular surgery .","problem":["ue dvt"],"test":[],"treatment":[],"problem_indices_start":[54],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood pt - 39.1 * inr ( pt )- 4.4 *","problem":[],"test":["inr ( pt )-","blood pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,18],"test_indices_end":[8,29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. aspirin 81 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po daily ( daily ) .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"during er evaluation pt was noted to have some degree of dyspnea as well as mental status changes , including loss of short term memory and brief unresponsive period after one dose of iv benadry and steroids prior to ct scan .","problem":["mental status changes","loss of short term memory","brief unresponsive period","dyspnea"],"test":["ct scan","er evaluation"],"treatment":["steroids","iv benadry"],"problem_indices_start":[57,76,110,140],"problem_indices_end":[64,97,135,165],"test_indices_start":[7,217],"test_indices_end":[20,224],"treatment_indices_start":[184,199],"treatment_indices_end":[194,207]}
{"text":"the pt was begun on heparin gtt and was noted to have platelet drop > 50% after infusion began , hepain was d\/c 'd.","problem":["platelet drop"],"test":[],"treatment":["infusion","heparin gtt","hepain"],"problem_indices_start":[54],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20,80,97],"treatment_indices_end":[31,88,103]}
{"text":"6. warfarin 2 mg tablet sig : 1.5 tablets po as directed : 3 mg 1943-05-29 and 6\/1 then as directed by dr mace .","problem":[],"test":[],"treatment":["warfarin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"argatroban was started abd a hit panel was sent , hit panel was positive .","problem":["positive"],"test":["hit panel","a hit panel"],"treatment":["argatroban"],"problem_indices_start":[64],"problem_indices_end":[72],"test_indices_start":[27,50],"test_indices_end":[38,59],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"5. amiodarone 200 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["amiodarone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"discharge diagnosis : s\/p avr 05-14 ( tissue ) readmitted 05-24 w\/ pulmonary embolism , rue dvt , hit positive","problem":["pulmonary embolism","rue dvt","hit positive"],"test":[],"treatment":["avr"],"problem_indices_start":[67,88,98],"problem_indices_end":[85,95,110],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[29]}
{"text":"asa 81 '","problem":[],"test":[],"treatment":["asa"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[3]}
{"text":"neurology was consulted and the pt also had mri which was negative .","problem":[],"test":["mri"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[44],"test_indices_end":[47],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pmh : htn , renal calculi , sleep apnea ,","problem":["htn","renal calculi","sleep apnea"],"test":[],"treatment":[],"problem_indices_start":[6,12,28],"problem_indices_end":[9,25,39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"follow-up inr to be drawn 06-01 , by dr lewis @ 597-4427","problem":[],"test":["follow-up inr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"atorvastatin 10 '","problem":[],"test":[],"treatment":["atorvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"take all medications as prescribed .","problem":[],"test":[],"treatment":["all medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[5],"treatment_indices_end":[20]}
{"text":"discharge instructions : keep wounds clean and dry .","problem":["wounds"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood heparin dependent antibodies - positive","problem":[],"test":["blood heparin dependent antibodies"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"avr ( tissue ) 05-14","problem":[],"test":[],"treatment":["avr ( tissue )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[14]}
{"text":"he was to have f\/u inr check with dr lewis on 05-31 .","problem":[],"test":["inr check"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"admission pe","problem":[],"test":["admission pe"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt admitted 05-24 from er after positive rue dvt finding in vascular lab .","problem":["positive rue dvt"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the ct was negative for cva but positive for pulmonary embolism .","problem":["pulmonary embolism","cva"],"test":["the ct"],"treatment":[],"problem_indices_start":[24,45],"problem_indices_end":[27,63],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neuro : mae , follows commands , slightly confused","problem":["slightly confused"],"test":[],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent : perrl\/eomi , no jvd","problem":["jvd"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on hd#6 the pt had a therapeudic inr ( 4.4 ) off argatroban and wad discharged home .","problem":[],"test":["a therapeudic inr"],"treatment":["argatroban"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[36],"treatment_indices_start":[49],"treatment_indices_end":[59]}
{"text":"at that time had ue duplex which revealed rue dvt involving ij , axillary , subclav , brachial , and basilic veins .","problem":["rue dvt"],"test":["ue duplex"],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[49],"test_indices_start":[17],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was transferred to csru for evaluation .","problem":[],"test":["evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[31],"test_indices_end":[41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"s\/p avr 05-14 .","problem":[],"test":[],"treatment":["avr"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[7]}
{"text":"by the following mornig all mental status changes had cleared and the pt was transferred to the floors for continued care .","problem":["all mental status changes"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"s\/p oral surgery","problem":[],"test":[],"treatment":["oral surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[16]}
{"text":"s\/p avr ( #27 pericardial )","problem":[],"test":[],"treatment":["avr"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[7]}
{"text":"lisinopril 5 '","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"the pt was given ceftriaxone \/ azithromycin \/ vancomycin in deanna .","problem":[],"test":[],"treatment":["azithromycin","ceftriaxone","vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17,31,46],"treatment_indices_end":[28,43,56]}
{"text":"1. no definite pulmonary embolism is identified .","problem":["definite pulmonary embolism"],"test":[],"treatment":[],"problem_indices_start":[6],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sputum culture also returned with staph. aureus .","problem":["staph. aureus"],"test":["sputum culture"],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[47],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ceftriaxone and azithro were discontinued , and vacomycin was continued .","problem":[],"test":[],"treatment":["ceftriaxone","vacomycin","azithro"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,16,48],"treatment_indices_end":[11,23,57]}
{"text":"cxr 2013-12-24 - there are faint ill-defined opacities within the right lower lung zone and left upper lung zone could represent a multifocal pneumonic process .","problem":["faint ill-defined opacities","a multifocal pneumonic process"],"test":["cxr"],"treatment":[],"problem_indices_start":[27,129],"problem_indices_end":[54,159],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neuts - 78.0 * lymphs - 17.0 * monos - 4.6 eos - 0.3 basos - 0.1","problem":[],"test":["monos","lymphs","neuts","basos","eos"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,15,31,43,53],"test_indices_end":[5,21,36,46,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cxr 2014-01-02 - impression :","problem":[],"test":["cxr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"removal of tunneled cath ( previously used for tpn )","problem":[],"test":[],"treatment":["tpn","removal of tunneled cath"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,47],"treatment_indices_end":[24,50]}
{"text":"this is consistent with the remainder of the pt 's history including fever , chills , sob and an elevated wbc count .","problem":["sob","chills","an elevated wbc count","fever"],"test":[],"treatment":[],"problem_indices_start":[69,77,86,94],"problem_indices_end":[74,83,89,115],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"multilobar pneumonia with interval worsening in the left lung but slight improvement in the right lower lobe .","problem":["interval worsening in the left lung","multilobar pneumonia"],"test":[],"treatment":[],"problem_indices_start":[0,26],"problem_indices_end":[20,61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head ct 2014-01-09 - ordered to evaluate for changes to explain delta ms","problem":["delta ms"],"test":["head ct"],"treatment":[],"problem_indices_start":[64],"problem_indices_end":[72],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the acute onset of chest pain was initially very concerning for a pe , however the chest ct demonstrated multifocal consolidation consistent with a bacterial pna .","problem":["multifocal consolidation","a bacterial pna","the acute onset of chest pain","a pe"],"test":["the chest ct"],"treatment":[],"problem_indices_start":[0,64,105,146],"problem_indices_end":[29,68,129,161],"test_indices_start":[79],"test_indices_end":[91],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"these findings are consistent with chronic pancreatitis with pseudocyst formation","problem":["chronic pancreatitis","pseudocyst formation"],"test":[],"treatment":[],"problem_indices_start":[35,61],"problem_indices_end":[55,81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left parietal subcortical hypodensity , likely ischemic .","problem":["ischemic","left parietal subcortical hypodensity"],"test":[],"treatment":[],"problem_indices_start":[0,47],"problem_indices_end":[37,55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no definite changes since the mr of in 2011-05-15 .","problem":["definite changes"],"test":["the mr"],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[19],"test_indices_start":[26],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"54 yo f with crohn 's disease s\/p ileostomy with subsequent short gut syndrome with port-o-cath for tpn presents with acute onset pleuritic chest pain with fever , chills , and sob .","problem":["sob","acute onset pleuritic chest pain","chills","short gut syndrome","crohn 's disease","fever"],"test":[],"treatment":["port-o-cath","ileostomy","tpn"],"problem_indices_start":[13,60,118,156,164,177],"problem_indices_end":[29,78,150,161,170,180],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34,84,100],"treatment_indices_end":[43,95,103]}
{"text":"2. clonazepam 1 mg qam , 1 mg q3pm , 2 mg po qhs","problem":[],"test":[],"treatment":["clonazepam"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"6. nystatin 100,000 unit \/ g cream sig : one ( 1 ) appl topical bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["nystatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"7. lansoprazole 30 mg capsule , delayed release ( e.c. ) sig : one ( 1 ) capsule , delayed release ( e.c. ) po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["lansoprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"a second 9 mm cystic lesion is seen in the head of the pancreas .","problem":["a second 9 mm cystic lesion"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ppx : ppi and heparin sc","problem":[],"test":[],"treatment":["heparin sc","ppi"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6,14],"treatment_indices_end":[9,24]}
{"text":"8. quetiapine 100 mg tablet sig : three ( 3 ) tablet po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["quetiapine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"v : 101.4 , 102 , 167\/54 -> 159\/77 , 24 -> 16 , 98% ra -> 96% ra","problem":[],"test":["v"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[1],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. propranolol 10 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["propranolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"father - stephanie tumor , no dm , no cad","problem":["dm","cad","stephanie tumor"],"test":[],"treatment":[],"problem_indices_start":[9,30,38],"problem_indices_end":[24,32,41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"absomen soft , tender to palpation over ruq , but no guarding or rebound","problem":["guarding","tender","rebound"],"test":["palpation over ruq"],"treatment":[],"problem_indices_start":[15,53,65],"problem_indices_end":[21,61,72],"test_indices_start":[25],"test_indices_end":[43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10. neurontin 300 mg capsule sig : three ( 3 ) capsule po three times a day : take 2 tabs in the morining , 4 tabs in the afternoon , and 4 tabs in the evening .","problem":[],"test":[],"treatment":["neurontin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"pneumonia","problem":["pneumonia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. quetiapine 300 mg qhs","problem":[],"test":[],"treatment":["quetiapine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"please continue taking your medications as prescribed .","problem":[],"test":[],"treatment":["your medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[39]}
{"text":"9. vistaril 50 mg once a day as needed for nausea .","problem":["nausea"],"test":[],"treatment":["vistaril"],"problem_indices_start":[43],"problem_indices_end":[49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"2. peripheral patchy opacities are seen bilaterally , most consistent with multifocal pneumonia .","problem":["multifocal pneumonia","peripheral patchy opacities"],"test":[],"treatment":[],"problem_indices_start":[3,75],"problem_indices_end":[30,95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10. zofran 4 mg po once a day as needed for nausea .","problem":["nausea"],"test":[],"treatment":["zofran"],"problem_indices_start":[44],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"wbc - 14.4 *# rbc - 3.82 * hgb - 11.5 * hct - 33.5 * mcv - 88 mch - 30.2 mchc - 34.5 rdw - 14.7","problem":[],"test":["hct","mcv","rbc","hgb","rdw","mch","mchc","wbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,14,27,40,53,62,73,85],"test_indices_end":[3,17,30,43,56,65,77,88],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. carbidopa-levodopa 25 - 250 mg tablet sig : one ( 1 ) tablet po 5 times a day ( ) .","problem":[],"test":[],"treatment":["carbidopa-levodopa"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[21]}
{"text":"plt count - 128 *","problem":[],"test":["plt count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. pramipexole 0.125 mg tablet sig : one ( 1 ) tablet po tid ( 3 times a day ) .","problem":[],"test":[],"treatment":["pramipexole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"cta 2013-12-24 - impression :","problem":[],"test":["cta"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abd ct performed 09-01 showed multiple calcifications in the body and tail of the pancreas with a larger cystic lesion in the tail of the pancreas .","problem":["a larger cystic lesion in the tail of the pancreas","multiple calcifications in the body and tail of the pancreas"],"test":["abd ct"],"treatment":[],"problem_indices_start":[30,96],"problem_indices_end":[90,146],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. clonazepam 1 mg tablet sig : one ( 1 ) tablet po tid ( 3 times a day ) .","problem":[],"test":[],"treatment":["clonazepam"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"pt - 12.3 ptt - 26.1 inr ( pt )- 1.0","problem":[],"test":["pt","ptt","inr ( pt )-"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,21],"test_indices_end":[2,13,32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was maintained sinemet .","problem":[],"test":[],"treatment":["sinemet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[34]}
{"text":"she was also given morphine 2 mg x3 , 4 mg iv x2 , dolasetron 12.5 mg x2 and ativan 1 mg iv x1 .","problem":[],"test":[],"treatment":["ativan","morphine","dolasetron"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,51,77],"treatment_indices_end":[27,61,83]}
{"text":"2. hx of multiple port-o-cath clots :","problem":["multiple port-o-cath clots"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. crohn 's disease , dx 1974 s\/p three bowel resections and eventual ileostomy , resulting in short gut syndrome","problem":["crohn 's disease","short gut syndrome"],"test":[],"treatment":["three bowel resections","eventual ileostomy"],"problem_indices_start":[3,95],"problem_indices_end":[19,113],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34,61],"treatment_indices_end":[56,79]}
{"text":"on admission she was taking quetiapine 300 mg qhs and clonazepam 1 mg qam , 1 mg q3pm , 2 mg po qhs .","problem":[],"test":[],"treatment":["clonazepam","quetiapine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28,54],"treatment_indices_end":[38,64]}
{"text":"the patient refused an lp .","problem":[],"test":["an lp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a head ct was done which ruled out any acute processes .","problem":["any acute processes"],"test":["a head ct"],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[54],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"they attributed it to polypharmacy , recent infection ( pneumonia ) and insomnia .","problem":["polypharmacy","recent infection ( pneumonia )","insomnia"],"test":[],"treatment":[],"problem_indices_start":[22,37,72],"problem_indices_end":[34,67,80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. restless leg syndrome","problem":["restless leg syndrome"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"although the pt is on warfarin chronically , her inr was subtherapeutic .","problem":[],"test":["her inr"],"treatment":["warfarin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[45],"test_indices_end":[52],"treatment_indices_start":[22],"treatment_indices_end":[30]}
{"text":"ileostomy bag present with gas and stool .","problem":[],"test":[],"treatment":["ileostomy bag"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"8. prevacid 30 mg po twice a day .","problem":[],"test":[],"treatment":["prevacid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"( home regimen , gabapentin 800 mg po qam , 1600 mg po q3pm , 1600 mg po qhs .","problem":[],"test":[],"treatment":["gabapentin","home regimen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2,17],"treatment_indices_end":[14,27]}
{"text":"3. ? parkinsons vs. eps side effects from risperdal","problem":["parkinsons","eps side effects"],"test":[],"treatment":["risperdal"],"problem_indices_start":[5,20],"problem_indices_end":[15,36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[42],"treatment_indices_end":[51]}
{"text":"initially coumadin was increased , however given concern for infected line , general surgery was consulted who removed the line in the icu .","problem":["infected line"],"test":[],"treatment":["coumadin","the line"],"problem_indices_start":[61],"problem_indices_end":[74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10,119],"treatment_indices_end":[18,127]}
{"text":"pt initially with mild ari , this was thought to be due to dehydration , after initial volume repletion her renal function improved to her baseline .","problem":["dehydration","mild ari"],"test":[],"treatment":["initial volume repletion"],"problem_indices_start":[18,59],"problem_indices_end":[26,70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[79],"treatment_indices_end":[103]}
{"text":"as the cxr was without any evidence of pna , or ptx , the pt subsequently received a cta to evaluate for pe which revealed multifocal bilateral pna but no pe .","problem":["multifocal bilateral pna","pe","pe","ptx","pna"],"test":["a cta","the cxr"],"treatment":[],"problem_indices_start":[39,48,105,123,155],"problem_indices_end":[42,51,107,147,157],"test_indices_start":[3,83],"test_indices_end":[10,88],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had completed her antibiotic course while in house .","problem":[],"test":[],"treatment":["her antibiotic course"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[47]}
{"text":"at this time , she was given vancomycin 1 g iv x1 .","problem":[],"test":[],"treatment":["vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[39]}
{"text":"they felt that her presentation was secondary to delirium and was multifactorial .","problem":["delirium"],"test":[],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"54 yo f with crohn 's s\/p ileostomy and subsequent short gut syndrome with port-a-cath placement for tpn who presents with progressive right sided chest pain that comes in waves .","problem":["progressive right sided chest pain","crohn 's","short gut syndrome"],"test":[],"treatment":["port-a-cath placement","tpn","ileostomy"],"problem_indices_start":[13,51,123],"problem_indices_end":[21,69,157],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,75,101],"treatment_indices_end":[35,96,104]}
{"text":"8. paranoia \/ depression , h\/o auditory hallucinations , ? mania","problem":["depression","mania","auditory hallucinations","paranoia"],"test":[],"treatment":[],"problem_indices_start":[3,14,31,59],"problem_indices_end":[11,24,54,64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"quetiapine was continued however clonipin was initially held when she was intubated on fentynyl \/ versed .","problem":[],"test":[],"treatment":["versed","quetiapine","clonipin","intubated","fentynyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,33,74,87,98],"treatment_indices_end":[10,41,83,95,104]}
{"text":"3. arf :","problem":["arf"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt initially was hypoxic requiring nrb for o2 sat of 94% , with any attempt to wean she would desat .","problem":["hypoxic"],"test":["o2 sat"],"treatment":["nrb"],"problem_indices_start":[17],"problem_indices_end":[24],"test_indices_start":[43],"test_indices_end":[49],"treatment_indices_start":[35],"treatment_indices_end":[38]}
{"text":"6. degenerative disc disease s\/p two back surgeries in 80 's","problem":["degenerative disc disease"],"test":[],"treatment":["two back surgeries"],"problem_indices_start":[3],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[33],"treatment_indices_end":[51]}
{"text":"mother-crohn 's ; daugher-ibs , colitis ; mother -- breast ca ,;","problem":["mother-crohn 's","breast ca","daugher-ibs","colitis"],"test":[],"treatment":[],"problem_indices_start":[0,18,32,52],"problem_indices_end":[15,29,39,61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"earlier that day pt had a chest x ray which showed diffuse infiltrative process concerning for ards .","problem":["ards","diffuse infiltrative process"],"test":["a chest x ray"],"treatment":[],"problem_indices_start":[51,95],"problem_indices_end":[79,99],"test_indices_start":[24],"test_indices_end":[37],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she self extubated the first day and was reintubated without any complications .","problem":["any complications"],"test":[],"treatment":[],"problem_indices_start":[61],"problem_indices_end":[78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"( the tunneled catheter later came back for negative for culture. )","problem":[],"test":["culture."],"treatment":["the tunneled catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[57],"test_indices_end":[65],"treatment_indices_start":[2],"treatment_indices_end":[23]}
{"text":"the pt has a history of paranoia \/ depression .","problem":["depression","paranoia"],"test":[],"treatment":[],"problem_indices_start":[24,35],"problem_indices_end":[32,45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abd : obese , multiple surgical scars .","problem":["obese","multiple surgical scars"],"test":[],"treatment":[],"problem_indices_start":[6,14],"problem_indices_end":[11,37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. chronic idiopathic pancreatitis , as demonstrated on ct in 09-01","problem":["chronic idiopathic pancreatitis"],"test":["ct"],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[34],"test_indices_start":[56],"test_indices_end":[58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. arthritis s\/p \" pin placement \" in left foot 05-01","problem":["arthritis"],"test":[],"treatment":["\" pin placement \" in left foot"],"problem_indices_start":[3],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17],"treatment_indices_end":[47]}
{"text":"you are to return to the hospital immediately if you should experience any chest pain , shortness of breath , fevers or any other worrisome symptom .","problem":["any other worrisome symptom","any chest pain","shortness of breath","fevers"],"test":[],"treatment":[],"problem_indices_start":[71,88,110,120],"problem_indices_end":[85,107,116,147],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after removal of tunneled line pt was given tube feeds while she was intubated .","problem":[],"test":[],"treatment":["tube feeds","tunneled line","intubated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17,44,69],"treatment_indices_end":[30,54,78]}
{"text":"it is associated with sob as well as fevers , chills .","problem":["sob","fevers","chills"],"test":[],"treatment":[],"problem_indices_start":[22,37,46],"problem_indices_end":[25,43,52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"post procedure pt remained intubated on ardsnet protocol .","problem":[],"test":[],"treatment":["ardsnet protocol","procedure","intubated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[5,27,40],"treatment_indices_end":[14,36,56]}
{"text":"haldol \/ compazine \/ phenergan \/ tigan \/ flagyl","problem":[],"test":[],"treatment":["haldol","tigan","compazine","flagyl","phenergan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,9,21,33,41],"treatment_indices_end":[6,18,30,38,47]}
{"text":"the pt reports sharp 10\/10 chest pain under the right breast which is getting progressively worse .","problem":["sharp 10\/10 chest pain under the right breast"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's narcotic and cmed ccu regimen was evaluated by psychiatry during her delirium .","problem":["her delirium"],"test":["patient"],"treatment":["cmed ccu regimen","the patient 's narcotic"],"problem_indices_start":[80],"problem_indices_end":[92],"test_indices_start":[4],"test_indices_end":[11],"treatment_indices_start":[0,28],"treatment_indices_end":[23,44]}
{"text":"given her hx of ileostomy secondary to crohn 's disease and resultant short gut syndrome , the pt requires nutritional support via tpn .","problem":["crohn 's disease","short gut syndrome"],"test":[],"treatment":["ileostomy","nutritional support","tpn"],"problem_indices_start":[39,70],"problem_indices_end":[55,88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16,107,131],"treatment_indices_end":[25,126,134]}
{"text":"the pain is worsened with deep inspiration or movement .","problem":["the pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest : crackles at right base with dec. air movement .","problem":["dec. air movement","crackles at right base"],"test":[],"treatment":[],"problem_indices_start":[8,36],"problem_indices_end":[30,53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. port-a-cath placement for iv hydration in setting of short gut syndrome , complicated by clotting x 4 , requiring replacement","problem":["clotting","short gut syndrome"],"test":[],"treatment":["iv hydration","replacement","port-a-cath placement"],"problem_indices_start":[56,92],"problem_indices_end":[74,100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,29,117],"treatment_indices_end":[24,41,128]}
{"text":"given her fever , sx of chest pain and sob as well as an elevated wbc count , she was initially thought to have a pna .","problem":["her fever","sx of chest pain","sob","an elevated wbc count","a pna"],"test":[],"treatment":[],"problem_indices_start":[6,18,39,54,112],"problem_indices_end":[15,34,42,75,117],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the pt denies abd pain , n\/v or increased ostomy output .","problem":["n\/v","abd pain","increased ostomy output"],"test":[],"treatment":[],"problem_indices_start":[14,25,32],"problem_indices_end":[22,28,55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at discharge the patient was on clonazepam 1 mg tid , seroquel 300 bid and neurontin 600 qam , 1200 qpm and 1200 qhs .","problem":[],"test":[],"treatment":["seroquel","clonazepam","neurontin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32,54,75],"treatment_indices_end":[42,62,84]}
{"text":"they made recommendations for adjustments to her anti-psychotic medications .","problem":[],"test":[],"treatment":["her anti-psychotic medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[45],"treatment_indices_end":[75]}
{"text":"she was unable to sleep at night , often pacing the halls .","problem":["unable to sleep"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was therefore given ceftriaxone 1 g iv x1 and azithromycin 500 mg po x1 in the deanna .","problem":[],"test":[],"treatment":["azithromycin","ceftriaxone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24,50],"treatment_indices_end":[35,62]}
{"text":"she was weaned off the oxygen and for the remainder of her course her o2sats were stable on room air .","problem":[],"test":["her o2sats"],"treatment":["the oxygen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[66],"test_indices_end":[76],"treatment_indices_start":[19],"treatment_indices_end":[29]}
{"text":"social history: lives w\/ her husband in john area ; smokes 05-04 cig \/d ( 30 pack year history ); no alcohol or recreational drug use , has had addiction to benzodiazepines and opioids in the past","problem":[],"test":[],"treatment":["opioids","benzodiazepines"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[157,177],"treatment_indices_end":[172,184]}
{"text":"the patient remained afebrile when she transferred to the medicine service .","problem":["afebrile"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition to her usual neuropathy pain , the pt initially appeared to have significant pain from the multi-focal pna as well .","problem":["her usual neuropathy pain","significant pain","the multi-focal pna"],"test":[],"treatment":[],"problem_indices_start":[15,77,99],"problem_indices_end":[40,93,118],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was held in the icu and she was given diluadid prn for pain control .","problem":[],"test":[],"treatment":["diluadid","pain control"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[43,60],"treatment_indices_end":[51,72]}
{"text":"this was restarted post extubation .","problem":[],"test":[],"treatment":["extubation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[34]}
{"text":"after extubation her o2 requirement was down to 1l nc with sats in mid 90s .","problem":["her o2 requirement"],"test":["sats"],"treatment":["1l nc"],"problem_indices_start":[17],"problem_indices_end":[35],"test_indices_start":[59],"test_indices_end":[63],"treatment_indices_start":[48],"treatment_indices_end":[53]}
{"text":"1. amylase-lipase-protease 33,200 - 10,000 - 37,500 unit capsule , delayed release ( e.c. ) sig : four ( 4 ) cap po w\/ meals and snacks ( ) .","problem":[],"test":[],"treatment":["amylase-lipase-protease"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[26]}
{"text":"7. saline flush","problem":[],"test":[],"treatment":["saline flush"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"goal inr 01-31 .","problem":[],"test":["inr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[5],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tender over right chest","problem":["tender over right chest"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. ferrous sulfate 300 mg \/ 5 ml liquid sig : one ( 1 ) po daily ( daily ) .","problem":[],"test":[],"treatment":["ferrous sulfate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"her o2 requirement improved on the vent over the next few days and she was weaned off the vent on 2013-01-01 .","problem":["her o2 requirement"],"test":[],"treatment":["the vent","the vent"],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31,86],"treatment_indices_end":[39,94]}
{"text":"the patient was transitioned to a low fat , low residue diet .","problem":[],"test":[],"treatment":["a low fat , low residue diet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32],"treatment_indices_end":[60]}
{"text":"cv : rrr , s1 , s2 distant","problem":["s2 distant"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. ferrous sulfate 325 po daily","problem":[],"test":[],"treatment":["ferrous sulfate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"ext : tr edema , 2+ dp bilaterally","problem":["tr edema"],"test":["dp bilaterally"],"treatment":[],"problem_indices_start":[6],"problem_indices_end":[14],"test_indices_start":[20],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"glucose - 208 * urea n - 21 * creat - 1.3 * sodium - 138 potassium - 4.2 chloride - 104 total co2 - 23 anion gap - 15","problem":[],"test":["sodium","urea n","creat","glucose","anion gap","total co2","chloride","potassium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,30,44,57,73,88,103],"test_indices_end":[7,22,35,50,66,81,97,112],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. benzo and opiod addiction","problem":[],"test":[],"treatment":["opiod","benzo"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,13],"treatment_indices_end":[8,18]}
{"text":"4. carbidopa-levodopa 25-250 mg po 5 times per day .","problem":[],"test":[],"treatment":["carbidopa-levodopa"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[21]}
{"text":"pt was intubated prior to tunneled catheter removal , see below .","problem":[],"test":[],"treatment":["tunneled catheter removal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[51]}
{"text":"5. gabapentin 800 mg po qam , 1600 mg po q3pm , 1600 mg po qhs","problem":[],"test":[],"treatment":["gabapentin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"6. heparin lock flush 10 unit \/ ml daily as needed .","problem":[],"test":[],"treatment":["heparin lock flush"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[21]}
{"text":"13. warfarin 1 mg po hs .","problem":[],"test":[],"treatment":["warfarin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"pt 's blood cultures came back positive for staph aureus and enterococcus , both were pansensitive .","problem":["enterococcus","staph aureus"],"test":["pt 's blood cultures"],"treatment":[],"problem_indices_start":[44,61],"problem_indices_end":[56,73],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"14. tpn","problem":[],"test":[],"treatment":["tpn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[7]}
{"text":"5. ? parkinson 's disease \/ akithesia :","problem":["akithesia","parkinson 's disease"],"test":[],"treatment":[],"problem_indices_start":[5,28],"problem_indices_end":[25,37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her course later became complicated by visual and auditory hallucinations .","problem":["visual and auditory hallucinations"],"test":[],"treatment":[],"problem_indices_start":[39],"problem_indices_end":[73],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"11. vitamin b-12 1,000 mcg \/ ml one injection every other week .","problem":[],"test":[],"treatment":["vitamin b-12"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[16]}
{"text":"12. vicodin 5-500 mg 1-2 tablets po every six ( 6 ) hours prn","problem":[],"test":[],"treatment":["vicodin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[11]}
{"text":"cxr 2014-01-09","problem":[],"test":["cxr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the kindred hospital hospital course was prolonged because of her delirium .","problem":["her delirium"],"test":[],"treatment":[],"problem_indices_start":[62],"problem_indices_end":[74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ctropnt -< 0.01","problem":[],"test":["ctropnt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. chest pain \/ fever \/ chills :","problem":["chills","fever","chest pain"],"test":[],"treatment":[],"problem_indices_start":[3,16,24],"problem_indices_end":[13,21,30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest pain","problem":["chest pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ck ( cpk )- 31","problem":[],"test":["ck ( cpk )-"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood , urine and sputum culutres were sent .","problem":[],"test":["blood , urine and sputum culutres"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. pain :","problem":["pain"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she required a 1:1 sitter .","problem":[],"test":[],"treatment":["a 1:1 sitter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[25]}
{"text":"2018-10-31 06:25 am blood glucose - 91 urean - 19 creat - 0.8 na - 134 k - 4.0 cl - 98 hco3 - 26 angap - 14","problem":[],"test":["angap","blood","glucose","hco3","cl","na","k","urean","creat"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,39,50,62,71,79,87,97],"test_indices_end":[25,33,44,55,64,72,81,91,102],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coronary artery disease s\/p coronary artery bypass graft x3","problem":["coronary artery disease"],"test":[],"treatment":["coronary artery bypass graft"],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28],"treatment_indices_end":[56]}
{"text":"aspirin 81 mg qd , toprol xl 50 mg qd , mvi , flexeril 10 mg qhs , plavix 75 mg qd ( last on 10-18 )","problem":[],"test":[],"treatment":["plavix","flexeril","toprol","mvi","aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,19,40,46,67],"treatment_indices_end":[7,25,43,54,73]}
{"text":"he tolerated the procedure well and was transferred to the csru for invasive monitoring in stable condition .","problem":[],"test":["invasive monitoring"],"treatment":["the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[68],"test_indices_end":[87],"treatment_indices_start":[13],"treatment_indices_end":[26]}
{"text":"13. lisinopril 5 mg tablet sig : 0.5 tablet po daily ( daily ).","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[14]}
{"text":"2018-10-29 06:50 am blood pt - 11.9 inr(pt) - 1.0","problem":[],"test":["blood","pt","inr(pt)"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,36],"test_indices_end":[25,28,43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2018-10-25 12:36 pm blood urean - 17 creat - 0.7 cl - 111 * hco3 - 23","problem":[],"test":["blood","urean","hco3","cl","creat"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,37,49,60],"test_indices_end":[25,31,42,51,64],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"11. furosemide 20 mg tablet sig : one ( 1 ) tablet po once a day for 2 weeks .","problem":[],"test":[],"treatment":["furosemide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[14]}
{"text":"beta blockers and diuretics were initiated on post-op day one .","problem":[],"test":[],"treatment":["beta blockers","diuretics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,18],"treatment_indices_end":[13,27]}
{"text":"he did have burst of atrial fibrillation and was started on a amiodarone gtt .","problem":["burst of atrial fibrillation"],"test":[],"treatment":["a amiodarone gtt"],"problem_indices_start":[12],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[60],"treatment_indices_end":[76]}
{"text":"6. amiodarone 200 mg tablet sig : two ( 2 ) tablet po bid ( 2 times a day ): please take 400 mg twice a day until 11-02 then decrease to 400 mg once a day for 1 week and then decrease to 200 mg once a day .","problem":[],"test":[],"treatment":["amiodarone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"on post-op day five he appeared to have left arm phlebitis and was started on antibiotics .","problem":["left arm phlebitis"],"test":[],"treatment":["antibiotics"],"problem_indices_start":[40],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[78],"treatment_indices_end":[89]}
{"text":"5. atorvastatin 10 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["atorvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"he had no further episodes of afib while on po amiodarone .","problem":["further episodes of afib"],"test":[],"treatment":["po amiodarone"],"problem_indices_start":[10],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[44],"treatment_indices_end":[57]}
{"text":"9. ascorbic acid 500 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["ascorbic acid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"the mitral valve leaflets are mildly thickened .","problem":["mildly thickened"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cath revealed severe 3 vessel disease .","problem":["severe 3 vessel disease"],"test":["cath"],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[37],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was discharged home on post-op day six with antibiotics and appropriate meds .","problem":[],"test":[],"treatment":["appropriate meds","antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47,63],"treatment_indices_end":[58,79]}
{"text":"post-bypass : lv and rv function is unchanged .","problem":[],"test":["lv and rv function"],"treatment":["post-bypass"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14],"test_indices_end":[32],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"2018-10-25 11:15 am blood wbc - 18.3 *# rbc - 3.42 * hgb - 10.9 * hct - 31.6 * mcv - 92 mch - 31.7 mchc - 34.4 rdw - 13.3 plt ct - 134 *","problem":[],"test":["mcv","blood","wbc","rbc","plt ct","rdw","mch","mchc","hgb","hct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,40,53,66,79,88,99,111,122],"test_indices_end":[25,29,43,56,69,82,91,103,114,128],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the descending thoracic aorta is mildly dilated .","problem":["mildly dilated"],"test":[],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. metoprolol succinate 50 mg tablet sustained release 24 hr sig : one ( 1 ) tablet sustained release 24 hr po daily ( daily ).","problem":[],"test":[],"treatment":["metoprolol succinate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[23]}
{"text":"he will have vna services and make the appropriate follow-up appointments .","problem":[],"test":[],"treatment":["vna services"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[25]}
{"text":"2018-10-31 06:25 am blood wbc - 13.6 * rbc - 2.72 * hgb - 8.6 * hct - 24.6 * mcv - 91 mch - 31.7 mchc - 35.0 rdw - 14.0 plt ct - 314","problem":[],"test":["mcv","blood","wbc","hct","rbc","mch","hgb","plt ct","rdw","mchc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,39,52,64,77,86,97,109,120],"test_indices_end":[25,29,42,55,67,80,89,101,112,126],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. ferrous gluconate 300 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["ferrous gluconate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[20]}
{"text":"chest tubes were removed on post-op day two and epicardial pacing wires on post-op day three .","problem":[],"test":[],"treatment":["chest tubes","epicardial pacing wires"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,48],"treatment_indices_end":[11,71]}
{"text":"mr. kammerer was a same day admit and on 10-25 was brought to the operating room where he underwent a coronary artery bypass graft x 3 .","problem":[],"test":[],"treatment":["a coronary artery bypass graft"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[100],"treatment_indices_end":[130]}
{"text":"2018-10-25 11:15 am blood pt - 13.3 * ptt - 30.0 inr(pt) - 1.2 *","problem":[],"test":["inr(pt)","blood","pt","ptt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,38,49],"test_indices_end":[25,28,41,56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pmh : carpal tunnel syndrome , hypertension , hyperlipidemia , arthritis","problem":["hypertension","carpal tunnel syndrome","arthritis","hyperlipidemia"],"test":[],"treatment":[],"problem_indices_start":[6,31,46,63],"problem_indices_end":[28,43,60,72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his beta blockers were also titrated for maximal bp and hr control .","problem":[],"test":[],"treatment":["maximal bp and hr control","his beta blockers"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,41],"treatment_indices_end":[17,66]}
{"text":"monitor wounds for infection - redness , drainage , or increased pain","problem":["increased pain","redness","drainage","wounds","infection"],"test":[],"treatment":[],"problem_indices_start":[8,19,31,41,55],"problem_indices_end":[14,28,38,49,69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left arm continue with elevation , ice , and complete all antibiotics","problem":[],"test":[],"treatment":["ice","all antibiotics","elevation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23,35,54],"treatment_indices_end":[32,38,69]}
{"text":"report any weight gain of greater than 2 pounds in 24 hours or 5 pounds in a week","problem":["any weight gain"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"report any fever greater than 101","problem":["any fever greater than 101"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"for surgical incision and left arm","problem":["surgical incision"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no creams , lotions , powders , or ointments to incisions","problem":["incisions"],"test":[],"treatment":["creams","powders","lotions","ointments"],"problem_indices_start":[48],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,12,22,35],"treatment_indices_end":[9,19,29,44]}
{"text":"67 y\/o male with worsening shortness of breath. had abnormal ett and referred for cath .","problem":["abnormal ett","worsening shortness of breath."],"test":["cath"],"treatment":[],"problem_indices_start":[17,52],"problem_indices_end":[47,64],"test_indices_start":[82],"test_indices_end":[86],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. docusate sodium 100 mg capsule sig : one ( 1 ) capsule po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"4. oxycodone - acetaminophen 5-325 mg tablet sig : 1-2 tablets po q4h ( every 4 hours ) as needed for pain .","problem":["pain"],"test":[],"treatment":["oxycodone - acetaminophen"],"problem_indices_start":[102],"problem_indices_end":[106],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[28]}
{"text":"10. cephalexin 500 mg capsule sig : one ( 1 ) capsule po q6h ( every 6 hours ) for 6 days : please complete full course .","problem":[],"test":[],"treatment":["cephalexin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[14]}
{"text":"12. potassium chloride 10 meq capsule , sustained release sig : one ( 1 ) capsule , sustained release po daily ( daily ) for 2 weeks .","problem":[],"test":[],"treatment":["potassium chloride"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[22]}
{"text":"carpal tunnel syndrome , hypertension , hyperlipidemia , arthritis , h\/o bell's palsy , hoh , s\/p tonsillectomy","problem":["arthritis","hyperlipidemia","hypertension","carpal tunnel syndrome","bell's palsy","hoh"],"test":[],"treatment":["tonsillectomy"],"problem_indices_start":[0,25,40,57,73,88],"problem_indices_end":[22,37,54,66,85,91],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[98],"treatment_indices_end":[111]}
{"text":"ext : warm , well-perfused - edema , - varicosities","problem":["varicosities","edema"],"test":[],"treatment":[],"problem_indices_start":[29,39],"problem_indices_end":[34,51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"then referred for surgical intervention .","problem":[],"test":[],"treatment":["surgical intervention"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[39]}
{"text":"echo 10-25 : pre-bypass : left ventricular wall thicknesses are normal .","problem":[],"test":["echo","left ventricular wall thicknesses"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,26],"test_indices_end":[4,59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient recorded as having no known allergies to drugs","problem":["known allergies"],"test":[],"treatment":["drugs"],"problem_indices_start":[30],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49],"treatment_indices_end":[54]}
{"text":"there are simple atheroma in the descending thoracic aorta .","problem":["simple atheroma in the descending thoracic aorta"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was diuresed towards his pre-op weight .","problem":[],"test":["his pre-op weight"],"treatment":["diuresed"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24],"test_indices_end":[41],"treatment_indices_start":[7],"treatment_indices_end":[15]}
{"text":"there is mild inferior wall hypokinesis .","problem":["mild inferior wall hypokinesis"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no aortic regurgitation is seen .","problem":["aortic regurgitation"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right ventricular chamber size and free wall motion are normal .","problem":[],"test":["free wall motion","right ventricular chamber size"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,35],"test_indices_end":[30,51],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"later on op day he was weaned from sedation , awoke neurologically intact , and","problem":[],"test":[],"treatment":["sedation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[35],"treatment_indices_end":[43]}
{"text":"there is no aortic valve stenosis .","problem":["aortic valve stenosis"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"shortness of breath","problem":["shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no pneumothorax .","problem":["pneumothorax"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cxr 10-30 : left lower lobe atelectasis has partially cleared .","problem":["left lower lobe atelectasis"],"test":["cxr"],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[39],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"trivial mitral regurgitation is seen .","problem":["trivial mitral regurgitation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mild postoperative widening of the cardiomediastinal silhouette is stable .","problem":["mild postoperative widening of the cardiomediastinal silhouette"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coronary artery bypass graft x3 ( left internal mammary -> left anterior descending , saphaneous vein graft -> obtuse marginal , saphaneous vein graft -> posterior descending artery ) 2018-10-25","problem":[],"test":[],"treatment":["coronary artery bypass graft","saphaneous vein graft -> posterior descending artery","saphaneous vein graft -> obtuse marginal","left internal mammary -> left anterior descending"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,34,86,129],"treatment_indices_end":[28,83,126,181]}
{"text":"father with mi in 50 's and underwent cabg .","problem":["mi"],"test":[],"treatment":["cabg"],"problem_indices_start":[12],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[42]}
{"text":"over the next several days he continued to improve his ambulation and mobility with physical therapy .","problem":[],"test":[],"treatment":["physical therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[84],"treatment_indices_end":[100]}
{"text":"the left ventricular cavity size is normal .","problem":[],"test":["the left ventricular cavity size"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest : ctab - w\/r\/r","problem":["w\/r\/r"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is akinesis \/ dyskinesis and thinning of the mid to distal inferior septum and the apex .","problem":["thinning of the mid to distal inferior septum","akinesis","dyskinesis"],"test":[],"treatment":[],"problem_indices_start":[9,20,35],"problem_indices_end":[17,30,80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent : eomi , perrl , nc\/at","problem":["nc\/at"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neck : supple , from , - jvd , - carotid bruits","problem":["carotid bruits","jvd"],"test":[],"treatment":[],"problem_indices_start":[25,33],"problem_indices_end":[28,47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"overall left ventricular systolic function is mildly depressed .","problem":["mildly depressed"],"test":["overall left ventricular systolic function"],"treatment":[],"problem_indices_start":[46],"problem_indices_end":[62],"test_indices_start":[0],"test_indices_end":[42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heart : rrr - c\/r\/m\/g","problem":["c\/r\/m\/g"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. ranitidine hcl 150 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["ranitidine hcl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[17]}
{"text":"2. aspirin 81 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po daily ( daily ).","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"vs : 65 20 160\/100 5 ' 7 \" 180 #","problem":[],"test":["vs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abd : soft , nt\/nd +bs","problem":["nt\/nd"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"general : wd\/wn male in nad","problem":["nad"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"for deep vein thrombosis prophylaxis she was treated with subcutaneous heparin and for gastrointestinal prophylaxis she was treated with protonix .","problem":[],"test":[],"treatment":["gastrointestinal prophylaxis","deep vein thrombosis prophylaxis","protonix","subcutaneous heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4,58,87,137],"treatment_indices_end":[36,78,115,145]}
{"text":"the patient was able to advance her diet well from liquids to solids , however , she was plagued with a persistent cough and some low grade fevers to 99.0 f .","problem":["a persistent cough","some low grade fevers"],"test":[],"treatment":[],"problem_indices_start":[102,125],"problem_indices_end":[120,146],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest ct scan was negative for pulmonary embolism but positive for consolidation .","problem":["pulmonary embolism","consolidation"],"test":["chest ct scan"],"treatment":[],"problem_indices_start":[31,67],"problem_indices_end":[49,80],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had coarse rhonchi on examination .","problem":["coarse rhonchi"],"test":["examination"],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[30],"test_indices_start":[34],"test_indices_end":[45],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. she was also instructed to follow-up with dr. reid from neurology within a month at ( 382 ) 716 4151 , given her neurological deficits during this presentation .","problem":["her neurological deficits"],"test":[],"treatment":[],"problem_indices_start":[112],"problem_indices_end":[137],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. atrovent multiple dose inhalers , one to two puffs q. six hours as needed .","problem":[],"test":[],"treatment":["atrovent multiple dose inhalers"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[34]}
{"text":"..... done on 02-24 , notable for mid-basilar artery high-grade stenosis .","problem":["mid-basilar artery high-grade stenosis"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ekg is notable for sinus tachycardia at 100 beats per minute , normal axis .","problem":["sinus tachycardia"],"test":["ekg"],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[36],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. the patient was instructed to contact dr. ralph at ( 428 ) 678-6930 , who is covering for her primary care physician , dr. erika witt , to adjust her dosages based on the inr levels .","problem":[],"test":["the inr levels"],"treatment":["her dosages"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[170],"test_indices_end":[184],"treatment_indices_start":[149],"treatment_indices_end":[160]}
{"text":"10. seizure history on neurontin .","problem":["seizure history"],"test":[],"treatment":["neurontin"],"problem_indices_start":[4],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[32]}
{"text":"will also have inr checked at once weekly until target of inr of 2.0 to 3.0 is reached .","problem":[],"test":["inr","inr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[15,58],"test_indices_end":[18,61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. subcutaneous heparin taken 5000 units twice a day .","problem":[],"test":[],"treatment":["subcutaneous heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[23]}
{"text":"chest x-ray revealed mild pulmonary edema .","problem":["mild pulmonary edema"],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[41],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. she was instructed to have blood drawn by the visiting nurses association the day after discharge and then a few days after discharge the same week to have inr .","problem":[],"test":["inr","blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[30,159],"test_indices_end":[35,162],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. albuterol multiple dose inhalers , one to two puffs q. six hours as needed .","problem":[],"test":[],"treatment":["albuterol multiple dose inhalers"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[35]}
{"text":"3. neurontin 300 mg taken three times a day .","problem":[],"test":[],"treatment":["neurontin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"2. aspirin \/ dipyridamole 25\/200 mg capsules taken two times a day .","problem":[],"test":[],"treatment":["aspirin","dipyridamole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,13],"treatment_indices_end":[10,25]}
{"text":"9. depression .","problem":["depression"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was started on levofloxacin but the patient became hypotensive at that point with blood pressure of 70\/45 and received a normal saline bolus to boost her blood pressure to 99\/60 ; however the patient was admitted to the medical intensive care unit for overnight observation because of her somnolence and hypotension .","problem":["hypotensive","hypotension","her somnolence"],"test":["blood pressure","her blood pressure","overnight observation"],"treatment":["a normal saline bolus","levofloxacin"],"problem_indices_start":[55,289,308],"problem_indices_end":[66,303,319],"test_indices_start":[86,154,256],"test_indices_end":[100,172,277],"treatment_indices_start":[19,123],"treatment_indices_end":[31,144]}
{"text":"she awoke with nausea on the day of admission and pleuritic chest pain .","problem":["nausea","pleuritic chest pain"],"test":[],"treatment":[],"problem_indices_start":[15,50],"problem_indices_end":[21,70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. levofloxacin 250 mg q. day for ten days .","problem":[],"test":[],"treatment":["levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"penicillin for which she reports a rash and dyspepsia when taking uncoated aspirin .","problem":["dyspepsia","a rash"],"test":[],"treatment":["penicillin","uncoated aspirin"],"problem_indices_start":[33,44],"problem_indices_end":[39,53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,66],"treatment_indices_end":[10,82]}
{"text":"10. protonix 40 mg q. day .","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"11. zanaflex 2 mg twice a day .","problem":[],"test":[],"treatment":["zanaflex"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"8. lisinopril 2.5 mg once a day .","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"9. trazodone 25 mg q. h.s. p.r.n.","problem":[],"test":[],"treatment":["trazodone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"she has a questionable sensitivity to iodine .","problem":["sensitivity"],"test":[],"treatment":["iodine"],"problem_indices_start":[23],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[44]}
{"text":"physical therapy felt that the patient was cleared for transfer home with services .","problem":[],"test":[],"treatment":["physical therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"7. citalopram 10 mg q. day .","problem":[],"test":[],"treatment":["citalopram"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"2. aggrenox .","problem":[],"test":[],"treatment":["aggrenox"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"11. left cmed cataract surgery in 2009-10-05 .","problem":[],"test":[],"treatment":["left cmed cataract surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[30]}
{"text":"12. chronic muscle spasms .","problem":["chronic muscle spasms"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was also evaluated by physical therapy and speech and swallow because of some report of dysphagia .","problem":["dysphagia"],"test":[],"treatment":["swallow","speech","physical therapy"],"problem_indices_start":[92],"problem_indices_end":[101],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,47,58],"treatment_indices_end":[42,53,65]}
{"text":"speech and swallow evaluated the patient at bedside and recommended advancing to regular diet with regular consistency and saw no evidence of any dysphagia .","problem":["any dysphagia"],"test":[],"treatment":["swallow","speech"],"problem_indices_start":[142],"problem_indices_end":[155],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,11],"treatment_indices_end":[6,18]}
{"text":"she presented with three days of general malaise , nausea , vomiting , shortness of breath , cough productive of white sputum .","problem":["cough","white sputum","shortness of breath","vomiting","nausea","general malaise"],"test":[],"treatment":[],"problem_indices_start":[33,51,60,71,93,113],"problem_indices_end":[48,57,68,90,98,125],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. neurontin 300 mg three times a day .","problem":[],"test":[],"treatment":["neurontin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"5. celexa 10 mg daily .","problem":[],"test":[],"treatment":["celexa"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"7. chronic diarrhea with multiple admissions for dehydration with most recent one on 2011-02-26 .","problem":["chronic diarrhea","dehydration"],"test":[],"treatment":[],"problem_indices_start":[3,49],"problem_indices_end":[19,60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was discharged on the 2011-03-15 on the following medications .","problem":[],"test":[],"treatment":["the following medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48],"treatment_indices_end":[73]}
{"text":"3. zanaflex .","problem":[],"test":[],"treatment":["zanaflex"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"8. venous stasis .","problem":["venous stasis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"occupational therapy was also in agreement with the patient 's disposition home with services .","problem":[],"test":[],"treatment":["occupational therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[20]}
{"text":"there was some question regarding restarting of the patient 's coumadin given her positive lupus anti-coagulant status as well as the presence of her basilar artery stenosis .","problem":["her positive lupus anti-coagulant status","her basilar artery stenosis"],"test":[],"treatment":["the patient 's coumadin"],"problem_indices_start":[78,146],"problem_indices_end":[118,173],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48],"treatment_indices_end":[71]}
{"text":"2. basilar stenosis .","problem":["basilar stenosis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white blood cell count were 11.8 , hematocrit 31.5 , platelets 151 .","problem":[],"test":["hematocrit","platelets","white blood cell count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,35,53],"test_indices_end":[22,45,62],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. prior transient ischemic attacks .","problem":["prior transient ischemic attacks"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen is soft and obese , nontender .","problem":["obese","nontender"],"test":[],"treatment":[],"problem_indices_start":[20,28],"problem_indices_end":[25,37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. right medial malleolus repair in 2004-08-05 .","problem":[],"test":[],"treatment":["right medial malleolus repair"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[32]}
{"text":"chem-7 was a sodium of 140 , potassium of 3.0 , chloride 108 , bicarbonate 24 , bun 22 , creatinine 1.0 and glucose 117 .","problem":[],"test":["potassium","chloride","a sodium","glucose","bun","bicarbonate","creatinine","chem-7"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,11,29,48,63,80,89,108],"test_indices_end":[6,19,38,56,74,83,99,115],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"for her depression , continued on citalopram 10 mg daily .","problem":["her depression"],"test":[],"treatment":["citalopram"],"problem_indices_start":[4],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[44]}
{"text":"for her paraplegia and associated muscle spasticity she was continued on her zanaflex .","problem":["her paraplegia","muscle spasticity"],"test":[],"treatment":["her zanaflex"],"problem_indices_start":[4,34],"problem_indices_end":[18,51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[73],"treatment_indices_end":[85]}
{"text":"the patient has some difficulty talking and grasping right hand .","problem":["some difficulty"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. positive lupus anti-coagulant .","problem":["positive lupus anti-coagulant"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is an 83 year old woman with a history of hypertension who presents with slurred speech when dehydrated .","problem":["dehydrated","slurred speech","hypertension"],"test":[],"treatment":[],"problem_indices_start":[47,78,98],"problem_indices_end":[59,92,108],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"due to her chronic diarrhea she was repleted with intravenous fluids .","problem":["her chronic diarrhea"],"test":[],"treatment":["intravenous fluids"],"problem_indices_start":[7],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[50],"treatment_indices_end":[68]}
{"text":"6. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. paraplegia secondary to htlv from a trip to the bahamas five to six years ago .","problem":["htlv","paraplegia"],"test":[],"treatment":[],"problem_indices_start":[3,27],"problem_indices_end":[13,31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has paraplegia secondary to htlv exposure while on vacation in the bahamas six years ago .","problem":["htlv exposure","paraplegia"],"test":[],"treatment":[],"problem_indices_start":[8,32],"problem_indices_end":[18,45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she came to the emergency department on the 2011-03-10 , with temperature of 99.0 f .; blood pressure of 97\/50 ; heart rate 100 ; respirations 27 ; o2 saturation 84% on room air and 94% on two liters .","problem":[],"test":["temperature","heart rate","blood pressure","o2 saturation","respirations"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[62,87,113,130,148],"test_indices_end":[73,101,123,142,161],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient also had a head ct scan in the emergency department before coming to the unit which reported no recent bleed and no change from a prior ct scan done on 2011-03-04 .","problem":["change","recent bleed"],"test":["a head ct scan","a prior ct scan"],"treatment":[],"problem_indices_start":[108,128],"problem_indices_end":[120,134],"test_indices_start":[21,140],"test_indices_end":[35,155],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after transfer to the floor , the patient was continued on levofloxacin for a ten to 14 day course for presumptive pneumonia .","problem":["pneumonia"],"test":[],"treatment":["levofloxacin"],"problem_indices_start":[115],"problem_indices_end":[124],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[59],"treatment_indices_end":[71]}
{"text":"on admission examination she was a well developed , well nourished female in no apparent distress .","problem":["apparent distress"],"test":["admission examination"],"treatment":[],"problem_indices_start":[80],"problem_indices_end":[97],"test_indices_start":[3],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiovascular examination is notable for a regular rate and rhythm ; no murmurs , rubs or gallops .","problem":["gallops","murmurs","rubs"],"test":["cardiovascular examination"],"treatment":[],"problem_indices_start":[73,83,91],"problem_indices_end":[80,87,98],"test_indices_start":[0],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her lungs revealed coarse bilateral rhonchi from base to midline .","problem":["coarse bilateral rhonchi"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extremities notable for two plus lower extremity edema and the ankles were noted to be in pressure stockings .","problem":["two plus lower extremity edema"],"test":[],"treatment":["pressure stockings"],"problem_indices_start":[24],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[90],"treatment_indices_end":[108]}
{"text":"1. enteric-coated aspirin .","problem":[],"test":[],"treatment":["enteric-coated aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[25]}
{"text":"12. tylenol 325 mg , one to two tablets q. four to six hours p.r.n.","problem":[],"test":[],"treatment":["tylenol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[11]}
{"text":"13. the patient was also discharged with the restarting of warfarin 2 mg daily .","problem":[],"test":[],"treatment":["warfarin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[59],"treatment_indices_end":[67]}
{"text":"this is a 47 - year-old male with a past medical history of type 2 diabetes , high cholesterol , hypertension , and coronary artery disease , status post percutaneous transluminal coronary angioplasty times two , who presented with acute coronary syndrome refractory to medical treatment and tnk , now status post angio-jet percutaneous transluminal coronary angioplasty and stent of proximal left anterior descending artery and percutaneous transluminal coronary angioplasty of first diagonal with intra-aortic balloon pump placement .","problem":["coronary artery disease","acute coronary syndrome","type 2 diabetes","hypertension","high cholesterol"],"test":[],"treatment":["status post percutaneous transluminal coronary angioplasty","medical treatment","intra-aortic balloon pump placement","percutaneous transluminal coronary angioplasty","status post angio-jet percutaneous transluminal coronary angioplasty","tnk","stent of proximal left anterior descending artery"],"problem_indices_start":[60,78,97,116,232],"problem_indices_end":[75,94,109,139,255],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[142,270,292,302,375,429,499],"treatment_indices_end":[200,287,295,370,424,475,534]}
{"text":"in addition , he had slight shortness of breath but denies headache , change in vision , dizziness , nausea , vomiting , abdominal pain , change in bowel or urinary habits , or fevers , chills , and sweats .","problem":["headache","slight shortness of breath","nausea","change in vision","change in bowel or urinary habits","vomiting","sweats","chills","fevers","abdominal pain","dizziness"],"test":[],"treatment":[],"problem_indices_start":[21,59,70,89,101,110,121,138,177,186,199],"problem_indices_end":[47,67,86,98,107,118,135,171,183,192,205],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. coronary artery disease ; the patient is status post percutaneous transluminal coronary angioplasty times three in 2009 at clinton hospital ; the patient is status post percutaneous transluminal coronary angioplasty times two in 2005 at waltham\/weston hospital .","problem":["coronary artery disease"],"test":[],"treatment":["status post percutaneous transluminal coronary angioplasty","status post percutaneous transluminal coronary angioplasty"],"problem_indices_start":[3],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[44,160],"treatment_indices_end":[102,218]}
{"text":"zestril 10 mg q.d. and atenolol 25 mg q.d. at discharge .","problem":[],"test":[],"treatment":["atenolol","zestril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,23],"treatment_indices_end":[7,31]}
{"text":"2. type 2 diabetes .","problem":["type 2 diabetes"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"angio-jet percutaneous transluminal coronary angioplasty and stenting was performed on proximal left anterior descending artery and the percutaneous transluminal coronary angioplasty was performed on first diagonal with good results .","problem":[],"test":[],"treatment":["angio-jet percutaneous transluminal coronary angioplasty","stenting","the percutaneous transluminal coronary angioplasty"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,61,132],"treatment_indices_end":[56,69,182]}
{"text":"primary care physician was to check inr and titrate zestril up and atenolol as tolerated .","problem":[],"test":["inr"],"treatment":["zestril","atenolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[36],"test_indices_end":[39],"treatment_indices_start":[52,67],"treatment_indices_end":[59,75]}
{"text":"anterior apex akinesis , inferior apex akinesis , and apex akinesis .","problem":["apex akinesis","inferior apex akinesis","anterior apex akinesis"],"test":[],"treatment":[],"problem_indices_start":[0,25,54],"problem_indices_end":[22,47,67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. hypercholesterolemia .","problem":["hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen had decreased bowel sounds , soft , nontender , and nondistended .","problem":["nondistended","nontender","decreased bowel sounds"],"test":[],"treatment":[],"problem_indices_start":[12,44,60],"problem_indices_end":[34,53,72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chem-7 revealed sodium of 136 , potassium 4.7 , chloride 103 , bicarbonate 22 , bun 16 , creatinine 0.8 , glucose 284 .","problem":[],"test":["potassium","creatinine","bun","chem-7","chloride","glucose","sodium","bicarbonate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,32,48,63,80,89,106],"test_indices_end":[6,22,41,56,74,83,99,113],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's father died of a myocardial infarction at age 40 , and a brother who died of a myocardial infarction at age 40 .","problem":["a myocardial infarction","a myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[30,92],"problem_indices_end":[53,115],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no s3 or s4 .","problem":["s4","s3"],"test":[],"treatment":[],"problem_indices_start":[3,9],"problem_indices_end":[5,11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the emergency department he received aspirin , nitroglycerin drip , heparin drip , dilaudid , and tnk with decreased in his pain but without resolution of symptoms .","problem":["his pain","symptoms"],"test":[],"treatment":["tnk","nitroglycerin drip","heparin drip","dilaudid","aspirin"],"problem_indices_start":[123,158],"problem_indices_end":[131,166],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40,50,71,86,101],"treatment_indices_end":[47,68,83,94,104]}
{"text":"neurologic examination revealed alert and oriented times three .","problem":[],"test":["neurologic examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"laboratories on admission revealed white count 7.8 , hematocrit was 41.7 , platelets of 252 , mcv 89 , rdw 12.7 .","problem":[],"test":["white count","hematocrit","laboratories","rdw","platelets","mcv"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,35,53,75,94,103],"test_indices_end":[12,46,63,84,97,106],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 47 - year-old male with a past medical history of coronary artery disease , status post 2-vessel percutaneous transluminal coronary angioplasty in 2005 , 3-vessel percutaneous transluminal coronary angioplasty in 2009 , hypertension , new onset type 2 diabetes , and hypercholesterolemia who presents with the sudden onset of substernal chest pain status post exercise .","problem":["coronary artery disease","substernal chest pain","hypertension","hypercholesterolemia","new onset type 2 diabetes"],"test":[],"treatment":["3-vessel percutaneous transluminal coronary angioplasty","status post 2-vessel percutaneous transluminal coronary angioplasty"],"problem_indices_start":[67,237,252,284,343],"problem_indices_end":[90,249,277,304,364],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[93,171],"treatment_indices_end":[160,226]}
{"text":"the patient was continued on lipitor and aspirin , and plavix was added and will be continued for 30 days post catheterization .","problem":[],"test":["catheterization"],"treatment":["plavix","aspirin","lipitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[111],"test_indices_end":[126],"treatment_indices_start":[29,41,55],"treatment_indices_end":[36,48,61]}
{"text":"the right groin revealed intra-aortic balloon pump site and pulmonary artery catheterization site were clean , dry and intact without tenderness .","problem":["tenderness"],"test":[],"treatment":["intra-aortic balloon pump","pulmonary artery catheterization"],"problem_indices_start":[134],"problem_indices_end":[144],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25,60],"treatment_indices_end":[50,92]}
{"text":"electrocardiogram at that time showed st elevations and j point elevations in v2 through v4 .","problem":["st elevations","j point elevations in v2 through v4"],"test":["electrocardiogram"],"treatment":[],"problem_indices_start":[38,56],"problem_indices_end":[51,91],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an intra-aortic balloon pump was placed at this time as well .","problem":[],"test":[],"treatment":["an intra-aortic balloon pump"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[28]}
{"text":"9. coumadin 5 mg p.o. q.d.","problem":[],"test":[],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"pt 14.2 , ptt 108.5 , inr 1.3 .","problem":[],"test":["inr","pt","ptt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,22],"test_indices_end":[2,13,25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the pain became worse over the next few minutes to 07-12 and increased to 10-12 while he was in the ambulance .","problem":["the pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was continued on heparin throughout his hospital course and transitioned to coumadin on hospital day four .","problem":[],"test":[],"treatment":["coumadin","heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29,88],"treatment_indices_end":[36,96]}
{"text":"5. atenolol 25 mg p.o. q.d.","problem":[],"test":[],"treatment":["atenolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"pulmonary artery pressure was 29\/15 with a mean of 22 .","problem":[],"test":["pulmonary artery pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"electrocardiogram post catheterization showed continued st elevations and j point elevations in v2 through v3 .","problem":["j point elevations in v2 through v3","continued st elevations"],"test":["catheterization","electrocardiogram"],"treatment":[],"problem_indices_start":[46,74],"problem_indices_end":[69,109],"test_indices_start":[0,23],"test_indices_end":[17,38],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extremities had no edema .","problem":["edema"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient presented to bournewood hospital on the morning of admission with a chief complaint of substernal burning without radiation which developed while doing exercise .","problem":["substernal burning"],"test":[],"treatment":[],"problem_indices_start":[99],"problem_indices_end":[117],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was transferred to sturdy memorial where he underwent catheterization .","problem":[],"test":["catheterization"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[66],"test_indices_end":[81],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac output was 7 ( that was on 6 of dopamine ) .","problem":[],"test":["cardiac output"],"treatment":["dopamine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[40],"treatment_indices_end":[48]}
{"text":"the was trace mitral regurgitation and trace tricuspid regurgitation .","problem":["trace mitral regurgitation","trace tricuspid regurgitation"],"test":[],"treatment":[],"problem_indices_start":[8,39],"problem_indices_end":[34,68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. glucophage 500 mg p.o. q.d.","problem":[],"test":[],"treatment":["glucophage"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"6. zestril 10 mg p.o. q.d.","problem":[],"test":[],"treatment":["zestril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"catheterization results showed 100% occlusion of the proximal left anterior descending artery and 50% stenosis of first diagonal .","problem":["50% stenosis of first diagonal","100% occlusion of the proximal left anterior descending artery"],"test":["catheterization results"],"treatment":[],"problem_indices_start":[31,98],"problem_indices_end":[93,128],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no hepatosplenomegaly .","problem":["hepatosplenomegaly"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was lying flat in no apparent distress .","problem":["apparent distress"],"test":[],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"intra-aortic balloon pump augmented systole was 109 , augmented diastole was 111 .","problem":[],"test":["intra-aortic balloon pump augmented systole","augmented diastole"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,54],"test_indices_end":[43,72],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"post catheterization echocardiogram showed an ejection fraction of 30% , moderate systolic dysfunction , basal anterior hypokinesis , mid anterior akinesis , basal anteroseptal hypokinesis , mid anteroseptal akinesis .","problem":["moderate systolic dysfunction","basal anterior hypokinesis","mid anterior akinesis","basal anteroseptal hypokinesis","mid anteroseptal akinesis"],"test":["post catheterization echocardiogram","an ejection fraction"],"treatment":[],"problem_indices_start":[73,105,134,158,191],"problem_indices_end":[102,131,155,188,216],"test_indices_start":[0,43],"test_indices_end":[35,63],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no murmurs , rubs or gallops .","problem":["rubs","murmurs","gallops"],"test":[],"treatment":[],"problem_indices_start":[3,13,21],"problem_indices_end":[10,17,28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his nitroglycerin patch did not help , and he only had slight relief with sublingual nitroglycerin times three .","problem":[],"test":[],"treatment":["his nitroglycerin patch","sublingual nitroglycerin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,74],"treatment_indices_end":[23,98]}
{"text":"cardiovascular revealed jugular venous distention not appreciated .","problem":["jugular venous distention"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lungs were clear to auscultation bilaterally , anteriorly and laterally .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. lipitor 10 mg p.o. q.d.","problem":[],"test":[],"treatment":["lipitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"the patient was continued on lopressor and captopril throughout his hospital course , and changed to","problem":[],"test":[],"treatment":["lopressor","captopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29,43],"treatment_indices_end":[38,52]}
{"text":"no lymphadenopathy .","problem":["lymphadenopathy"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. plavix 75 mg p.o. q.d. times 30 days .","problem":[],"test":[],"treatment":["plavix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"temperature maximum 98.7 , temperature current 98.3 , pulse ranged from 82 to 92 , blood pressure 104 to 124\/67 to 74 with a mean of 86 to 99 , respiratory rate of 11 to 16 , oxygen saturation 94% to 98% on 2 liters .","problem":[],"test":["pulse","temperature current","temperature maximum","oxygen saturation","respiratory rate","blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,27,54,83,144,175],"test_indices_end":[19,46,59,97,160,192],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. prevacid 30 mg p.o. q.d.","problem":[],"test":[],"treatment":["prevacid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"2. aspirin 325 mg p.o. q.d.","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"dopamine was discontinued on day one .","problem":[],"test":[],"treatment":["dopamine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"the intra-aortic balloon pump was discontinued on day two .","problem":[],"test":[],"treatment":["the intra-aortic balloon pump"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[29]}
{"text":"7. glyset 25 mg p.o. q.d.","problem":[],"test":[],"treatment":["glyset"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"diltiazem 180 mg p.o. q.d. , lipitor 10 mg p.o. q.d. , glyset 25 mg p.o. q.d. , prevacid 30 mg p.o. q.d. , metoprolol 50 mg p.o. b.i.d. , glucophage 500 mg p.o. q.d.","problem":[],"test":[],"treatment":["glucophage","prevacid","metoprolol","glyset","diltiazem","lipitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,29,55,80,107,138],"treatment_indices_end":[9,36,61,88,117,148]}
{"text":"allergies included penicillin and iodine .","problem":["allergies"],"test":[],"treatment":["iodine","penicillin"],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,34],"treatment_indices_end":[29,40]}
{"text":"the patient was discharged to the medical floor on hospital day three and discharged from the hospital once his inr was within the 2 to 2.5 range .","problem":[],"test":["his inr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[108],"test_indices_end":[115],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"carotids had normal upstroke and normal volume with bilateral bruits .","problem":["bilateral bruits"],"test":[],"treatment":[],"problem_indices_start":[52],"problem_indices_end":[68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dorsalis pedis pulses were 2+ bilaterally .","problem":[],"test":["dorsalis pedis pulses"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"creatine kinase at 11 a.m. was 83 , at 5 p.m. was 3021 .","problem":[],"test":["creatine kinase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"arterial blood gas at 11 a.m. was 7.33\/46\/115 .","problem":[],"test":["arterial blood gas"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"creatine kinases trended from 11:15 on the day of admission from 83 to 3021 at 5 p.m. to 3450 at 11 p.m. , to 1734 at 5:30 a.m. on 11-07 , to 1277 at 11:30 a.m. on 11-07 , to 83 at 9:30 a.m. on 11-11 .","problem":[],"test":["creatine kinases"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the cardiac monitor showed occasional irregularities in a paced rhythm .","problem":["occasional irregularities"],"test":["the cardiac monitor"],"treatment":["a paced rhythm"],"problem_indices_start":[27],"problem_indices_end":[52],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[56],"treatment_indices_end":[70]}
{"text":"2017-09-03 pt - 13.8 * ptt - 33.1 inr ( pt )- 1.2 *","problem":[],"test":["inr ( pt )-","ptt","pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11,23,34],"test_indices_end":[13,26,45],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"epoetin 4000 units mwf","problem":[],"test":[],"treatment":["epoetin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"spironolactone 25 mg po daily","problem":[],"test":[],"treatment":["spironolactone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[14]}
{"text":"pt. was initially admitted to ccu on 2017-09-03 , transferred to pendleton on 2017-09-05 , triggered on 2017-09-10 for hypotension with bp 67\/38 and transferred back to ccu on 2017-09-10 .","problem":["hypotension"],"test":["bp"],"treatment":[],"problem_indices_start":[119],"problem_indices_end":[130],"test_indices_start":[136],"test_indices_end":[138],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tiotropium bromide","problem":[],"test":[],"treatment":["tiotropium bromide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[18]}
{"text":"the patient was therefore intubated for ventilation , and continued to be diuresed .","problem":[],"test":[],"treatment":["ventilation","intubated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,40],"treatment_indices_end":[35,51]}
{"text":"fluticasone \/ salmeterol","problem":[],"test":[],"treatment":["salmeterol","fluticasone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,14],"treatment_indices_end":[11,24]}
{"text":"all sedating medications were held and serial abgs were trended to follow the resolution of the metabolic alkalosis .","problem":["the metabolic alkalosis"],"test":["serial abgs"],"treatment":["all sedating medications"],"problem_indices_start":[92],"problem_indices_end":[115],"test_indices_start":[39],"test_indices_end":[50],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"his co2 improved and he was extubated after a few days .","problem":[],"test":["his co2"],"treatment":["extubated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[28],"treatment_indices_end":[37]}
{"text":"asa 81 mg po daily","problem":[],"test":[],"treatment":["asa"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[3]}
{"text":"simvastatin 40 mg po qhs","problem":[],"test":[],"treatment":["simvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"2017-09-03 glucose - 206 * urea n - 28 * creat - 1.8 * sodium - 135 potassium - 4.1 chloride - 85 * total co2 - 42 * anion gap - 12","problem":[],"test":["anion gap","urea n","creat","sodium","potassium","chloride","total co2","glucose"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11,27,41,55,68,84,100,117],"test_indices_end":[18,33,46,61,77,92,109,126],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pantoprazole 40 mg po daily","problem":[],"test":[],"treatment":["pantoprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"s1 , s2 with grade ii\/vi sem . +s3 .","problem":["+s3","grade ii\/vi sem"],"test":[],"treatment":[],"problem_indices_start":[13,31],"problem_indices_end":[28,34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"subq heparin","problem":[],"test":[],"treatment":["subq heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"calcium acetate 667 mg po tid","problem":[],"test":[],"treatment":["calcium acetate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"soft , nt\/nd with normoactive bs .","problem":["nt\/nd"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"amiodarone 200 mg po daily","problem":[],"test":[],"treatment":["amiodarone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"pump","problem":[],"test":[],"treatment":["pump"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[4]}
{"text":"2. levothyroxine 100 mcg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["levothyroxine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"3. duloxetine 20 mg capsule , delayed release( e.c. ) sig : one ( 1 ) capsule , delayed release ( e.c. ) po qhs ( once a day ( at bedtime ) ) .","problem":[],"test":[],"treatment":["duloxetine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"he had 4 surgeries ( 3 cardiac surgeries ) earlier in the summer , so it is likely that he required copious ivf hydration surrounding these procedures which may have been the cause of his massive fluid overload .","problem":["his massive fluid overload"],"test":[],"treatment":["copious ivf hydration","these procedures","3 cardiac surgeries","4 surgeries"],"problem_indices_start":[184],"problem_indices_end":[210],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[7,21,100,134],"treatment_indices_end":[18,40,121,150]}
{"text":"this acutely worsened on 2017-09-18 , when the patient was found to have mental status changes and an abg revealed a co2 of over 100 , likley due to a depressed respiratory drive secondary to sedatives given for agitation on top of a preexisting alkalosis .","problem":["agitation","mental status changes","a preexisting alkalosis","a depressed respiratory drive"],"test":["an abg","a co2"],"treatment":["sedatives"],"problem_indices_start":[73,149,212,232],"problem_indices_end":[94,178,221,255],"test_indices_start":[99,115],"test_indices_end":[105,120],"treatment_indices_start":[192],"treatment_indices_end":[201]}
{"text":"1. docusate sodium 100 mg capsule sig : one ( 1 ) capsule po tid ( 3 times a day ) as needed for constipation .","problem":["constipation"],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[97],"problem_indices_end":[109],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"mvi","problem":[],"test":[],"treatment":["mvi"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[3]}
{"text":"tylenol prn","problem":[],"test":[],"treatment":["tylenol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"likely due to chf exacerbation , with diuresis of over 36 l during his admission .","problem":["chf exacerbation"],"test":[],"treatment":["diuresis"],"problem_indices_start":[14],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[46]}
{"text":"5. fluticasone - salmeterol 100-50 mcg \/ dose disk with device sig : one ( 1 ) disk with device inhalation bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["salmeterol","fluticasone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,17],"treatment_indices_end":[14,27]}
{"text":"he remained fluid overloaded and a swan catheter was placed .","problem":["fluid overloaded"],"test":[],"treatment":["a swan catheter"],"problem_indices_start":[12],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[33],"treatment_indices_end":[48]}
{"text":"6. tiotropium bromide 18 mcg capsule , w\/ inhalation device sig : one ( 1 ) cap inhalation daily ( daily ) .","problem":[],"test":[],"treatment":["tiotropium bromide","inhalation device"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,42],"treatment_indices_end":[21,59]}
{"text":"he is not ambulatory and is very deconditioned secondary to several complications within the past two months related to an aicd pocket infection .","problem":["several complications","an aicd pocket infection","very deconditioned"],"test":[],"treatment":[],"problem_indices_start":[28,60,120],"problem_indices_end":[46,81,144],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3# metabolic alkalosis \/ hypochloremia :","problem":["metabolic alkalosis","hypochloremia"],"test":[],"treatment":[],"problem_indices_start":[3,25],"problem_indices_end":[22,38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. lactulose 10 g \/ 15 ml syrup sig : thirty ( 30 ) ml po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["lactulose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"he was then transitioned to oral lasix for maintainence .","problem":[],"test":[],"treatment":["oral lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28],"treatment_indices_end":[38]}
{"text":"the patient was started on levofloxacin at newton-wellesley hospital for a question of uti based on u\/a positive for wbc .","problem":["uti"],"test":["u\/a","wbc"],"treatment":["levofloxacin"],"problem_indices_start":[87],"problem_indices_end":[90],"test_indices_start":[100,117],"test_indices_end":[103,120],"treatment_indices_start":[27],"treatment_indices_end":[39]}
{"text":"9. oxycodone - acetaminophen 5-325 mg tablet sig : 1-2 tablets po q4-6h ( every 4 to 6 hours ) as needed for pain .","problem":["pain"],"test":[],"treatment":["oxycodone","acetaminophen"],"problem_indices_start":[109],"problem_indices_end":[113],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,15],"treatment_indices_end":[12,28]}
{"text":"97.6 95\/48 71 98% 4l nc","problem":[],"test":[],"treatment":["4l nc"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[23]}
{"text":"the patient had an echo on 2017-09-04 with the results above in detail .","problem":[],"test":["an echo"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"slight confustion with place but oriented with some re-direction .","problem":["slight confustion"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. amiodarone 200 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["amiodarone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"- hyperlipidemia","problem":["hyperlipidemia"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. calcium acetate 667 mg capsule sig : one ( 1 ) capsule po tid w\/meals ( 3 times a day with meals ) .","problem":[],"test":[],"treatment":["calcium acetate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"- s\/p bovine avr 1999","problem":[],"test":[],"treatment":["s\/p bovine avr"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[16]}
{"text":"13. simvastatin 40 mg tablet sig : one ( 1 ) tablet po qhs ( once a day ( at bedtime ) ) .","problem":[],"test":[],"treatment":["simvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[15]}
{"text":"- copd","problem":["copd"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"12. aspirin 81 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po daily ( daily ) .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[11]}
{"text":"he also had a high co and low svr suggestive of sepsis , but he never had an elevated wbc and was afebrile during his entire hospital admission with negative blood , urine , wound , and pleural fluid cultures .","problem":["a high co","sepsis","low svr","an elevated wbc","afebrile"],"test":["blood , urine , wound , and pleural fluid cultures"],"treatment":[],"problem_indices_start":[12,26,48,74,98],"problem_indices_end":[21,33,54,89,106],"test_indices_start":[158],"test_indices_end":[208],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- t2dm c\/b neuropathy and nephropathy","problem":["nephropathy","neuropathy","t2dm"],"test":[],"treatment":[],"problem_indices_start":[2,11,26],"problem_indices_end":[6,21,37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"14. pantoprazole 40 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po daily ( daily ) .","problem":[],"test":[],"treatment":["pantoprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[16]}
{"text":"11. miconazole nitrate 2 % powder sig : one ( 1 ) appl topical bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["miconazole nitrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[22]}
{"text":"sister with diabetes .","problem":["diabetes"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10. multivitamin capsule sig : one ( 1 ) cap po daily ( daily ) .","problem":[],"test":[],"treatment":["multivitamin capsule"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[24]}
{"text":"- lumbar sympathectomy","problem":["lumbar sympathectomy"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- chronic lbp","problem":["chronic lbp"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a swan was placed for a more accurate picture of his volume status and he was volume overloaded by swan numbers with an elevated pad and elevated cvp without an obtainable wedge pressure .","problem":["volume overloaded","elevated cvp","an elevated pad"],"test":["a swan","swan numbers","an obtainable wedge pressure"],"treatment":[],"problem_indices_start":[78,117,137],"problem_indices_end":[95,132,149],"test_indices_start":[0,99,158],"test_indices_end":[6,111,186],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the lasix drip was eventually changed to iv lasix boluses , with a net diuresis of over 36 liters for the hospital stay .","problem":[],"test":[],"treatment":["a net diuresis","the lasix drip","iv lasix boluses"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,41,65],"treatment_indices_end":[14,57,79]}
{"text":"19. spironolactone 25 mg tablet sig : two ( 2 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["spironolactone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[18]}
{"text":"inr 3.5 , pt 32.5 , ptt 41","problem":[],"test":["ptt","inr","pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,20],"test_indices_end":[3,12,23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"20. albuterol 90 mcg\/actuation aerosol sig : 4-6 puffs inhalation q6h ( every 6 hours ) .","problem":[],"test":[],"treatment":["albuterol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"21. metoprolol succinate 25 mg tablet sustained release 24hr sig : one ( 1 ) tablet sustained release 24hr po daily ( daily ) .","problem":[],"test":[],"treatment":["metoprolol succinate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[24]}
{"text":"15. lidocaine 5 %( 700 mg \/ patch ) adhesive patch , medicated sig : two ( 2 ) adhesive patch , medicated topical daily ( daily ) .","problem":[],"test":[],"treatment":["lidocaine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"16. furosemide 40 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["furosemide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[14]}
{"text":"2017-09-03 ck ( cpk )- 38","problem":[],"test":["ck ( cpk )-"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-09-03 ck - mb - not done ctropnt - 0.22 *","problem":[],"test":["ck - mb","ctropnt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11,30],"test_indices_end":[18,37],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"17. ferrous sulfate 325 ( 65 ) mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["ferrous sulfate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[19]}
{"text":"18. epoetin alfa 4,000 unit\/ml solution sig : one ( 1 ) injection qmowefr ( monday - wednesday - friday ) .","problem":[],"test":[],"treatment":["epoetin alfa"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[16]}
{"text":"24. warfarin 1 mg tablet sig : one ( 1 ) tablet po at bedtime : please monitor inr with goal 02-24 .","problem":[],"test":["inr"],"treatment":["warfarin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[79],"test_indices_end":[82],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"congestive heart failure exacerbation","problem":["congestive heart failure exacerbation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- cva","problem":["cva"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[5],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- gerd","problem":["gerd"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coronary artery disease","problem":["coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- cad s\/p lad ptca 33 years ago","problem":["cad"],"test":[],"treatment":["s\/p lad ptca"],"problem_indices_start":[2],"problem_indices_end":[5],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6],"treatment_indices_end":[18]}
{"text":"22. finasteride 5 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["finasteride"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[15]}
{"text":"2017-09-03 ck ( cpk )- 16 *","problem":[],"test":["ck ( cpk )-"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-09-03 ck - mb - not done probnp - 2656 *","problem":[],"test":["ck - mb","probnp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11,30],"test_indices_end":[18,36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"23. gabapentin 300 mg capsule sig : one ( 1 ) capsule po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["gabapentin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[14]}
{"text":"his mental status did clear somewhat with the addition of standing lactulose ; he was discharged on this medication .","problem":[],"test":[],"treatment":["standing lactulose","this medication"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[58,100],"treatment_indices_end":[76,115]}
{"text":"4. echo 2017-09-14","problem":[],"test":["echo"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an eeg showed mild encephalopathy , but no other findings .","problem":["mild encephalopathy"],"test":["an eeg"],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[33],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was started on glargine for tighter glycemic control and was covered with an insulin sliding scale .","problem":[],"test":[],"treatment":["glargine","an insulin sliding scale"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,86],"treatment_indices_end":[35,110]}
{"text":"the patient was initially admitted for likely chf exacerbation .","problem":["chf exacerbation"],"test":[],"treatment":[],"problem_indices_start":[46],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the left atrium is mildly dilated .","problem":["mildly dilated"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was continued on his outpatient dose of levothyroxine .","problem":[],"test":[],"treatment":["levothyroxine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[52],"treatment_indices_end":[65]}
{"text":"gram stain and cultures were negative , cytology was negative .","problem":[],"test":["cytology","cultures","gram stain"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,15,40],"test_indices_end":[10,23,48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9# hypothyroidism :","problem":["hypothyroidism"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"all cultures , including bcx , ucx , pleural fluid culture , and wound culture have been negative .","problem":[],"test":["all cultures","ucx","bcx","wound culture","pleural fluid culture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,25,31,37,65],"test_indices_end":[12,28,34,58,78],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , he still appeared volume overloaded with minimal improvement in his oxygen requirement .","problem":["volume overloaded","his oxygen requirement"],"test":[],"treatment":[],"problem_indices_start":[28,74],"problem_indices_end":[45,96],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"70 y\/o male with h\/o cad , t2dm , hyperlipidemia , and copd who presented to the juan on 2017-09-03 with worsening sob x 5 days from morton hospital & medical center .","problem":["copd","hyperlipidemia","t2dm","cad","worsening sob"],"test":[],"treatment":[],"problem_indices_start":[21,27,34,55,105],"problem_indices_end":[24,31,48,59,118],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gradually , the dopamine gtt was weaned .","problem":[],"test":[],"treatment":["the dopamine gtt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[28]}
{"text":"compared with the prior study ( images reviewed ) of 2017-09-04 , there is probably no significant change .","problem":[],"test":["the prior study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he diuresed well on the dopamine gtt and his bp was supported .","problem":[],"test":["his bp"],"treatment":["the dopamine gtt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[41],"test_indices_end":[47],"treatment_indices_start":[20],"treatment_indices_end":[36]}
{"text":"10# ? uti :","problem":["uti"],"test":[],"treatment":[],"problem_indices_start":[6],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the right pleural effusion slowly re-accumulated after tap but resolved after continued diuresis .","problem":["the right pleural effusion"],"test":[],"treatment":["tap","continued diuresis"],"problem_indices_start":[0],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[55,78],"treatment_indices_end":[58,96]}
{"text":"he was transferred back to the ccu and started on a dopamine gtt .","problem":[],"test":[],"treatment":["a dopamine gtt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[50],"treatment_indices_end":[64]}
{"text":"he was given percocet for back pain , lasix 80 mg iv , and combivent neb .","problem":["back pain"],"test":[],"treatment":["percocet","lasix","combivent neb"],"problem_indices_start":[26],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,38,59],"treatment_indices_end":[21,43,72]}
{"text":"after several days , he became hypotensive and triggered for bps 60s\/30s .","problem":["hypotensive"],"test":["bps"],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[42],"test_indices_start":[61],"test_indices_end":[64],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ucx during this hospitalization were negative and levofloxacin was d\/c 'd .","problem":[],"test":["ucx"],"treatment":["levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[50],"treatment_indices_end":[62]}
{"text":"he was given ivf without an adequate response in his pressures .","problem":[],"test":["his pressures"],"treatment":["ivf"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[49],"test_indices_end":[62],"treatment_indices_start":[13],"treatment_indices_end":[16]}
{"text":"in the juan , his vs were 97.8 150\/80 88 12 89-94% 3l nc .","problem":[],"test":["his vs"],"treatment":["3l nc"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14],"test_indices_end":[20],"treatment_indices_start":[51],"treatment_indices_end":[56]}
{"text":"medications , metabolic disturbances , and infection are among the most common causes .","problem":["infection","metabolic disturbances"],"test":[],"treatment":["medications"],"problem_indices_start":[14,43],"problem_indices_end":[36,52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"the patient was treated with a lidocaine patch and percocet prn .","problem":[],"test":[],"treatment":["a lidocaine patch","percocet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29,51],"treatment_indices_end":[46,59]}
{"text":"he was monitored with qid fingersticks .","problem":[],"test":["qid fingersticks"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22],"test_indices_end":[38],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"11# chronic lower back pain :","problem":["chronic lower back pain"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"stronger narcotics were avoided given somnolence and ms changes .","problem":["somnolence","ms changes"],"test":[],"treatment":["stronger narcotics"],"problem_indices_start":[38,53],"problem_indices_end":[48,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[18]}
{"text":"- ischemic colitis and ischemic liver 2017-06-22 ( post air embolism from post mediastinal exploration )","problem":["ischemic colitis","ischemic liver","air embolism"],"test":["mediastinal exploration"],"treatment":[],"problem_indices_start":[2,23,56],"problem_indices_end":[18,37,68],"test_indices_start":[79],"test_indices_end":[102],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abnormal eeg due to the moderately slow posterior background and occasional bursts of generalized slowing .","problem":["the moderately slow posterior background","generalized slowing","abnormal eeg"],"test":[],"treatment":[],"problem_indices_start":[0,20,86],"problem_indices_end":[12,60,105],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"repeat cxr showed improvement of the effusion and on discharge he had been breathing well on room air without complications","problem":["complications","the effusion"],"test":["repeat cxr"],"treatment":[],"problem_indices_start":[33,110],"problem_indices_end":[45,123],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5# t2dm :","problem":["t2dm"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has left chest wound and left gluteal pressure ulcer .","problem":["left chest wound","left gluteal pressure ulcer"],"test":[],"treatment":[],"problem_indices_start":[16,37],"problem_indices_end":[32,64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is completely pacer-dependent , being epicardially paced at 70 .","problem":["completely pacer-dependent"],"test":[],"treatment":["epicardially paced"],"problem_indices_start":[15],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[50],"treatment_indices_end":[68]}
{"text":"12# wound care :","problem":[],"test":[],"treatment":["wound care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[14]}
{"text":"for the left gluteal pressure ulcer , they recommended gentle cleansing with normal saline or commercial wound cleaner , thin layer of duoderm gel , air dry , allevyn foam adhesive over the site , and change every 2 days or prn .","problem":["the left gluteal pressure ulcer"],"test":[],"treatment":["gentle cleansing","normal saline","commercial wound cleaner","duoderm gel","allevyn foam adhesive"],"problem_indices_start":[4],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[55,77,94,135,159],"treatment_indices_end":[71,90,118,146,180]}
{"text":"no prominent focal abnormalities were evident , and there were no epileptiform features .","problem":["epileptiform features","prominent focal abnormalities"],"test":[],"treatment":[],"problem_indices_start":[3,66],"problem_indices_end":[32,87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the aortic valve leaflets are mildly thickened .","problem":["mildly thickened"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"overall left ventricular systolic function cannot be reliably assessed .","problem":[],"test":["overall left ventricular systolic function"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no evidence of intraaxial or extraaxial hemorrhage , mass effect , shift of normally midline structures , or acute major or minor vascular territorial infarction .","problem":["shift of normally midline structures","acute major or minor vascular territorial infarction","mass effect","intraaxial or extraaxial hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[24,62,76,118],"problem_indices_end":[59,73,112,170],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's inr became supratherapeutic and coumadin was held .","problem":["supratherapeutic"],"test":["the patient 's inr"],"treatment":["coumadin"],"problem_indices_start":[26],"problem_indices_end":[42],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[47],"treatment_indices_end":[55]}
{"text":"anti-coagulation was started with warfarin 5 mg with a goal of 2-3 and a plan for cardioversion in 6 weeks .","problem":[],"test":[],"treatment":["cardioversion","anti-coagulation","warfarin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,34,82],"treatment_indices_end":[16,42,95]}
{"text":"again seen are subtle hypodensities within the periventricular white matter which is an indication of chronic microvascular ischemic changes , stable .","problem":["subtle hypodensities within the periventricular white matter","chronic microvascular ischemic changes"],"test":[],"treatment":[],"problem_indices_start":[15,102],"problem_indices_end":[75,140],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"for the left chest wound , they recommended cleansing with commercial wound cleanser , pat dry , pack aquacel ag rope and moisten with saline , cover with dry gauze and change daily .","problem":["the left chest wound"],"test":[],"treatment":["commercial wound cleanser","saline","pack aquacel ag rope","dry gauze"],"problem_indices_start":[4],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[59,97,135,155],"treatment_indices_end":[84,117,141,164]}
{"text":"his coumadin was transitioned to 2 mg and then 1 mg .","problem":[],"test":[],"treatment":["his coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"he was quickly weaned to 3l o2 via nc , o2 sats 100% .","problem":[],"test":["o2 sats"],"treatment":["nc","3l o2"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[40],"test_indices_end":[47],"treatment_indices_start":[25,35],"treatment_indices_end":[30,37]}
{"text":"stable microvascular ischemic changes in the periventricular white matter .","problem":["stable microvascular ischemic changes in the periventricular white matter"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[73],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it appears that his diet was regulated at rehab but there is concern for medication non-compliance at rehab , per previous discharge summaries .","problem":["medication non-compliance"],"test":[],"treatment":[],"problem_indices_start":[73],"problem_indices_end":[98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. 2017-09-30 eeg :","problem":[],"test":["eeg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on discharge , the patient was maintained on standing diuretics as well as prn nebs and inh copd meds .","problem":[],"test":[],"treatment":["standing diuretics","inh copd meds","prn nebs"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[45,75,88],"treatment_indices_end":[63,83,101]}
{"text":"he was started on finsateride on the day prior to admission .","problem":[],"test":[],"treatment":["finsateride"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[29]}
{"text":"extensive carotid artery calcifications are identified .","problem":["extensive carotid artery calcifications"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"until then , his foley should remain in place .","problem":[],"test":[],"treatment":["his foley"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[22]}
{"text":"no evidence of acute or chronic infarction .","problem":["acute or chronic infarction"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"levothyroxine 100 mcg po daily","problem":[],"test":[],"treatment":["levothyroxine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"duloxetine 20 mg po qhs","problem":[],"test":[],"treatment":["duloxetine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"single ap view of the chest .","problem":[],"test":["single ap view of the chest"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the mitral valve leaflets are mildly thickened .","problem":["mildly thickened"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mild cardiomegaly is stable .","problem":["mild cardiomegaly"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ondansetron prn","problem":[],"test":[],"treatment":["ondansetron"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"a small right pleural effusion has decreased in size .","problem":["a small right pleural effusion"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"percocet 1 tab prn","problem":[],"test":[],"treatment":["percocet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"6. 2017-09-28 chest x ray :","problem":[],"test":["chest x ray"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"senna prn","problem":[],"test":[],"treatment":["senna"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"colace prn","problem":[],"test":[],"treatment":["colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"lasix 80 mg po bid","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"there has been almost complete resolution of pulmonary edema .","problem":["pulmonary edema"],"test":[],"treatment":[],"problem_indices_start":[45],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"almost complete resolution of pulmonary edema .","problem":["pulmonary edema"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his inr continued to flucuate .","problem":[],"test":["his inr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lactulose prn","problem":[],"test":[],"treatment":["lactulose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"he was started on a lasix gtt the night of admission with a good response .","problem":[],"test":[],"treatment":["a lasix gtt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[29]}
{"text":"his inr will have to be monitored closely unitl his levels are stable .","problem":[],"test":["his inr","his levels"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,48],"test_indices_end":[7,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lidocaine patch","problem":[],"test":[],"treatment":["lidocaine patch"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"7. 2017-09-29 ct head :","problem":[],"test":["ct head"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this am while talking with his daughter on the phone , he was noted to desaturate into the high 80s and he was brought to the the hospital for orthopedics juan for further evaluation .","problem":[],"test":["further evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[164],"test_indices_end":[182],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no pneumothorax .","problem":["pneumothorax"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his inr goal is 02-24 .","problem":[],"test":["inr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[4],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nystatin powder","problem":[],"test":[],"treatment":["nystatin powder"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"2# sob on admission :","problem":["sob"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gabapentin 300 mg po tid","problem":[],"test":[],"treatment":["gabapentin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"patient is post median sternotomy .","problem":[],"test":[],"treatment":["median sternotomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[33]}
{"text":"alb nebs","problem":[],"test":[],"treatment":["alb nebs"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"right pic catheter tip ends in the lower svc .","problem":[],"test":[],"treatment":["right pic catheter tip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[22]}
{"text":"the patient had another echo on 2017-09-14 with no new changes .","problem":[],"test":["another echo"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"scattered parenchymal opacities in the left lower lobe represent superimposed infection vs atelectasis .","problem":["scattered parenchymal opacities in the left lower lobe","superimposed infection","atelectasis"],"test":[],"treatment":[],"problem_indices_start":[0,65,91],"problem_indices_end":[54,87,102],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was continued on aspirin , metoprolol and lipitor with no further issues .","problem":["further issues"],"test":[],"treatment":["aspirin","lipitor","metoprolol"],"problem_indices_start":[61],"problem_indices_end":[75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20,30,45],"treatment_indices_end":[27,40,52]}
{"text":"the mitral valve leaflets are mildly thickened .","problem":["mildly thickened"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"underlying infectious consolidation in the right lower lobe not excluded .","problem":["underlying infectious consolidation in the right lower lobe"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had an initial troponin bump on admission which was most likely secondary to chf exacerbation .","problem":["an initial troponin bump","chf exacerbation"],"test":[],"treatment":[],"problem_indices_start":[16,89],"problem_indices_end":[40,105],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. increasing large right-sided pleural effusion and pulmonary edema .","problem":["pulmonary edema","increasing large right-sided pleural effusion"],"test":[],"treatment":[],"problem_indices_start":[3,53],"problem_indices_end":[48,68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ischemia","problem":["ischemia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no evidence of abscess .","problem":["abscess"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"central venous catheter and swan ganz catheter placement","problem":[],"test":[],"treatment":["central venous catheter","swan ganz catheter placement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,28],"treatment_indices_end":[23,56]}
{"text":"his dry weight is 70.4 kg .","problem":[],"test":["his dry weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at discharge the patient was thought to be euvolemic , satting well on room air and without peripheral edema .","problem":["peripheral edema"],"test":[],"treatment":[],"problem_indices_start":[92],"problem_indices_end":[108],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a bioprosthetic aortic valve prosthesis is present .","problem":[],"test":[],"treatment":["a bioprosthetic aortic valve prosthesis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[39]}
{"text":"the left ventricular inflow pattern suggests a restrictive filling abnormality , with elevated left atrial pressure .","problem":["a restrictive filling abnormality","elevated left atrial pressure"],"test":["the left ventricular inflow pattern"],"treatment":[],"problem_indices_start":[45,86],"problem_indices_end":[78,115],"test_indices_start":[0],"test_indices_end":[35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the aortic prosthesis leaflets appear to move normally .","problem":[],"test":[],"treatment":["the aortic prosthesis leaflets"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[30]}
{"text":"5. ct chest 2017-09-16 :","problem":[],"test":["ct chest"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was unchanged in comparison to 2017-08-14 with similar ventricular function and inferior and inferolateral hypokinesis .","problem":["inferior and inferolateral hypokinesis"],"test":["ventricular function"],"treatment":[],"problem_indices_start":[83],"problem_indices_end":[121],"test_indices_start":[58],"test_indices_end":[78],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"endotracheal intubation","problem":[],"test":[],"treatment":["endotracheal intubation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[23]}
{"text":"etiology most likely a combination of contraction alkalosis and \/ or post-hypercapnia .","problem":["post-hypercapnia","contraction alkalosis"],"test":[],"treatment":[],"problem_indices_start":[38,69],"problem_indices_end":[59,85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the transaortic gradient is normal for this prosthesis .","problem":[],"test":[],"treatment":["this prosthesis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39],"treatment_indices_end":[54]}
{"text":"there is no pericardial effusion .","problem":["pericardial effusion"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"riss","problem":[],"test":[],"treatment":["riss"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[4]}
{"text":"there is mild symmetric left ventricular hypertrophy .","problem":["mild symmetric left ventricular hypertrophy"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. echo 2017-09-04","problem":[],"test":["echo"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his underlying rhythm is atrial flutter ; it was unclear whether he had previously been cardioverted .","problem":["atrial flutter"],"test":["his underlying rhythm"],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[39],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient states that he has felt \" cloudy \" of late which seems to relate to his worsening sob .","problem":["cloudy","his worsening sob"],"test":[],"treatment":[],"problem_indices_start":[38,80],"problem_indices_end":[44,97],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"resting regional wall motion abnormalities include inferior and inferolateral hypokinesis .","problem":["inferior and inferolateral hypokinesis","resting regional wall motion abnormalities"],"test":[],"treatment":[],"problem_indices_start":[0,51],"problem_indices_end":[42,89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"medicine","problem":[],"test":[],"treatment":["medicine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"4# pleural effusions : s\/p right thoracentesis on 2017-09-06 , 1600 ml of serosanguinous fluid removed from right pleural space .","problem":["serosanguinous fluid","pleural effusions"],"test":[],"treatment":["s\/p right thoracentesis"],"problem_indices_start":[3,74],"problem_indices_end":[20,94],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[46]}
{"text":"compared to pa and lateral chest of the prior day .","problem":[],"test":["pa and lateral chest"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rhythm","problem":[],"test":["rhythm"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the heart is markedly enlarged .","problem":["markedly enlarged"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his blood sugars were in the 100s on discharge .","problem":[],"test":["his blood sugars"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right-sided picc line with its tip in the distal svc .","problem":[],"test":[],"treatment":["right-sided picc line"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[21]}
{"text":"there remains a large right and small left pleural effusion , not significantly changed .","problem":["a large right and small left pleural effusion"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient remains in congestive heart failure , though it may be slightly improved compared to the prior study .","problem":["congestive heart failure"],"test":["the prior study"],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[43],"test_indices_start":[93],"test_indices_end":[108],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lv systolic function appears depressed .","problem":["depressed"],"test":["lv systolic function"],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[38],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"congestive heart failure with bilateral effusions ( r > l ) , with possible underlying consolidation in the rll and to a lesser degree the rml and lll .","problem":["congestive heart failure","bilateral effusions","underlying consolidation in the rll"],"test":[],"treatment":[],"problem_indices_start":[0,30,76],"problem_indices_end":[24,49,111],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he is on amiodarone for post-op afib and this was continued this entire admission .","problem":["post-op afib"],"test":[],"treatment":["amiodarone"],"problem_indices_start":[24],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9],"treatment_indices_end":[19]}
{"text":"the ventricles and sulci are mildly prominent , but stable in size and appearance .","problem":["mildly prominent"],"test":[],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. cxr 2017-09-04","problem":[],"test":["cxr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"for unclear reasons , he was placed on a nrb in the juan .","problem":[],"test":[],"treatment":["a nrb"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39],"treatment_indices_end":[44]}
{"text":"neurology was also consulted and a head ct showed old lacunar infarcts but no acute causes for a change in mental status .","problem":["a change in mental status","old lacunar infarcts"],"test":["a head ct"],"treatment":[],"problem_indices_start":[50,95],"problem_indices_end":[70,120],"test_indices_start":[33],"test_indices_end":[42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. cxr ( pa\/lateral ) 2017-09-03","problem":[],"test":["cxr ( pa\/lateral )"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has a history of baseline dementia which was confounded by delerium in the face of metabolic abnormalities .","problem":["delerium","metabolic abnormalities","baseline dementia"],"test":[],"treatment":[],"problem_indices_start":[29,71,95],"problem_indices_end":[46,79,118],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right ventricular chamber size is normal and free wall motion may be mildly impaired .","problem":["mildly impaired"],"test":[],"treatment":[],"problem_indices_start":[69],"problem_indices_end":[84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-09-03 wbc - 9.1 rbc - 2.77 * hgb - 8.8 * hct - 27.2 * mcv - 99 * mch - 31.9 mchc - 32.4 rdw - 18.0 *","problem":[],"test":["mcv","mch","mchc","rdw","hct","hgb","rbc","wbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11,21,34,46,59,70,81,93],"test_indices_end":[14,24,37,49,62,73,85,96],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was continued on nebs","problem":[],"test":[],"treatment":["nebs"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[33]}
{"text":"8# ms changes :","problem":["ms changes"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6# hyperlipidemia :","problem":["hyperlipidemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7# copd :","problem":["copd"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the left atrium is mildly dilated .","problem":["mildly dilated"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was continued on his statin .","problem":[],"test":[],"treatment":["his statin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[39]}
{"text":"70 y\/o male with h\/o cad s\/p lad ptca 33 yrs ago , copd , t2dm , and aicd pocket infection who presented to the juan on 2017-09-03 with worsening sob x 5 days and feeling \" cloudy .\"","problem":["cad","copd","t2dm","worsening sob","aicd pocket infection"],"test":[],"treatment":["s\/p lad ptca"],"problem_indices_start":[21,51,58,69,136],"problem_indices_end":[24,55,62,90,149],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25],"treatment_indices_end":[37]}
{"text":"arterial line placement","problem":[],"test":[],"treatment":["arterial line placement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[23]}
{"text":"2017-09-03 neuts - 79.5 * lymphs - 9.9 * monos - 4.9 eos - 5.4 * basos - 0.2","problem":[],"test":["basos","eos","monos","lymphs","neuts"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11,26,41,53,65],"test_indices_end":[16,32,46,56,70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- hypothyroidism","problem":["hypothyroidism"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he denies any cp , n\/v\/d , abdominal pain , or ha .","problem":["n\/v\/d","abdominal pain","ha","any cp"],"test":[],"treatment":[],"problem_indices_start":[10,19,27,47],"problem_indices_end":[16,24,41,49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-09-03 hypochrom - 2+ anisocyt - 1+ macrocyt - 2+","problem":[],"test":["macrocyt","anisocyt","hypochrom"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11,26,40],"test_indices_end":[20,34,48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-09-03 plt count - 124 *","problem":[],"test":["plt count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"shortness of breath","problem":["shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2+ pitting edema to knees b\/l .","problem":["pitting edema to knees b\/l"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient recorded as having no known allergies to drugs","problem":["known allergies to drugs"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"crackles halfway up lung fields b\/l .","problem":["crackles halfway up lung fields b\/l"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"jvd difficult to access 02-23 increased neck girth .","problem":["increased neck girth","jvd"],"test":[],"treatment":[],"problem_indices_start":[0,30],"problem_indices_end":[3,50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was currently at hubbard regional hospital and began to develop worsening sob for the past 5 days .","problem":["worsening sob"],"test":[],"treatment":[],"problem_indices_start":[76],"problem_indices_end":[89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right sided thoracentesis","problem":[],"test":[],"treatment":["right sided thoracentesis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[25]}
{"text":"transmitral doppler and tissue velocity imaging are consistent with grade iii\/iv ( severe ) left ventricular diastolic dysfunction .","problem":["grade iii\/iv ( severe ) left ventricular diastolic dysfunction"],"test":["transmitral doppler","tissue velocity imaging"],"treatment":[],"problem_indices_start":[68],"problem_indices_end":[130],"test_indices_start":[0,24],"test_indices_end":[19,47],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- aicd pocket infection c\/b mssa bacteremia , pericardial effusion s\/p mediastinal exploration , evacuation of pericardial effusion & hematoma ( 2017-07-24 )","problem":["pericardial effusion","hematoma","pericardial effusion","aicd pocket infection","mssa bacteremia"],"test":["s\/p mediastinal exploration"],"treatment":["evacuation"],"problem_indices_start":[2,28,46,111,134],"problem_indices_end":[23,43,66,131,142],"test_indices_start":[67],"test_indices_end":[94],"treatment_indices_start":[97],"treatment_indices_end":[107]}
{"text":"3. please call your pcp c. lettinga or seek medical attention in the juan if you experience worsening shortness of breath , chest pain , dizziness , passing out , or any other concerning symptom .","problem":["any other concerning symptom","chest pain","dizziness","passing out","worsening shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[92,124,137,149,166],"problem_indices_end":[121,134,146,160,194],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"these findings indicate a widespread encephalopathic condition affecting both cortical and subcortical structures .","problem":["a widespread encephalopathic condition"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"compared with the prior study ( images reviewed ) of 2017-08-14 , ventricular function is now similar.","problem":[],"test":["the prior study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ef 35-40% .","problem":[],"test":["ef"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the aortic root is mildly dilated .","problem":["mildly dilated"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the aortic valve leaflets are mildly thickened .","problem":["mildly thickened"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"during this admission you have been treated for a chf exacerbation .","problem":["a chf exacerbation"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. please take all medications as prescribed .","problem":[],"test":[],"treatment":["all medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[30]}
{"text":"the ascending aorta is mildly dilated .","problem":["mildly dilated"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is mild pulmonary artery systolic hypertension .","problem":["mild pulmonary artery systolic hypertension"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was discharged hemodynamicallly stable , afebrile with appropriate follow up .","problem":["afebrile"],"test":[],"treatment":[],"problem_indices_start":[53],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the tricuspid valve leaflets are mildly thickened .","problem":["mildly thickened"],"test":[],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no pericardial effusion .","problem":["pericardial effusion"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hypertension","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"type 2 diabetes mellitus","problem":["type 2 diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chronic obstructive pulmonary disease","problem":["chronic obstructive pulmonary disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he then became dusky and cyanotic , and stopped breathing on his own .","problem":["cyanotic","dusky","stopped breathing"],"test":[],"treatment":[],"problem_indices_start":[15,25,40],"problem_indices_end":[20,33,57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , they felt this event could not account for his new , severe global deficit ; this was thought to be secondary to a more pervasive process , likely anoxic encephalopathy , for which the prognosis is extremely grim .","problem":["a more pervasive process","his new , severe global deficit","anoxic encephalopathy"],"test":[],"treatment":[],"problem_indices_start":[53,123,157],"problem_indices_end":[84,147,178],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"old twi v4-6 .","problem":["old twi v4-6"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"atrial fibrillation , occasional v-paced , rate 74 .","problem":["atrial fibrillation"],"test":["rate"],"treatment":["occasional v-paced"],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[43],"test_indices_end":[47],"treatment_indices_start":[22],"treatment_indices_end":[40]}
{"text":"ekg in john :","problem":[],"test":["ekg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"anemia of chronic disease","problem":["anemia of chronic disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mr. lockley is a 73 yo male with a complicated past medical history , recently discharged from st. margaret 's center for women & infants on 08-02 following a prolonged admission for stemi , respiratory failure felt secondary to pulmonary edema requiring intubation and subsequent tracheostomy 02-22 failure to wean , sepsis and c.difficile colitis treated with vancomycin and flagyl with a course of levophed .","problem":["sepsis","respiratory failure","pulmonary edema","failure to wean","c.difficile colitis","stemi"],"test":[],"treatment":["subsequent tracheostomy","vancomycin","flagyl","levophed"],"problem_indices_start":[183,191,229,300,318,329],"problem_indices_end":[188,210,244,315,324,348],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[270,362,377,401],"treatment_indices_end":[293,372,383,409]}
{"text":"the left ventricular inflow pattern suggests impaired relaxation .","problem":["impaired relaxation"],"test":["the left ventricular inflow pattern"],"treatment":[],"problem_indices_start":[45],"problem_indices_end":[64],"test_indices_start":[0],"test_indices_end":[35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at osh , sputum cultures grew pseudomonas and mrsa , and he was restarted on zosyn ( 08-08 ) and vancomycin ( 08-09 ).","problem":["mrsa","pseudomonas"],"test":["sputum cultures"],"treatment":["vancomycin","zosyn"],"problem_indices_start":[30,46],"problem_indices_end":[41,50],"test_indices_start":[9],"test_indices_end":[24],"treatment_indices_start":[77,97],"treatment_indices_end":[82,107]}
{"text":"mild ( 1+ ) aortic regurgitation is seen .","problem":["mild ( 1+ ) aortic regurgitation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"jevity 1.2 65 ml \/ hour continuous with water 240 cc q 8 hours","problem":[],"test":[],"treatment":["jevity"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"long qt interval ( qtc 462 ms ).","problem":["long qt interval"],"test":["qtc"],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[19],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"st depressions v4 , 5 .","problem":["st depressions v4 , 5"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in john , bp 80\/60 , hr 80 .","problem":[],"test":["hr","bp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10,21],"test_indices_end":[12,23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was disconnected from the ventilator and all medications beyond a morphine drip were stopped , and he expired shortly thereafter .","problem":[],"test":[],"treatment":["the ventilator","a morphine drip","all medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25,44,67],"treatment_indices_end":[39,59,82]}
{"text":"2017-08-15 sputum culture - preliminary { pseudomonas aeruginosa }","problem":["pseudomonas aeruginosa"],"test":["sputum culture"],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[64],"test_indices_start":[11],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lansoprazole 30 mg po qam","problem":[],"test":[],"treatment":["lansoprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"he was transferred to st. margaret 's center for women & infants john for further management on ac , rr 15 , peep 5 , vt 500 , fi02 1.0 .","problem":[],"test":["ac","fi02","vt","peep","rr"],"treatment":["further management"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[96,101,109,118,127],"test_indices_end":[98,103,113,120,131],"treatment_indices_start":[74],"treatment_indices_end":[92]}
{"text":"there is no aortic valve stenosis .","problem":["aortic valve stenosis"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hyponatremia","problem":["hyponatremia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"asa 325 mg po qd","problem":[],"test":[],"treatment":["asa"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[3]}
{"text":"mild st elevation in v3 .","problem":["mild st elevation in v3"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-08-14 cxr :","problem":[],"test":["cxr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vancomycin 1 gm iv q 36 hours ( last dose at 2000 on 08-13 ) .","problem":[],"test":[],"treatment":["vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"ac , rr 15 , peep 5 , vt 500 cc , fio2 1.0 .","problem":[],"test":["vt","peep","rr","ac","fio2"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,5,13,22,34],"test_indices_end":[2,7,17,24,38],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abg done on fio2 100% 7.36\/66\/417\/98% .","problem":[],"test":["abg"],"treatment":["fio2"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[12],"treatment_indices_end":[16]}
{"text":"lasix 40 mg iv qam ( given 08-14 )","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"old twi v4-6 .","problem":["old twi v4-6"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"metoprolol 37.5 mg q 12 hours ( last dose 07\/25 in am )","problem":[],"test":[],"treatment":["metoprolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"the ascending aorta is mildly dilated .","problem":["mildly dilated"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"s\/p right pneumonectomy .","problem":[],"test":[],"treatment":["s\/p right pneumonectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[23]}
{"text":"patient placed on fio2 100% .","problem":[],"test":[],"treatment":["fio2"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[22]}
{"text":"zosyn 4.5 gm iv q 8 hours ( last dose on 08-14 at 1400 ) , started 08-08 .","problem":[],"test":[],"treatment":["zosyn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"vitals reportedly hr 88-98 , bp 150\/80 .","problem":[],"test":["hr","bp","vitals"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,18,29],"test_indices_end":[6,20,31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blunting of left cpa likely effusion .","problem":["effusion","blunting of left cpa"],"test":[],"treatment":[],"problem_indices_start":[0,28],"problem_indices_end":[20,36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heparin 5000 units sc tid","problem":[],"test":[],"treatment":["heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"ipratropium \/ albuterol inhaler 4 puffs qid","problem":[],"test":[],"treatment":["albuterol inhaler","ipratropium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,14],"treatment_indices_end":[11,31]}
{"text":"1. non-small cell lung cancer s\/p xrt and chemotherapy in french guiana , s\/p right pneumonectomy in 2016-09-21 for recurrence .","problem":["non-small cell lung cancer","recurrence"],"test":[],"treatment":["s\/p xrt","chemotherapy","s\/p right pneumonectomy"],"problem_indices_start":[3,116],"problem_indices_end":[29,126],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30,42,74],"treatment_indices_end":[37,54,97]}
{"text":"completed course of flagyl 07-25 --> 08-10 .","problem":[],"test":[],"treatment":["flagyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[26]}
{"text":"new lower left lateral cw opacity , likely loculated pleural fluid .","problem":["new lower left lateral cw opacity","loculated pleural fluid"],"test":[],"treatment":[],"problem_indices_start":[0,43],"problem_indices_end":[33,66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"unchanged appearance of right pneumonectomy .","problem":[],"test":[],"treatment":["right pneumonectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[43]}
{"text":"there is a small pericardial effusion .","problem":["a small pericardial effusion"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"resting wma include mid to distal septal akinesis , apical akinesis , inferior akinesis\/hypokinesis , and mid to distal anterolateral hypokinesis \/ akinesis .","problem":["mid to distal septal akinesis","apical akinesis","inferior akinesis\/hypokinesis","mid to distal anterolateral hypokinesis","akinesis"],"test":["resting wma"],"treatment":[],"problem_indices_start":[20,52,70,106,148],"problem_indices_end":[49,67,99,145,156],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pseudomonal pneumonia","problem":["pseudomonal pneumonia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-07-19 echo :","problem":[],"test":["echo"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"anoxic encephalopathy","problem":["anoxic encephalopathy"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"medicine","problem":[],"test":[],"treatment":["medicine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"volume overload","problem":["volume overload"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left-to-right shunt across the interatrial septum .","problem":["left-to-right shunt across the interatrial septum"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"continued on ivf ( received total 2300 cc ) , with improved bp to sbp 105-118 .","problem":[],"test":["sbp","bp"],"treatment":["ivf"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[60,66],"test_indices_end":[62,69],"treatment_indices_start":[13],"treatment_indices_end":[16]}
{"text":"chronic respiratory failure","problem":["chronic respiratory failure"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lvef 25% .","problem":[],"test":["lvef"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. non-small cell lung cancer s\/p xrt and chemotherapy in western sahara , s\/p right pneumonectomy in 2016-09-21 for recurrence .","problem":["recurrence","non-small cell lung cancer"],"test":[],"treatment":["s\/p right pneumonectomy","chemotherapy","s\/p xrt"],"problem_indices_start":[3,117],"problem_indices_end":[29,127],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30,42,75],"treatment_indices_end":[37,54,98]}
{"text":"trivial mitral regurgitation is seen .","problem":["trivial mitral regurgitation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ekg without acute changes .","problem":["acute changes"],"test":["ekg"],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[25],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at vencor hospital , bp dropped to 90 , and patient was started on ns ivf , with improvement in bp .","problem":["bp dropped"],"test":["bp"],"treatment":["ns ivf"],"problem_indices_start":[21],"problem_indices_end":[31],"test_indices_start":[96],"test_indices_end":[98],"treatment_indices_start":[67],"treatment_indices_end":[73]}
{"text":"on this head ct without contrast , the evaluation is limited .","problem":[],"test":["this head ct","the evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3,35],"test_indices_end":[15,49],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. hypertension","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chronic left pleural effusion .","problem":["chronic left pleural effusion"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. sick sinus syndrome status post pm\/icd placement","problem":["sick sinus syndrome"],"test":[],"treatment":["status post pm\/icd placement"],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[51]}
{"text":"no definite apical thrombus seen ( cannot exclude ).","problem":["apical thrombus"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"+ s4 .","problem":["s4"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[4],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"01-22+ ar .","problem":["ar"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"wbc - 4.9 rbc - 2.92 * hgb - 8.8 * hct - 26.2 * mcv - 90 mch - 30.1 mchc - 33.5 rdw - 18.5 * neuts - 86.5 * lymphs - 7.5 * monos - 4.7 eos - 1.2 basos - 0.1 plt count - 145 * glucose - 91 urea n - 21 * creat - 0.6 sodium - 143 potassium - 4.2 chloride - 106 total co2 - 32 anion gap - 9 lactate - 1.4 k+ - 3.9","problem":[],"test":["lymphs","neuts","rdw","urea n","basos","eos","monos","creat","glucose","plt count","chloride","potassium","sodium","lactate","k+","total co2","anion gap","hct","mcv","mch","mchc","wbc","rbc","hgb"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,23,35,48,57,68,80,93,108,123,135,145,157,175,188,202,214,227,243,258,273,287,301],"test_indices_end":[3,13,26,38,51,60,72,83,98,114,128,138,150,166,182,194,207,220,236,251,267,282,294,303],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ronchorous breath sounds left chest .","problem":["ronchorous breath sounds left chest"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"peg in place , site without drainage .","problem":["drainage"],"test":[],"treatment":["peg"],"problem_indices_start":[28],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[3]}
{"text":"there are no echocardiographic signs of tamponade","problem":["tamponade"],"test":["echocardiographic signs"],"treatment":[],"problem_indices_start":[40],"problem_indices_end":[49],"test_indices_start":[13],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1+ tr .","problem":["tr"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[5],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"trivial mr .","problem":["trivial mr"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chronic obstructive pulmonary disease","problem":["chronic obstructive pulmonary disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-08-16 ct head :","problem":[],"test":["ct head"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no epileptiform features were seen .","problem":["epileptiform features"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no murmur appreciated .","problem":["murmur"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"intubated , opens eyes , responds to painful stimulus .","problem":[],"test":["painful stimulus"],"treatment":["intubated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[37],"test_indices_end":[53],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"new rounded low-density area measuring 2.5 cm in left basal ganglia , which partially extends to the left thalamus , probably representing subacute infarction .","problem":["subacute infarction","new rounded low-density area"],"test":[],"treatment":[],"problem_indices_start":[0,139],"problem_indices_end":[28,158],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was thoroughly evaluated by neurology and underwent head ct , mri , lp , and eeg .","problem":[],"test":["head ct","mri","eeg","lp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[55,65,71,80],"test_indices_end":[62,68,73,83],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bp 90s-118\/47-59 , hr 80-90s .","problem":[],"test":["hr","bp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,19],"test_indices_end":[2,21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was also evidence of subcortical dysfunction on the right side .","problem":["subcortical dysfunction on the right side"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"findings consistent with failure or fluid overload .","problem":["fluid overload","failure"],"test":[],"treatment":[],"problem_indices_start":[25,36],"problem_indices_end":[32,50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"13. status post tracheostomy 2017-07-21 02-22 failure to wean","problem":["failure to wean"],"test":[],"treatment":["status post tracheostomy"],"problem_indices_start":[46],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[28]}
{"text":"the end result of these discussion was that the patient 's wishes would not be consistent with this new level of functioning from which he had little hope of recovery ; the family decided to make him comfort measures only .","problem":[],"test":[],"treatment":["comfort measures only"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[200],"treatment_indices_end":[221]}
{"text":"limited examination .","problem":[],"test":["limited examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"development of small loculated pleural fluid collection along the periphery of the left major fissure or so-called pseudotumor , consistent with the recent chest x-ray .","problem":["so-called pseudotumor","small loculated pleural fluid collection along the periphery"],"test":["the recent chest x-ray"],"treatment":[],"problem_indices_start":[15,105],"problem_indices_end":[75,126],"test_indices_start":[145],"test_indices_end":[167],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-08-16 echo :","problem":[],"test":["echo"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"opens eyes spontaneously , withdraws to painful stimulus .","problem":[],"test":["painful stimulus"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[40],"test_indices_end":[56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"overall lvef is difficult to assess due to poor echo windows although the basal lv appeas hyperdynamic without regional contraction abnormality ( suspect significant improvement compared to prior study dated 2017-07-18 ).","problem":["hyperdynamic","regional contraction abnormality"],"test":["overall lvef","the basal lv","prior study","echo windows"],"treatment":[],"problem_indices_start":[90,111],"problem_indices_end":[102,143],"test_indices_start":[0,48,70,190],"test_indices_end":[12,60,82,201],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"per dr. john c. corrigan mental health center , patient remained ventilator dependent , intermittently on ps 20\/5 and back on ac 15\/5\/500\/0.35 on 08-08 .","problem":["ventilator dependent"],"test":[],"treatment":["ac","ps"],"problem_indices_start":[65],"problem_indices_end":[85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[106,126],"treatment_indices_end":[108,128]}
{"text":"2017-08-14 07:30 pm type - art po2 - 468 * pco2 - 44 ph - 7.50 * total co2 - 36 * base xs - 10 intubated - intubated","problem":[],"test":["pco2","ph","art po2","base xs","total co2"],"treatment":["intubated","intubated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[27,43,53,65,82],"test_indices_end":[34,47,55,74,89],"treatment_indices_start":[95,107],"treatment_indices_end":[104,116]}
{"text":"2017-08-17 eeg :","problem":[],"test":["eeg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"markedly abnormal portable eeg due to the voltage suppression over the left hemisphere and due to the bursts of generalized slowing and right hemisphere slowing .","problem":["markedly abnormal portable eeg","the bursts of generalized slowing","the voltage suppression over the left hemisphere","right hemisphere slowing"],"test":[],"treatment":[],"problem_indices_start":[0,38,98,136],"problem_indices_end":[30,86,131,160],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the first abnormality raises the possibility of material ( such as subdural fluid ) interposed between the brain and recording electrodes or widespread cortical dysfunction on that side .","problem":["the first abnormality","widespread cortical dysfunction on that side","material ( such as subdural fluid ) interposed between the brain"],"test":[],"treatment":[],"problem_indices_start":[0,48,141],"problem_indices_end":[21,112,185],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the generalized slowing indicates a non specific dysfunction in midline structures .","problem":["the generalized slowing","a non specific dysfunction in midline structures"],"test":[],"treatment":[],"problem_indices_start":[0,34],"problem_indices_end":[23,82],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"unable to assess jvp .","problem":[],"test":["jvp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mr. lockley was admitted with respiratory failure , thought to be related to mucus plugging as well as a pseudomonal pneumonia .","problem":["a pseudomonal pneumonia","respiratory failure","mucus plugging"],"test":[],"treatment":[],"problem_indices_start":[30,77,103],"problem_indices_end":[49,91,126],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bronchiectasis","problem":["bronchiectasis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , the issue that dominated the admission was his recent acute decline in mental status .","problem":["his recent acute decline in mental status"],"test":[],"treatment":[],"problem_indices_start":[53],"problem_indices_end":[94],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this work-up demonstrated a small left basal ganglia infarct , likely cardioembolic .","problem":["a small left basal ganglia infarct","cardioembolic"],"test":["this work-up"],"treatment":[],"problem_indices_start":[26,70],"problem_indices_end":[60,83],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ekg ( at athol memorial hospital , 17:11 ) :","problem":[],"test":["ekg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"14. status post partial colectomy 1972","problem":[],"test":[],"treatment":["status post partial colectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[33]}
{"text":"12. status post peg tube placement 2017-07-21","problem":[],"test":[],"treatment":["status post peg tube placement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[34]}
{"text":"stool sent for c.diff and given flagyl 500 mg po x 1 dose .","problem":["c.diff"],"test":["stool"],"treatment":["flagyl"],"problem_indices_start":[15],"problem_indices_end":[21],"test_indices_start":[0],"test_indices_end":[5],"treatment_indices_start":[32],"treatment_indices_end":[38]}
{"text":"2017-08-16 cta chest :","problem":[],"test":["cta chest"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10. recent mrsa pneumonia and sepsis 2017-07-21 , treated with vancomycin","problem":["sepsis","recent mrsa pneumonia"],"test":[],"treatment":["vancomycin"],"problem_indices_start":[4,30],"problem_indices_end":[25,36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[63],"treatment_indices_end":[73]}
{"text":"2017-08-17 stool clostridium difficile toxin assay - pending","problem":[],"test":["stool clostridium difficile toxin assay"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[50],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no masses or thrombi are seen in the left ventricle ( due to poor echo windows cannot fully exclude ).","problem":["masses","thrombi"],"test":["echo windows"],"treatment":[],"problem_indices_start":[3,13],"problem_indices_end":[9,20],"test_indices_start":[66],"test_indices_end":[78],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. copd\/bronchiectasis","problem":["copd\/bronchiectasis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bronchial breathing over right hemithorax .","problem":["bronchial breathing over right hemithorax"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"withdraws to painful stimulus .","problem":[],"test":["painful stimulus"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sclera anicteric .","problem":["sclera anicteric"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pupils minimally reactive .","problem":["pupils minimally reactive"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. left femoral av fistula 2017-04-19","problem":["left femoral av fistula"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2+ edema both upper extremities , sacral edema .","problem":["sacral edema","2+ edema both upper extremities"],"test":[],"treatment":[],"problem_indices_start":[0,34],"problem_indices_end":[31,46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. depression","problem":["depression"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cool extremities .","problem":["cool extremities"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-08-16 csf ; spinal fluid gram stain - neg fluid culture - neg ; fungal culture - pending ; acid fast culture - pending ; viral culture - pending","problem":[],"test":["fungal culture","fluid culture","spinal fluid gram stain","viral culture","acid fast culture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17,47,69,96,126],"test_indices_end":[40,60,83,113,139],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. copd\/bronchiectasis","problem":["copd\/bronchiectasis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"limited examination .","problem":[],"test":["limited examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. bph","problem":["bph"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. chf with ef 25% on last echo on 2017-07-19","problem":["chf"],"test":["last echo","ef"],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[6],"test_indices_start":[12,22],"test_indices_end":[14,31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"foley in place .","problem":[],"test":[],"treatment":["foley"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"protein \/ soy supplement 2 scoops q 12 hours","problem":[],"test":[],"treatment":["protein \/ soy supplement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"11. c. difficile colitis treated with flagyl ( completed 08-10 )","problem":["c. difficile colitis"],"test":[],"treatment":["flagyl"],"problem_indices_start":[4],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[44]}
{"text":"afib , occasional v-paced , rate 83 bpm .","problem":["afib"],"test":["rate"],"treatment":["occasional v-paced"],"problem_indices_start":[0],"problem_indices_end":[4],"test_indices_start":[28],"test_indices_end":[32],"treatment_indices_start":[7],"treatment_indices_end":[25]}
{"text":"5. cad , with known to rca .","problem":["cad"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. bph","problem":["bph"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. left femoral av fistula 2017-04-19","problem":["left femoral av fistula"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no evidence for pulmonary embolism .","problem":["pulmonary embolism"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"acute respiratory failure","problem":["acute respiratory failure"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. hypertension","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. depression","problem":["depression"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. chf with ef 25% on last echo on 2017-07-19","problem":["chf"],"test":["last echo","ef"],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[6],"test_indices_start":[12,22],"test_indices_end":[14,31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. cad , with known to rca .","problem":["cad"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-08-15 blood culture ngtd","problem":[],"test":["blood culture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sulfonamides","problem":[],"test":[],"treatment":["sulfonamides"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"10. recent mrsa pneumonia and sepsis 2017-07-21 , treated with vancomycin","problem":["sepsis","recent mrsa pneumonia"],"test":[],"treatment":["vancomycin"],"problem_indices_start":[4,30],"problem_indices_end":[25,36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[63],"treatment_indices_end":[73]}
{"text":"chronic left pleural effusion .","problem":["chronic left pleural effusion"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abg :","problem":[],"test":["abg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lumbar puncture on 08-16","problem":[],"test":["lumbar puncture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ett in correct position .","problem":[],"test":[],"treatment":["ett"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[3]}
{"text":"2. sss status post pm\/icd placement","problem":["sss"],"test":[],"treatment":["status post pm\/icd placement"],"problem_indices_start":[3],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[7],"treatment_indices_end":[35]}
{"text":"pm wires in good position .","problem":[],"test":[],"treatment":["pm wires"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"however , today around 17:45 , while being moved by the nursing staff , mr. lockley bosche started coughing .","problem":["coughing"],"test":[],"treatment":[],"problem_indices_start":[99],"problem_indices_end":[107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no grimacing with palpation .","problem":["grimacing"],"test":["palpation"],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[12],"test_indices_start":[18],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-08-15 urine culture - final","problem":[],"test":["urine culture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he completed his course of vancomycin on 2017-08-10 .","problem":[],"test":[],"treatment":["vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[37]}
{"text":"bs present , hypoactive .","problem":["hypoactive"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"transfer from athol memorial hospital for acute on chronic respiratory distress .","problem":["chronic respiratory distress"],"test":[],"treatment":[],"problem_indices_start":[51],"problem_indices_end":[79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2017-08-15 blood culture ngtd","problem":[],"test":["blood culture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was discharged to athol memorial hospital for continued weaning .","problem":[],"test":[],"treatment":["continued weaning"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49],"treatment_indices_end":[66]}
{"text":"13. status post tracheostomy 2017-07-21 02-22 failure to wean","problem":["failure to wean"],"test":[],"treatment":["status post tracheostomy"],"problem_indices_start":[46],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[28]}
{"text":"14. status post partial colectomy 1972","problem":[],"test":[],"treatment":["status post partial colectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[33]}
{"text":"11. c. difficile colitis treated with flagyl ( completed 08-10 )","problem":["c. difficile colitis"],"test":[],"treatment":["flagyl"],"problem_indices_start":[4],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[44]}
{"text":"12. status post peg tube placement 2017-07-21","problem":[],"test":[],"treatment":["status post peg tube placement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[34]}
{"text":"a code was called , + pulse .","problem":[],"test":["pulse"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nt .","problem":["nt"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[2],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. ecg changes - patient had an episode of chest pain during her hospital stay that was both right and left sided with no radiation and no associated symptoms .","problem":["associated symptoms","chest pain","ecg changes"],"test":[],"treatment":[],"problem_indices_start":[3,43,139],"problem_indices_end":[14,53,158],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nasal washings for influenza were negative ; culture pending .","problem":["influenza"],"test":["culture","nasal washings"],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[28],"test_indices_start":[0,45],"test_indices_end":[14,52],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen - obese .","problem":["obese"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"11. s\/p l shoulder hemiarthroplasty following a left humeral fracuture in 2018-11-10- dumas was complicated by a pea arrest secondary to pe .","problem":["a left humeral fracuture","a pea arrest","pe"],"test":[],"treatment":["s\/p l shoulder hemiarthroplasty"],"problem_indices_start":[46,111,137],"problem_indices_end":[70,123,139],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[35]}
{"text":"2. respiratory - intubated for airway protection due to change in mental status .","problem":["change in mental status"],"test":[],"treatment":["airway protection","intubated"],"problem_indices_start":[56],"problem_indices_end":[79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17,31],"treatment_indices_end":[26,48]}
{"text":"in the juan , the pt 's vs were singificant for a fever of 103.8 , tachycardia in the 130s-150s , and initial hypertensive in the 140s .","problem":["initial hypertensive","tachycardia","a fever"],"test":["the pt 's vs"],"treatment":[],"problem_indices_start":[48,67,102],"problem_indices_end":[55,78,122],"test_indices_start":[14],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nd .","problem":["nd"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[2],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"per pt 's son , she is bedbound at baseline due to her multiple le femur fractures .","problem":["bedbound","her multiple le femur fractures"],"test":[],"treatment":[],"problem_indices_start":[23,51],"problem_indices_end":[31,82],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cultures drawn off the hd cath are negative to date .","problem":[],"test":["cultures"],"treatment":["the hd cath"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[19],"treatment_indices_end":[30]}
{"text":"she was given flagyl for presumed c. diff. colitis , however this was stopped when c. diff b toxin came back negative on 2019-01-10 .","problem":["c. diff. colitis"],"test":["c. diff b toxin"],"treatment":["flagyl"],"problem_indices_start":[34],"problem_indices_end":[50],"test_indices_start":[83],"test_indices_end":[98],"treatment_indices_start":[14],"treatment_indices_end":[20]}
{"text":"extremities - feet mildly cool .","problem":["feet mildly cool"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. hypertension","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extubated 12-28 with no incident .","problem":[],"test":[],"treatment":["extubated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"patient was found to have a new humerus fracture distal to the hardware on film this admission .","problem":["a new humerus fracture distal to the hardware"],"test":["film"],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[71],"test_indices_start":[75],"test_indices_end":[79],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10. anemia of chronic disease","problem":["anemia of chronic disease"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2+ dp pulses bilaterally .","problem":[],"test":["2+ dp pulses bilaterally"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"medicine","problem":[],"test":[],"treatment":["medicine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"plan to continue vancomycin for 08-19 day course to treat empiric line infection .","problem":["empiric line infection"],"test":[],"treatment":["vancomycin"],"problem_indices_start":[58],"problem_indices_end":[80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17],"treatment_indices_end":[27]}
{"text":"ac 500 \/ 15 \/ .50 \/ peep 5","problem":[],"test":[],"treatment":["peep"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[24]}
{"text":"wound care should be continued as described after discharge .","problem":[],"test":[],"treatment":["wound care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"on 12-18 flagyl and cefepime were discontinued as all culture data negative to date .","problem":[],"test":["all culture data"],"treatment":["cefepime","flagyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[50],"test_indices_end":[66],"treatment_indices_start":[9,20],"treatment_indices_end":[15,28]}
{"text":"question mild erythema and warmth of left le .","problem":["warmth of left le","mild erythema"],"test":[],"treatment":[],"problem_indices_start":[9,27],"problem_indices_end":[22,44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"c diff neg : 12-28 , 12-31 , 01-01 , 01-02 .","problem":[],"test":["c diff"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gen - sedated and intubated .","problem":[],"test":[],"treatment":["sedated","intubated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6,18],"treatment_indices_end":[13,27]}
{"text":"however , a septic component to the hypotension was also considered as the pt was found to have citrobacter in her urine and c diff in her stool .","problem":["c diff in her stool","citrobacter in her urine","the hypotension","a septic component"],"test":[],"treatment":[],"problem_indices_start":[10,32,96,125],"problem_indices_end":[28,47,120,144],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urine cx 12-26 : > 100k vre likely colonized , 01-03 yest and vre","problem":["vre","vre"],"test":["urine cx"],"treatment":[],"problem_indices_start":[24,62],"problem_indices_end":[27,65],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"anicteric sclera .","problem":["anicteric sclera"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chronic kidney disease - on hemodialysis type 2 diabetes hypercholestrolemia anemia of chornic disease h\/o pe , s\/p pea arrest 11-14","problem":["s\/p pea arrest","anemia of chornic disease","type 2 diabetes","chronic kidney disease","pe","hypercholestrolemia"],"test":[],"treatment":["hemodialysis"],"problem_indices_start":[0,41,57,77,107,112],"problem_indices_end":[22,56,76,102,109,126],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28],"treatment_indices_end":[40]}
{"text":"steroids were discontinued .","problem":[],"test":[],"treatment":["steroids"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"2. diabetic nephropathy resulting in esrd for which she is on hd .","problem":["esrd","diabetic nephropathy"],"test":[],"treatment":["hd"],"problem_indices_start":[3,37],"problem_indices_end":[23,41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[62],"treatment_indices_end":[64]}
{"text":"echo was obtained which showed wma and ef of 35-40% .","problem":["wma"],"test":["echo","ef"],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[34],"test_indices_start":[0,39],"test_indices_end":[4,41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt was note started on asa as she does not tolerate this well , bb was also not started given sbps in the 110s .","problem":[],"test":["sbps"],"treatment":["asa","bb"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[94],"test_indices_end":[98],"treatment_indices_start":[23,64],"treatment_indices_end":[26,66]}
{"text":"no m,r,g .","problem":["m,r,g"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coumadin was stopped and she received ffp for tunneled line change over a wire .","problem":[],"test":[],"treatment":["tunneled line change over a wire","ffp","coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,38,46],"treatment_indices_end":[8,41,78]}
{"text":"8. back pain","problem":["back pain"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urine culture came back positive for vre , however , since patient improved without treatement ( ie linezolid ) initially .","problem":["vre"],"test":["urine culture"],"treatment":["treatement","linezolid"],"problem_indices_start":[37],"problem_indices_end":[40],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[84,100],"treatment_indices_end":[94,109]}
{"text":"unclear etiology headache over the three days prior to admission in association with fever was concerning for a cns etiology .","problem":["headache","fever"],"test":[],"treatment":[],"problem_indices_start":[17,85],"problem_indices_end":[25,90],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"when pt spiked a temperature and became hypotensive she was started on linezolid was started for presumed vre infection in the urine .","problem":["vre infection in the urine","hypotensive","a temperature"],"test":[],"treatment":["linezolid"],"problem_indices_start":[15,40,106],"problem_indices_end":[28,51,132],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[71],"treatment_indices_end":[80]}
{"text":"on the floor the vancomycin was discontinued as the catheter tip culture was negative .","problem":[],"test":["the catheter tip culture"],"treatment":["the vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[48],"test_indices_end":[72],"treatment_indices_start":[13],"treatment_indices_end":[27]}
{"text":"on vit c. and zinc as well to aid w\/ wound healing .","problem":[],"test":[],"treatment":["zinc","vit c."],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,14],"treatment_indices_end":[9,18]}
{"text":"id was consulted who suggested broad spectrum antibiotics if she were to spike .","problem":["spike"],"test":[],"treatment":["broad spectrum antibiotics"],"problem_indices_start":[73],"problem_indices_end":[78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31],"treatment_indices_end":[57]}
{"text":"coumadin was restarted at a dose of 2 mg qhs .","problem":[],"test":[],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"12. pe 2018-11-17 leading to pea arrest","problem":["pe","pea arrest"],"test":[],"treatment":[],"problem_indices_start":[4,29],"problem_indices_end":[6,39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if you have chest pain , shortness of breath , diahrrea or fevers please contact your pcp .","problem":["chest pain","shortness of breath","diahrrea","fevers"],"test":[],"treatment":[],"problem_indices_start":[12,25,47,59],"problem_indices_end":[22,44,55,65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her left knee is slightly erythematous compared to the right but not impressive .","problem":["slightly erythematous"],"test":[],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. type 2 dm - patient was initially covered with an insulin drip while septic and then transitioned back to insulin sliding scale .","problem":["type 2 dm","septic"],"test":[],"treatment":["insulin sliding scale","an insulin drip"],"problem_indices_start":[3,72],"problem_indices_end":[12,78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[50,109],"treatment_indices_end":[65,130]}
{"text":"3. status post left femur fracture","problem":["status post left femur fracture"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. esrd on hd - pt has esrd secondary to her dm and is on hd .","problem":["esrd","her dm","esrd"],"test":[],"treatment":["hd","hd"],"problem_indices_start":[3,23,41],"problem_indices_end":[7,27,47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[11,58],"treatment_indices_end":[13,60]}
{"text":"4. hyponatremia","problem":["hyponatremia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was dialysed but was slightly limited by hypotension .","problem":["slightly limited","hypotension"],"test":[],"treatment":[],"problem_indices_start":[25,45],"problem_indices_end":[41,56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was also started on fluconazole for yeast in the urine , to be treated with fluconazole for total 7 days .","problem":["yeast in the urine"],"test":[],"treatment":["fluconazole","fluconazole"],"problem_indices_start":[40],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24,80],"treatment_indices_end":[35,91]}
{"text":"5. hypercholesterolemia","problem":["hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. unsteady gait","problem":["unsteady gait"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient 's le ulcers appear chronic and do not appear to be the source of infection .","problem":["infection","patient 's le ulcers"],"test":[],"treatment":[],"problem_indices_start":[0,74],"problem_indices_end":[20,83],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. cataracts","problem":["cataracts"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"color - yellow appear - slhazy sp barajas - 1.005","problem":[],"test":["appear","color"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,15],"test_indices_end":[5,21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the tunneled catheter line was changed over a wire and the tip was also negative .","problem":[],"test":["the tip"],"treatment":["the tunneled catheter line","a wire"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[55],"test_indices_end":[62],"treatment_indices_start":[0,44],"treatment_indices_end":[26,50]}
{"text":"the picc line should be discontinued promptly after the linezolid course is completed .","problem":[],"test":[],"treatment":["the linezolid course","the picc line"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,52],"treatment_indices_end":[13,72]}
{"text":"2018-12-26 08:28 pm urine","problem":[],"test":["pm urine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. type 2 diabetes mellitus","problem":["type 2 diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"per notes , pt denied sob , cp , and abdominal pain prior to intubation .","problem":["abdominal pain","cp","sob"],"test":[],"treatment":["intubation"],"problem_indices_start":[22,28,37],"problem_indices_end":[25,30,51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61],"treatment_indices_end":[71]}
{"text":"she normally receives hd on mon , wed , and fri .","problem":[],"test":[],"treatment":["hd"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[24]}
{"text":"blood - lge nitrite - neg protein - 500 glucose - tr ketone - neg bilirubin - neg urobilngn - neg ph - 7.0 leuk - neg","problem":[],"test":["blood","protein","glucose","ketone","urobilngn","bilirubin","ph","leuk","lge nitrite"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,8,26,40,53,66,82,98,107],"test_indices_end":[5,19,33,47,59,75,91,100,111],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt was due for hd but missed it secondary to her illness .","problem":["her illness"],"test":[],"treatment":["hd"],"problem_indices_start":[45],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[17]}
{"text":"when this medication was discontinued , her bp came back up to the 70s-90s \/ 30s-50s .","problem":[],"test":["her bp"],"treatment":["this medication"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[40],"test_indices_end":[46],"treatment_indices_start":[5],"treatment_indices_end":[20]}
{"text":"sepsis -? source","problem":["sepsis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the juan , she received vancomycin , levofloxacin , flagyl , and cefepime ( 2 gm ).","problem":[],"test":[],"treatment":["cefepime","flagyl","levofloxacin","vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,40,55,68],"treatment_indices_end":[37,52,61,76]}
{"text":"rbc - 225 * wbc - 8 * bacteria - none yeast - none epi - < 1","problem":[],"test":["yeast","epi","wbc","bacteria","rbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,12,22,38,51],"test_indices_end":[3,15,30,43,54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ck ( cpk )- 350 *","problem":[],"test":["ck ( cpk )-"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ck - mb - 3 ctropnt - 0.40 *","problem":[],"test":["ck","ctropnt","mb"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,5,12],"test_indices_end":[2,7,19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2018-12-26 08:28 pm urine","problem":[],"test":["pm urine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"although there was never any bacteria isolated from the blood you had some bacteria in the urine which you are being treated for .","problem":["some bacteria in the urine","any bacteria"],"test":["the blood"],"treatment":[],"problem_indices_start":[25,70],"problem_indices_end":[37,96],"test_indices_start":[52],"test_indices_end":[61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was obtunded and was thus intubated for airway protection .","problem":["obtunded"],"test":[],"treatment":["intubated","airway protection"],"problem_indices_start":[8],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30,44],"treatment_indices_end":[39,61]}
{"text":"10ml ns followed by 1ml of 100 units\/ml heparin ( 100 units heparin ) each lumen qd and prn .","problem":[],"test":[],"treatment":["ns","heparin","heparin","lumen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[5,40,60,75],"treatment_indices_end":[7,47,67,80]}
{"text":"micro : sputum 12-27 : grm stn and cx negative","problem":[],"test":["sputum","cx","grm stn"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[8,23,35],"test_indices_end":[14,30,37],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her oxygen saturation was 96% on ra but she was tachypneic to 31 .","problem":["tachypneic"],"test":["her oxygen saturation"],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[58],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"13. heparin flush picc ( 100 units \/ ml ) 2 ml iv daily : prn 10 ml ns followed by 2 ml of 100 units \/ ml heparin ( 200 units heparin ) each lumen daily and prn .","problem":[],"test":[],"treatment":["lumen","heparin","heparin flush picc","heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4,106,126,141],"treatment_indices_end":[22,113,133,146]}
{"text":"pt was then initiated on the sepsis protocol .","problem":[],"test":[],"treatment":["the sepsis protocol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25],"treatment_indices_end":[44]}
{"text":"her son reports that she then developed a headache and fevers started three days ago which were treated with tylenol .","problem":["fevers","a headache"],"test":[],"treatment":["tylenol"],"problem_indices_start":[40,55],"problem_indices_end":[50,61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[109],"treatment_indices_end":[116]}
{"text":"cardiac enzymes were cycled and were normal .","problem":[],"test":["cardiac enzymes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ecg showed new diffuse twi in all leads .","problem":["new diffuse twi in all leads"],"test":["ecg"],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[39],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"post-intubation , the pt 's bp acutely dropped to 58\/19 in the setting of propofol .","problem":[],"test":["the pt 's bp"],"treatment":["propofol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[18],"test_indices_end":[30],"treatment_indices_start":[74],"treatment_indices_end":[82]}
{"text":"she may be started on asa , bb , statin by pcp as stephen .","problem":[],"test":[],"treatment":["statin","asa","bb"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,28,33],"treatment_indices_end":[25,30,39]}
{"text":"she did complain of a left frontal headache .","problem":["a left frontal headache"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. shoulder fracture - patient is s\/p a left hip fracture ( decision not to operate ) and a left shoulder fracture with hemiarthroplasty 11-14 .","problem":["shoulder fracture","s\/p a left hip fracture","a left shoulder fracture"],"test":[],"treatment":["hemiarthroplasty"],"problem_indices_start":[3,34,90],"problem_indices_end":[20,57,114],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[120],"treatment_indices_end":[136]}
{"text":"you were admitted with low blood pressure and fevers likely due to an infection .","problem":["fevers","low blood pressure","an infection"],"test":[],"treatment":[],"problem_indices_start":[23,46,67],"problem_indices_end":[41,52,79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"15. dolasetron mesylate 12.5 mg iv q8h : prn","problem":[],"test":[],"treatment":["dolasetron mesylate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[23]}
{"text":"catheter tip 01-05 , ng .","problem":[],"test":[],"treatment":["ng","catheter tip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,21],"treatment_indices_end":[12,23]}
{"text":"stop linezolid on 2019-01-17 .","problem":[],"test":[],"treatment":["linezolid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[5],"treatment_indices_end":[14]}
{"text":"bld cx 12-26 , 12-27 , 12-28 , 12-31 - ng .","problem":[],"test":["bld cx"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"herpes simplex virus pcr - pnd","problem":[],"test":["herpes simplex virus pcr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please complete a total 14 day course of linezolid .","problem":[],"test":[],"treatment":["linezolid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[41],"treatment_indices_end":[50]}
{"text":"statin was also deffered .","problem":[],"test":[],"treatment":["statin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"16. medication","problem":[],"test":[],"treatment":["medication"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[14]}
{"text":"picc line was removed empirically .","problem":[],"test":[],"treatment":["picc line"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"calcium - 6.2 * phosphate - 1.7 * magnesium - 0.9 *","problem":[],"test":["phosphate","magnesium","calcium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,34],"test_indices_end":[7,25,43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt was recently admitted to the hospital for orthopedics from 12-07 thorugh 12-14 with hypotension thought to be secondary to overdiuresis at hd.","problem":["overdiuresis","hypotension"],"test":[],"treatment":["hd."],"problem_indices_start":[87,126],"problem_indices_end":[98,138],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[142],"treatment_indices_end":[145]}
{"text":"5. papain - urea 544 287 0616 unit - mg \/ g ointment sig : one ( 1 ) appl topical daily ( daily ) .","problem":[],"test":[],"treatment":["papain - urea"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"tip could not be cultured due to contamination .","problem":["contamination"],"test":[],"treatment":["tip"],"problem_indices_start":[33],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[3]}
{"text":"pt was then sent to the the hospital for orthopedics juan for further evaluation .","problem":[],"test":["further evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[62],"test_indices_end":[80],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"csf grm stn \/ cx : negative","problem":[],"test":["cx","csf grm stn"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,14],"test_indices_end":[11,16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt is now transferred to the ficu for further care .","problem":[],"test":[],"treatment":["further care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[50]}
{"text":"cxr , lp , ua and abdominal ct showed no sign of infection .","problem":["infection"],"test":["ua","lp","abdominal ct","cxr"],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[58],"test_indices_start":[0,6,11,18],"test_indices_end":[3,8,13,30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cortisol - 10.3","problem":[],"test":["cortisol"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"wbc - 9.0 rbc - 2.93 * hgb - 9.0 * hct - 29.7 * mcv - 101 * mch - 30.8 mchc - 30.4 * rdw - 24.1 *","problem":[],"test":["wbc","mcv","mch","mchc","rdw","rbc","hct","hgb"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,23,35,48,60,71,85],"test_indices_end":[3,13,26,38,51,63,75,88],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. metoprolol tartrate 25 mg tablet sig : 0.5 tablet po tid ( 3 times a day ) : hold for sbp < 100 , hr < 60 .","problem":[],"test":[],"treatment":["metoprolol tartrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"hypochrom - 3+ anisocyt - 3+ poikilocy - 1+ macrocyt - 3+ microcyt - 1+","problem":[],"test":["anisocyt","hypochrom","macrocyt","microcyt","poikilocy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,15,29,44,58],"test_indices_end":[9,23,38,52,66],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. zinc sulfate 220 mg capsule sig : one ( 1 ) capsule po daily ( daily ) .","problem":[],"test":[],"treatment":["zinc sulfate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"assumed to be secondary to trauma when moving patient into ambulance .","problem":["trauma"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. calcium acetate 667 mg tablet sig : one ( 1 ) tablet po tid w\/ meals ( 3 times a day with meals ) .","problem":[],"test":[],"treatment":["calcium acetate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"he son also notes that she appeared to be working hard to breath .","problem":["working hard to breath"],"test":[],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cmed service was consulted and recommended wtd woulnd care and sling at all times .","problem":[],"test":[],"treatment":["sling","wtd woulnd care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[43,63],"treatment_indices_end":[58,68]}
{"text":"given stress dose steroids empirically and sanchez stim showed cortisol of 9.3 --> 10.3 therefore steroids continued .","problem":[],"test":["sanchez stim","cortisol"],"treatment":["stress dose steroids","steroids"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[43,63],"test_indices_end":[55,71],"treatment_indices_start":[6,98],"treatment_indices_end":[26,106]}
{"text":"she received a total of 4 liters of ns then was started on levophed for continued hypotension .","problem":["continued hypotension"],"test":[],"treatment":["levophed","ns"],"problem_indices_start":[72],"problem_indices_end":[93],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36,59],"treatment_indices_end":[38,67]}
{"text":"2. folic acid 1 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["folic acid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"4. acetaminophen 325 mg tablet sig : 1-2 tablets po q4-6h ( every 4 to 6 hours ) as needed .","problem":[],"test":[],"treatment":["acetaminophen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"she was found to be febrile to 101.9 and received levoflox and vancomycin .","problem":["febrile"],"test":[],"treatment":["levoflox","vancomycin"],"problem_indices_start":[20],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[50,63],"treatment_indices_end":[58,73]}
{"text":"9. tylenol 650 mg q4h prn","problem":[],"test":[],"treatment":["tylenol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"then , this morning she developed fatigue and did not eat well .","problem":["fatigue"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"covered broadly with vancomycin , flagyl , and cefipime .","problem":[],"test":[],"treatment":["cefipime","vancomycin","flagyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21,34,47],"treatment_indices_end":[31,40,55]}
{"text":"10. ondansetron 4 mg q6h prn","problem":[],"test":[],"treatment":["ondansetron"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[15]}
{"text":"1. ascorbic acid 500 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["ascorbic acid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"intubation for airway protection tunneled line change over wire 2019-01-08","problem":[],"test":[],"treatment":["airway protection","intubation","tunneled line change over wire"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,15,33],"treatment_indices_end":[10,32,63]}
{"text":"14. heparin flush cvl ( 100 units \/ ml ) 1 ml iv daily : prn","problem":[],"test":[],"treatment":["heparin flush cvl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[21]}
{"text":"her dialysis was managed by renal service in house .","problem":[],"test":[],"treatment":["her dialysis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"12. linezolid 600 mg iv q12h","problem":[],"test":[],"treatment":["linezolid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"7. pe ( 11-14 )- on heparin drip .","problem":["pe"],"test":[],"treatment":["heparin drip"],"problem_indices_start":[3],"problem_indices_end":[5],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[32]}
{"text":"1. sepsis \/ id- started on sepsis protocol .","problem":["sepsis"],"test":[],"treatment":["sepsis protocol"],"problem_indices_start":[3],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[42]}
{"text":"restared coumadin on 12-29 .","problem":[],"test":[],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9],"treatment_indices_end":[17]}
{"text":"losartan \/ aspirin \/ lisinopril-hctz","problem":[],"test":[],"treatment":["lisinopril-hctz","aspirin","losartan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,11,21],"treatment_indices_end":[8,18,36]}
{"text":"11. warfarin 2 mg tablet sig : one ( 1 ) tablet po hs ( at bedtime ) : titrate dose to goal inr 03-15 .","problem":[],"test":["inr"],"treatment":["warfarin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[92],"test_indices_end":[95],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"10. insulin regular human 300 unit \/ 3 ml insulin pen sig : as directed subcutaneous four times a day : please administer 8 units glargine at dinner and regular insulin sliding scale as prescribed .","problem":[],"test":[],"treatment":["regular insulin sliding scale","glargine","insulin regular human"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4,130,153],"treatment_indices_end":[25,138,182]}
{"text":"chief complaint : fever","problem":["fever"],"test":[],"treatment":[],"problem_indices_start":[18],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. fluconazole 200 mg tablet sig : one ( 1 ) tablet po q24h ( every 24 hours ) for 2 days .","problem":[],"test":[],"treatment":["fluconazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"heparin discontinued on 01-01 when inr was 2.0 .","problem":[],"test":["inr"],"treatment":["heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[35],"test_indices_end":[38],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"69 y\/o female wtih pmh significant for esrd on hd , type 2 dm , and recent pe resulting in pea arrest admitted through the juan with sepsis of unknown etiology .","problem":["esrd","pea arrest","sepsis","type 2 dm","recent pe"],"test":[],"treatment":["hd"],"problem_indices_start":[39,52,68,91,133],"problem_indices_end":[43,61,77,101,139],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47],"treatment_indices_end":[49]}
{"text":"69 y\/o female wtih pmh significant for esrd on hd , type 2 dm , and recent pe resulting in pea arrest admitted through the juan with sepsis of unknown etiology .","problem":["pea arrest","sepsis","type 2 dm","recent pe","esrd","pmh"],"test":[],"treatment":["hd"],"problem_indices_start":[19,39,52,68,91,133],"problem_indices_end":[22,43,61,77,101,139],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47],"treatment_indices_end":[49]}
{"text":"2018-12-26 08:28 pm urine","problem":[],"test":["pm urine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this should be titrated after discharge for inr goal of 2-3 .","problem":[],"test":["inr goal"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[44],"test_indices_end":[52],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. pvd :","problem":["pvd"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"continue to monitor for sign of infection .","problem":["infection"],"test":["monitor"],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[41],"test_indices_start":[12],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. ipratropium bromide 0.02 % solution sig : one ( 1 ) inhalation q4h ( every 4 hours ) .","problem":[],"test":[],"treatment":["ipratropium bromide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"9. left ue markedly more edematous than right ue , this could be from fracture , or there could be a clot , an abscess in the area also a possiblity .","problem":["a clot","an abscess in the area","more edematous","fracture"],"test":[],"treatment":[],"problem_indices_start":[20,70,99,108],"problem_indices_end":[34,78,105,130],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"crp - 46.2 *","problem":[],"test":["crp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lactate - 1.8","problem":[],"test":["lactate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right dialysis catheter ( 2018-11-05 ) was changed over a wire 2019-01-08 .","problem":[],"test":[],"treatment":["a wire","right dialysis catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,56],"treatment_indices_end":[23,62]}
{"text":"picc line placed 2019-01-08 , this should be discontinued immediately after pt finishes the linezolid course .","problem":[],"test":[],"treatment":["picc line","the linezolid course"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,88],"treatment_indices_end":[9,108]}
{"text":"wound care consult given anasarca to prevent decub .","problem":["decub"],"test":[],"treatment":["anasarca"],"problem_indices_start":[45],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25],"treatment_indices_end":[33]}
{"text":"type - mix temp - 35.6 rates -\/ 15 tidal vol - 500 peep - 5 o2 - 50 po2 - 34 * pco2 - 39 ph - 7.32 * total co2 - 21 base xs - -6","problem":[],"test":["tidal vol","rates","total co2","ph","pco2","base xs","mix temp","o2","po2"],"treatment":["peep"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[7,23,35,60,68,79,89,101,116],"test_indices_end":[15,28,44,62,71,83,91,110,123],"treatment_indices_start":[51],"treatment_indices_end":[55]}
{"text":"1. ascorbic acid 500 mg bid","problem":[],"test":[],"treatment":["ascorbic acid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"tunnled catheter tip 01-08 - ngtd","problem":[],"test":[],"treatment":["tunnled catheter tip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[20]}
{"text":"ultrasound without clot .","problem":["clot"],"test":["ultrasound"],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[23],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"glucose - 210 * urea n - 29 * creat - 3.2 * sodium - 139 potassium - 3.9 chloride - 112 * total co2 - 17 * anion gap - 14","problem":[],"test":["potassium","urea n","glucose","sodium","creat","anion gap","total co2","chloride"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,30,44,57,73,90,107],"test_indices_end":[7,22,35,50,66,81,99,116],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"continue elevation and tight dressing to lue >","problem":[],"test":[],"treatment":["elevation","tight dressing to lue"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9,23],"treatment_indices_end":[18,44]}
{"text":"c. diff b - negative","problem":[],"test":["c. diff b"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it is important that you complete the antibiotic course as prescribed .","problem":[],"test":[],"treatment":["the antibiotic course"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[55]}
{"text":"infl a and b 12-27 : negative","problem":[],"test":["infl a and b"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dry gangrene of toes bilaterally w\/ necrosis of the heels and posterior calf .","problem":["necrosis of the heels and posterior calf","dry gangrene of toes bilaterally"],"test":[],"treatment":[],"problem_indices_start":[0,36],"problem_indices_end":[32,76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sed rate - 33 *","problem":[],"test":["sed rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neuts - 65.2 lymphs - 25.2 monos - 6.0 eos - 3.3 basos - 0.4","problem":[],"test":["monos","eos","lymphs","basos","neuts"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,27,39,49],"test_indices_end":[5,19,32,42,54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- assist \/ con intubated - intubated","problem":[],"test":[],"treatment":["intubated","intubated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15,27],"treatment_indices_end":[24,36]}
{"text":"7. vitamin b complex 1 tab daily","problem":[],"test":[],"treatment":["vitamin b complex"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[20]}
{"text":"robert the shortness of breath gets worse please return to emergency room .","problem":["the shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. neutra phos 2 tabs bid","problem":[],"test":[],"treatment":["neutra phos"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"4. riss","problem":[],"test":[],"treatment":["riss"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[7]}
{"text":"neuro - sedated .","problem":["sedated"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. coumadin - dose unknown","problem":[],"test":[],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"lactate - 1.6","problem":[],"test":["lactate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. humulin insulin 2 units qam","problem":[],"test":[],"treatment":["humulin insulin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"please continue to take all medications as prescirbed and follow up with all your appointments .","problem":[],"test":[],"treatment":["all medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[39]}
{"text":"if you have fevers please contact your pcp or return to the emergency room .","problem":["fevers"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. pantoprazole 40 mg bid","problem":[],"test":[],"treatment":["pantoprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"2. folic acid 1 mg daily","problem":[],"test":[],"treatment":["folic acid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"do not appear infected .","problem":["infected"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"skin breakdown between toes .","problem":["skin breakdown between toes"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pressure ulcers under bilateral le right above the ankles .","problem":["pressure ulcers under bilateral le"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"plt count - 177","problem":[],"test":["plt count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2+ pitting edema bilateral le .","problem":["2+ pitting edema bilateral le"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cortisol - 9.3","problem":[],"test":["cortisol"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10. access - left ij placed 12-26 in juan was discontinued during the hospitilization .","problem":[],"test":[],"treatment":["left ij"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[20]}
{"text":"sodium 140 , potassium 5.2 , bun 38 , creatinine .7 , tsh 1.8 , digoxin level less than 0.2 .","problem":[],"test":["tsh","digoxin level","creatinine","potassium","bun","sodium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,29,38,54,64],"test_indices_end":[6,22,32,48,57,77],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. hypotension - the patient was initially mildly hypotensive with systolic blood pressures in the 80s .","problem":["hypotension","mildly hypotensive"],"test":["systolic blood pressures"],"treatment":[],"problem_indices_start":[3,43],"problem_indices_end":[14,61],"test_indices_start":[67],"test_indices_end":[91],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was walking in the hall , dragging his intravenous pole when he tripped over the foot of the pole and lost his balance .","problem":[],"test":[],"treatment":["his intravenous pole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[58]}
{"text":"he was seen by his primary care physician the day before admission and complained of two weeks of increasing shortness of breath and fatigue , weight gain and abdominal fullness .","problem":["weight gain","abdominal fullness","fatigue","increasing shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[98,133,143,159],"problem_indices_end":[128,140,154,177],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he did not sleep at all the night before and was extremely fatigued .","problem":["extremely fatigued"],"test":[],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"of note , this echocardiogram was performed when the patient was tachycardiac .","problem":["tachycardiac"],"test":["this echocardiogram"],"treatment":[],"problem_indices_start":[65],"problem_indices_end":[77],"test_indices_start":[10],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was sent to the emergency department for further evaluation .","problem":[],"test":["further evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[44],"test_indices_end":[62],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. abnormal liver function tests - the patient had an isolated , elevated alkaline phosphatase with a confirmatory elevation in his gamma glutamyl transferase .","problem":["a confirmatory elevation","an isolated , elevated alkaline phosphatase"],"test":["his gamma glutamyl transferase","abnormal liver function tests"],"treatment":[],"problem_indices_start":[51,100],"problem_indices_end":[94,124],"test_indices_start":[3,128],"test_indices_end":[32,158],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient reported feeling at his baseline with chronic mild dyspnea on exertion until two weeks prior to admission .","problem":["chronic mild dyspnea"],"test":[],"treatment":[],"problem_indices_start":[50],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white blood cell count 10.5 , hematocrit 38.1 , platelets 254 , inr 1.8 .","problem":[],"test":["inr","platelets","hematocrit","white blood cell count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,30,48,64],"test_indices_end":[22,40,57,67],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is a 59 year old male with a past medical history significant for an atrioseptal defect repair at age 18 , congestive heart failure with an ejection fraction of 45% and a recent cardiac myocardial infarction , pulmonary hypertension and mitral regurgitation , and atrial fibrillation .","problem":["a recent cardiac myocardial infarction","pulmonary hypertension","congestive heart failure","mitral regurgitation","atrial fibrillation"],"test":["an ejection fraction"],"treatment":["an atrioseptal defect repair"],"problem_indices_start":[112,174,215,242,269],"problem_indices_end":[136,212,237,262,288],"test_indices_start":[142],"test_indices_end":[162],"treatment_indices_start":[71],"treatment_indices_end":[99]}
{"text":"his neurological examination at that time was nonfocal and the head was atraumatic without any evidence of a hematoma .","problem":["atraumatic","a hematoma"],"test":["his neurological examination"],"treatment":[],"problem_indices_start":[72,107],"problem_indices_end":[82,117],"test_indices_start":[0],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he denied fevers , chills , nausea or vomiting , chest pain or diaphoresis .","problem":["chills","nausea","fevers","diaphoresis","vomiting","chest pain"],"test":[],"treatment":[],"problem_indices_start":[10,19,28,38,49,63],"problem_indices_end":[16,25,34,46,59,74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a computerized axial tomography scan of his head at that time did not reveal any extra or intracranial hemorrhage .","problem":["any extra or intracranial hemorrhage"],"test":["a computerized axial tomography scan of his head"],"treatment":[],"problem_indices_start":[77],"problem_indices_end":[113],"test_indices_start":[0],"test_indices_end":[48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"during this period he had also been weaned off of his digoxin starting early in february .","problem":[],"test":[],"treatment":["his digoxin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[50],"treatment_indices_end":[61]}
{"text":"alt 14 , ast 31 , alkaline phosphatase 283 , total bilirubin 1.0 , amylase 71 , glucose tolerance test 317 .","problem":[],"test":["glucose tolerance test","total bilirubin","amylase","ast","alkaline phosphatase","alt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,9,18,45,67,80],"test_indices_end":[3,12,38,60,74,102],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"over the two weeks prior to admission he had noticed an increasing heart rate from his baseline in the 60s to a heart rate in the 120s .","problem":["an increasing heart rate"],"test":["a heart rate"],"treatment":[],"problem_indices_start":[53],"problem_indices_end":[77],"test_indices_start":[110],"test_indices_end":[122],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. rectal bleeding - the patient has a history of rectal bleeding , ever since his brachytherapy for his prostate cancer .","problem":["his prostate cancer","rectal bleeding","rectal bleeding"],"test":[],"treatment":["his brachytherapy"],"problem_indices_start":[3,50,101],"problem_indices_end":[18,65,120],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[79],"treatment_indices_end":[96]}
{"text":"he had also some increased shortness of breath and a 10 pound weight gain and new three to four pillow orthopnea with a dry cough .","problem":["some increased shortness of breath","a 10 pound weight gain","a dry cough","pillow orthopnea"],"test":[],"treatment":[],"problem_indices_start":[12,51,96,118],"problem_indices_end":[46,73,112,129],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition , plans were made to evaluate the patient 's cardiac arteries to determine if he had any component of ischemic cardiomyopathy .","problem":["ischemic cardiomyopathy"],"test":[],"treatment":[],"problem_indices_start":[114],"problem_indices_end":[137],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was some concern that the patient may have a partial biliary obstruction and the patient was sent for an magnetic resonance cholangiopancreatography to further evaluate the biliary system .","problem":["a partial biliary obstruction"],"test":["an magnetic resonance cholangiopancreatography"],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[78],"test_indices_start":[108],"test_indices_end":[154],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition the patient was started on verapamil since his heart rate had remained mildly tachycardiac in the low 100s .","problem":["mildly tachycardiac"],"test":["his heart rate"],"treatment":["verapamil"],"problem_indices_start":[83],"problem_indices_end":[102],"test_indices_start":[55],"test_indices_end":[69],"treatment_indices_start":[39],"treatment_indices_end":[48]}
{"text":"digoxin 0.125 , discontinued one month prior to admission , toprol xl 100 mg daily , trazodone 50 mg once daily , lipitor 10 mg daily , diovan 40 mg daily , atrovent \/ albuterol prn , pulmicort , coumadin 2.5 mg daily , vitamin e , vitamin c , iron supplement .","problem":[],"test":[],"treatment":["vitamin e","coumadin","pulmicort","albuterol","atrovent","diovan","iron supplement","vitamin c","toprol xl","lipitor","trazodone","digoxin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,60,85,114,136,157,168,184,196,220,232,244],"treatment_indices_end":[7,69,94,121,142,165,177,193,204,229,241,259]}
{"text":"the patient was loaded once again with digoxin and his beta blocker was increased to 100 mg of lopressor , three times a day .","problem":[],"test":[],"treatment":["lopressor","digoxin","his beta blocker"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39,51,95],"treatment_indices_end":[46,67,104]}
{"text":"moderate to severe 3+ mitral regurgitation and 3+ tricuspid regurgitation along with moderate pulmonary early systolic hypertension .","problem":["moderate to severe 3+ mitral regurgitation","moderate pulmonary early systolic hypertension","3+ tricuspid regurgitation"],"test":[],"treatment":[],"problem_indices_start":[0,47,85],"problem_indices_end":[42,73,131],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"echocardiogram showed moderate dilated left atrium , no atrioseptal defect , severe global left ventricular hypokinesis with severe left ventricular systolic function and moderately dilated right ventricle .","problem":["moderately dilated right ventricle","severe left ventricular systolic function","severe global left ventricular hypokinesis","moderate dilated left atrium","atrioseptal defect"],"test":["echocardiogram"],"treatment":[],"problem_indices_start":[22,56,77,125,171],"problem_indices_end":[50,74,119,166,205],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an ultrasound of the right upper quadrant did not reveal any cholelithiasis or cholecystitis , however , an irregular hepatic contour was seen which is suggestive of underlying chronic liver disease .","problem":["underlying chronic liver disease","an irregular hepatic contour","any cholelithiasis","cholecystitis"],"test":["an ultrasound of the right upper quadrant"],"treatment":[],"problem_indices_start":[57,79,105,166],"problem_indices_end":[75,92,133,198],"test_indices_start":[0],"test_indices_end":[41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was global hypokinesis apical throughout the right ventricle and abnormal septal motion consistent with right ventricular volume overload .","problem":["global hypokinesis apical throughout the right ventricle","abnormal septal motion","right ventricular volume overload"],"test":[],"treatment":[],"problem_indices_start":[10,71,110],"problem_indices_end":[66,93,143],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"magnetic resonance cholangiopancreatography did not reveal any evidence of biliary dilatation or of any obstructing pancreatic mass .","problem":["any obstructing pancreatic mass","biliary dilatation"],"test":["magnetic resonance cholangiopancreatography"],"treatment":[],"problem_indices_start":[75,100],"problem_indices_end":[93,131],"test_indices_start":[0],"test_indices_end":[43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was felt that this potentially had lead to his atrial flutter and atrial fibrillation with rapid ventricular response .","problem":["rapid ventricular response","atrial fibrillation","his atrial flutter"],"test":[],"treatment":[],"problem_indices_start":[46,69,94],"problem_indices_end":[64,88,120],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"initially he was treated with intravenous fluids with a dramatic response in his systolic blood pressure .","problem":[],"test":["his systolic blood pressure"],"treatment":["intravenous fluids"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[77],"test_indices_end":[104],"treatment_indices_start":[30],"treatment_indices_end":[48]}
{"text":"again seen was a slightly irregular contour of the liver with dilated hepatic veins suggesting chronic hepatic vascular congestion .","problem":["chronic hepatic vascular congestion","dilated hepatic veins","a slightly irregular contour of the liver"],"test":[],"treatment":[],"problem_indices_start":[15,62,95],"problem_indices_end":[56,83,130],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"medicine","problem":[],"test":[],"treatment":["medicine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"2. atrial fibrillation - the patient 's digoxin had been weaned off prior to his admission .","problem":["atrial fibrillation"],"test":[],"treatment":["the patient 's digoxin"],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25],"treatment_indices_end":[47]}
{"text":"it was felt that he may have had some component of vascular congestion from his congestive heart failure as well as possibly some mild cirrhotic changes secondary to his previous alcohol use .","problem":["some mild cirrhotic changes","vascular congestion","his congestive heart failure"],"test":[],"treatment":[],"problem_indices_start":[51,76,125],"problem_indices_end":[70,104,152],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"upon admission it was unclear whether or not the patient was volume overloaded or volume depleted .","problem":["volume overloaded","volume depleted"],"test":[],"treatment":[],"problem_indices_start":[61,82],"problem_indices_end":[78,97],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"serial cardiac enzymes negative .","problem":[],"test":["serial cardiac enzymes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"atrioseptal defect repair in 1970 , cardiomyopathy , right-sided congestive heart failure , pulmonary hypertension , history of atrial fibrillation and atrial flutter , history of prostate cancer , status post brachytherapy , history of rectal bleeding , obstructive sleep apnea on cpap .","problem":["prostate cancer","atrial fibrillation","atrial flutter","right-sided congestive heart failure","rectal bleeding","cardiomyopathy","pulmonary hypertension","obstructive sleep apnea"],"test":[],"treatment":["atrioseptal defect repair","status post brachytherapy","cpap"],"problem_indices_start":[36,53,92,128,152,180,237,255],"problem_indices_end":[50,89,114,147,166,195,252,278],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,198,282],"treatment_indices_end":[25,223,286]}
{"text":"the decision was made to have the patient undergo a cardiac catheterization to fully evaluate the hemodynamics to determine the etiology of the patient 's heart failure .","problem":["the patient 's heart failure"],"test":["a cardiac catheterization"],"treatment":[],"problem_indices_start":[140],"problem_indices_end":[168],"test_indices_start":[50],"test_indices_end":[75],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was initially treated with intravenous fluids , however , subsequently he was diuresed when he became symptomatic and short of breath .","problem":["short of breath","symptomatic"],"test":[],"treatment":["intravenous fluids"],"problem_indices_start":[114,130],"problem_indices_end":[125,145],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39],"treatment_indices_end":[57]}
{"text":"therefore the focus of treatment was changed to controlling his rate .","problem":[],"test":["his rate"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[60],"test_indices_end":[68],"treatment_indices_start":[23],"treatment_indices_end":[32]}
{"text":"chest x-rays revealed evidence of congestive heart failure .","problem":["congestive heart failure"],"test":["chest x-rays"],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[58],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"electrocardiogram showed atrial fibrillation with rapid ventricular response and atrial flutter .","problem":["atrial fibrillation","rapid ventricular response","atrial flutter"],"test":["electrocardiogram"],"treatment":[],"problem_indices_start":[25,50,81],"problem_indices_end":[44,76,95],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ace inhibitors , possible allergy to barium reported by the patient during a barium swallow 25 years ago .","problem":["allergy"],"test":[],"treatment":["barium","ace inhibitors","a barium swallow"],"problem_indices_start":[26],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,37,75],"treatment_indices_end":[14,43,91]}
{"text":"however , subsequent it was determined that the patient 's hypotension may have been related to his rapid ventricular response and right heart failure .","problem":["the patient 's hypotension","his rapid ventricular response","right heart failure"],"test":[],"treatment":[],"problem_indices_start":[44,96,131],"problem_indices_end":[70,126,150],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has been treated with argon laser therapy in the past for his rectal bleeding and it is recommended that he follow up with his gastroenterologist for repeat argon laser therapy .","problem":["his rectal bleeding"],"test":[],"treatment":["argon laser therapy","repeat argon laser therapy"],"problem_indices_start":[70],"problem_indices_end":[89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34,162],"treatment_indices_end":[53,188]}
{"text":"3. congestive heart failure - during the initial course of the patient 's admission , it was unclear as to whether or not he was volume overloaded or volume depleted .","problem":["congestive heart failure","volume depleted","volume overloaded"],"test":[],"treatment":[],"problem_indices_start":[3,129,150],"problem_indices_end":[27,146,165],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has very mild left lower extremity pain which is largely unchanged .","problem":["very mild left lower extremity pain"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. congestive heart failure .","problem":["congestive heart failure"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. diabetes mellitus .","problem":["diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"14. regular insulin sliding scale .","problem":[],"test":[],"treatment":["regular insulin sliding scale"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[33]}
{"text":"3. renagel 1600 mg p.o. t.i.d.","problem":[],"test":[],"treatment":["renagel"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"she received intermittent doses of lasix to assure overall negative intakes and outputs .","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[35],"treatment_indices_end":[40]}
{"text":"10. epogen 5000 units two times weekly , on monday and thursday .","problem":[],"test":[],"treatment":["epogen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"8. protonix 40 mg p.o. q day .","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"internal medicine","problem":[],"test":[],"treatment":["internal medicine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[17]}
{"text":"11. colace 100 mg p.o. b.i.d.","problem":[],"test":[],"treatment":["colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"3. acute renal failure .","problem":["acute renal failure"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. aspirin 325 mg p.o. q day .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"of note , her blood pressure significantly improved in the 120s-130s which assured better perfusion in her kidneys .","problem":[],"test":["her blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. magnesium oxide 800 mg p.o. b.i.d.","problem":[],"test":[],"treatment":["magnesium oxide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"7. flagyl 500 mg p.o. t.i.d. for the next five weeks for osteomyelitis .","problem":["osteomyelitis"],"test":[],"treatment":["flagyl"],"problem_indices_start":[57],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"6. levofloxacin 250 mg p.o. q48 hours for the next five weeks for osteomyelitis .","problem":["osteomyelitis"],"test":[],"treatment":["levofloxacin"],"problem_indices_start":[66],"problem_indices_end":[79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"2. warfarin 3 mg p.o. q h.s.","problem":[],"test":[],"treatment":["warfarin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"she progressed beautifully with physical therapy and occupational therapy and was able to ambulate with assistance .","problem":[],"test":[],"treatment":["physical therapy","occupational therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32,53],"treatment_indices_end":[48,73]}
{"text":"5. osteomyelitis .","problem":["osteomyelitis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. amiodarone 200 mg p.o. q day .","problem":[],"test":[],"treatment":["amiodarone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"13. nph insulin 7 units in the morning and 5 units at night .","problem":[],"test":[],"treatment":["nph insulin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[15]}
{"text":"4. acute myocardial infarction .","problem":["acute myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her renal function significantly improved , and her discharge creatinine was 3.1 .","problem":[],"test":["her discharge creatinine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[48],"test_indices_end":[72],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"12. lasix 80 mg p.o. b.i.d.","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[9]}
{"text":"1. coronary artery disease .","problem":["coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. miconazole powder 2% t.i.d.","problem":[],"test":[],"treatment":["miconazole powder"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[20]}
{"text":"echo 11-02 : pre-bypass : left ventricular wall thickness , cavity size , and systolic function are normal ( lvef>55% ).","problem":[],"test":["lvef>55%","echo"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,109],"test_indices_end":[4,117],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-11-13 06:15 am blood wbc - 8.8 rbc - 2.79 * hgb - 8.6 * hct - 25.4 * mcv - 91 mch - 30.9 mchc - 33.8 rdw - 15.6 * plt ct - 583 *","problem":[],"test":["plt ct","rdw","wbc","hgb","mcv","hct","mch","mchc","rbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,36,49,61,74,83,94,106,119],"test_indices_end":[29,39,52,64,77,86,98,109,125],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"meds at transfer : levoxyl , celexa , folate , lopressor , colace , riss , b12 , protonix , lasix , zocor , verapamil , lovenox , lisinopril","problem":[],"test":[],"treatment":["folate","lopressor","meds","celexa","levoxyl","lasix","colace","lisinopril","lovenox","verapamil","riss","protonix","zocor","b12"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,19,29,38,47,59,68,75,81,92,100,108,120,130],"treatment_indices_end":[4,26,35,44,56,65,72,78,89,97,105,117,127,140]}
{"text":"brother w\/ cad since age 40 and died in 70 's after cardiac surgery .","problem":["cad"],"test":[],"treatment":["cardiac surgery"],"problem_indices_start":[11],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[52],"treatment_indices_end":[67]}
{"text":"she underwent an immediate head ct and neuro consult and was transferred back to the csru .","problem":[],"test":["an immediate head ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-11-12 06:00 am blood wbc - 7.7 rbc - 2.73 * hgb - 8.3 * hct - 25.1 * mcv - 92 mch - 30.4 mchc - 33.1 rdw - 15.5 plt ct - 528 *","problem":[],"test":["rbc","wbc","hct -","mcv","hgb","rdw","mch","mchc","plt ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,36,49,61,74,83,94,106,117],"test_indices_end":[29,39,52,66,77,86,98,109,123],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"resting regional wall motion abnormalities include mild apical hypokinesis .","problem":["mild apical hypokinesis","resting regional wall motion abnormalities"],"test":[],"treatment":[],"problem_indices_start":[0,51],"problem_indices_end":[42,74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"meds at home : coumadin , levoxyl , folate , colace , byetta , verapamil , lisinopril , pravachol , nexium , lasix , celexa","problem":[],"test":[],"treatment":["nexium","celexa","lasix","verapamil","pravachol","lisinopril","colace","byetta","coumadin","meds","levoxyl","folate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,15,26,36,45,54,63,75,88,100,109,117],"treatment_indices_end":[4,23,33,42,51,60,72,85,97,106,114,123]}
{"text":"son died at 14 d\/t asd .","problem":["asd"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-11-11 05:45 am blood pt - 14.5 * ptt - 51.4 * inr(pt) - 1.3 *","problem":[],"test":["pt","inr(pt)","ptt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,38,51],"test_indices_end":[28,41,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-11-11 05:45 am blood creat - 1.6 * k - 4.7","problem":[],"test":["creat","k"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,40],"test_indices_end":[31,41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is evidence of prior cardiac surgery .","problem":[],"test":[],"treatment":["prior cardiac surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[42]}
{"text":"cxr 11-06 : allowing for technical changes , no major adverse interval change has occurred .","problem":["major adverse interval change"],"test":["cxr"],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[77],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cnis 10-29 :","problem":[],"test":["cnis"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gen : nad","problem":["nad"],"test":[],"treatment":[],"problem_indices_start":[6],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-10-28 03:30 pm blood glucose - 98 urean - 26 * creat - 1.6 * na - 140 k - 4.6 cl - 104 hco3 - 27 angap - 14","problem":[],"test":["glucose","creat","urean","angap","hco3","cl","k","na"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,39,52,66,75,83,92,102],"test_indices_end":[33,44,57,68,76,85,96,107],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was then started on heparin with transition to coumadin ( goal inr of 2-3 secondary to h\/o bilateral dvt 's).","problem":["bilateral dvt"],"test":["inr"],"treatment":["coumadin","heparin"],"problem_indices_start":[95],"problem_indices_end":[108],"test_indices_start":[67],"test_indices_end":[70],"treatment_indices_start":[24,51],"treatment_indices_end":[31,59]}
{"text":"ct 11-04 : no acute intracranial hemorrhage .","problem":["acute intracranial hemorrhage"],"test":["ct"],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[43],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coronary artery disease , hypertension , hyperlipidemia , diabetes mellitus , hypothyroid , h\/o bilateral dvt 's ( on chronic coumadin therapy ), pleural disorder ? sarcoidosis , gastritis , b12 deficiency , chronic renal insufficiency , s\/p appendectomy , s\/p lap cholectomy , s\/p total abdominal hysterectomy","problem":["diabetes mellitus","chronic renal insufficiency","hypothyroid","hypertension","hyperlipidemia","coronary artery disease","bilateral dvt 's","gastritis","b12 deficiency","sarcoidosis","pleural disorder"],"test":[],"treatment":["appendectomy","total abdominal hysterectomy","lap cholectomy","chronic coumadin therapy"],"problem_indices_start":[0,26,41,58,78,96,146,165,179,191,208],"problem_indices_end":[23,38,55,75,89,112,162,176,188,205,235],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[118,242,261,282],"treatment_indices_end":[142,254,275,310]}
{"text":"2015-11-12 06:00 am blood glucose - 85 urean - 19 creat - 1.6 * na - 140 k - 4.4 cl - 105 hco3 - 24 angap - 15","problem":[],"test":["creat","hco3","na","k -","angap -","cl","urean","glucose"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,39,50,64,73,81,90,100],"test_indices_end":[33,44,55,66,76,83,94,107],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"epicardial pacing wires were removed on post-op day four .","problem":[],"test":[],"treatment":["epicardial pacing wires"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[23]}
{"text":"after remaining stable in the csru for several days without change in neuro status she was transferred back to the sdu on post-op day four .","problem":["change in neuro status"],"test":[],"treatment":[],"problem_indices_start":[60],"problem_indices_end":[82],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"11. docusate sodium 100 mg capsule sig : one ( 1 ) capsule po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[19]}
{"text":"ms. bridge is a 74 y\/o female admitted to outside hospital on 2015-10-21 with chest discomfort , vomiting and shortness of breath .","problem":["shortness of breath","vomiting","chest discomfort"],"test":[],"treatment":[],"problem_indices_start":[78,97,110],"problem_indices_end":[94,105,129],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10. metoprolol tartrate 25 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["metoprolol tartrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[23]}
{"text":"she eventually underwent a cardiac cath to assess coronary disease which revealed three vessel coronary artery disease .","problem":["three vessel coronary artery disease","coronary disease"],"test":["a cardiac cath"],"treatment":[],"problem_indices_start":[50,82],"problem_indices_end":[66,118],"test_indices_start":[25],"test_indices_end":[39],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. folic acid 1 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["folic acid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"2015-11-12 06:00 am blood pt - 15.5 * ptt - 62.4 * inr(pt) - 1.4 *","problem":[],"test":["ptt","inr(pt)","pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,38,51],"test_indices_end":[28,41,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"initial ekg showed st depressions , but cardiac enzymes were not elevated .","problem":["elevated","st depressions"],"test":["initial ekg","cardiac enzymes"],"treatment":[],"problem_indices_start":[19,65],"problem_indices_end":[33,73],"test_indices_start":[0,40],"test_indices_end":[11,55],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"later on op day sedation was weaned , she awoke neurologically intact and was extubated .","problem":[],"test":[],"treatment":["extubated","sedation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16,78],"treatment_indices_end":[24,87]}
{"text":"12. coumadin 5 mg tablet sig : one ( 1 ) tablet po once a day : check inr 11-15 with results called to dr. lynn .","problem":[],"test":["inr"],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[70],"test_indices_end":[73],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"2015-11-02 coronary artery bypass graft x 2 ( lima to lad , svg to om )","problem":[],"test":[],"treatment":["coronary artery bypass graft","lima to lad","svg to om"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[11,46,60],"treatment_indices_end":[39,57,69]}
{"text":"there are complex (> 4 mm ) atheroma in the descending thoracic aorta .","problem":["complex (> 4 mm ) atheroma in the descending thoracic aorta"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. citalopram 20 mg tablet sig : 0.5 tablet po daily ( daily ).","problem":[],"test":[],"treatment":["citalopram"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"2015-10-30 left carotid stenting","problem":[],"test":[],"treatment":["left carotid stenting"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[11],"treatment_indices_end":[32]}
{"text":"4. simvastatin 40 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["simvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"tape \/ benadryl","problem":[],"test":[],"treatment":["benadryl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[7],"treatment_indices_end":[15]}
{"text":"13. tramadol 50 mg tablet sig : one ( 1 ) tablet po q4-6h ( every 4 to 6 hours ) as needed .","problem":[],"test":[],"treatment":["tramadol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"monitor wounds for signs of infection . please call with any concerns or questions .","problem":["signs of infection","wounds"],"test":[],"treatment":[],"problem_indices_start":[8,19],"problem_indices_end":[14,37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. ascorbic acid 500 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["ascorbic acid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"7. ferrous gluconate 300 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["ferrous gluconate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[20]}
{"text":"no lifting more than 10 lbs for at least 10 weeks from the date of surgery .","problem":[],"test":[],"treatment":["surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[67],"treatment_indices_end":[74]}
{"text":"6. clopidogrel 75 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["clopidogrel"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"no creams , lotions or ointments to incisions .","problem":["incisions"],"test":[],"treatment":["ointments","lotions","creams"],"problem_indices_start":[36],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,12,23],"treatment_indices_end":[9,19,32]}
{"text":"mother died of mi at age 55 .","problem":["mi"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pmh : hypertension , hyperlipidemia , diabetes mellitus , hypothyroid , h\/o bilateral dvt 's, pleural disorder ? sarcoidosis , gastritis , b12 deficiency , chronic renal insufficiency , s\/p appendectomy , s\/p lap cholectomy , s\/p total abdominal hysterectomy","problem":["b12 deficiency","gastritis","diabetes mellitus","sarcoidosis","bilateral dvt 's,","hypertension","pleural disorder","chronic renal insufficiency","hyperlipidemia","hypothyroid"],"test":[],"treatment":["total abdominal hysterectomy","lap cholectomy","appendectomy"],"problem_indices_start":[6,21,38,58,76,94,113,127,139,156],"problem_indices_end":[18,35,55,69,93,110,124,136,153,183],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[190,209,230],"treatment_indices_end":[202,223,258]}
{"text":"she underwent usual pre-operative testing along with carotid ultrasound .","problem":[],"test":["usual pre-operative testing","carotid ultrasound"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14,53],"test_indices_end":[41,71],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 11-02 she was brought to the operating room where she underwent a coronary artery bypass graft x 2 .","problem":[],"test":[],"treatment":["a coronary artery bypass graft"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[67],"treatment_indices_end":[97]}
{"text":"she tolerated the procedure well and was transferred to the csru for invasive monitoring in stable condition .","problem":[],"test":["invasive monitoring"],"treatment":["the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[69],"test_indices_end":[88],"treatment_indices_start":[14],"treatment_indices_end":[27]}
{"text":"post-operative transient ischemic attack","problem":["post-operative transient ischemic attack"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cnis revealed carotid stenosis and she ultimately underwent left carotid stenting by vascular surgery on 10-30 .","problem":["carotid stenosis"],"test":["cnis"],"treatment":["left carotid stenting"],"problem_indices_start":[14],"problem_indices_end":[30],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[60],"treatment_indices_end":[81]}
{"text":"coronary artery disease s\/p coronary artery bypass graft x 2","problem":["coronary artery disease"],"test":[],"treatment":["coronary artery bypass graft"],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28],"treatment_indices_end":[56]}
{"text":"heart : rrr - c\/r\/m\/g","problem":["c\/r\/m\/g"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ext : cool , 1 + pedal pulses , - varicosities , - edema","problem":["varicosities","edema"],"test":["pedal pulses"],"treatment":[],"problem_indices_start":[34,51],"problem_indices_end":[46,56],"test_indices_start":[17],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"some rashes on acw around ekg leads","problem":["some rashes on acw"],"test":[],"treatment":["ekg leads"],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[35]}
{"text":"1. 60-69% stenosis of the right internal carotid artery .","problem":["60-69% stenosis of the right internal carotid artery"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. 80-99% stenosis of the left internal carotid artery .","problem":["80-99% stenosis of the left internal carotid artery"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"carotid stenosis s\/p left carotid stenting","problem":["carotid stenosis"],"test":[],"treatment":["left carotid stenting"],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[42]}
{"text":"complications .","problem":["complications"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the aortic valve leaflets ( 3 ) appear structurally normal with good leaflet excursion and no aortic regurgitation .","problem":["aortic regurgitation"],"test":[],"treatment":[],"problem_indices_start":[94],"problem_indices_end":[114],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the mitral valve appears structurally normal with trivial mitral regurgitation .","problem":["trivial mitral regurgitation"],"test":[],"treatment":[],"problem_indices_start":[50],"problem_indices_end":[78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct angiogram demonstrates no stenosis or aneurysm in the intracranial circulation .","problem":["stenosis","aneurysm in the intracranial circulation"],"test":["ct angiogram"],"treatment":[],"problem_indices_start":[29,41],"problem_indices_end":[37,81],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-11-13 06:15 am blood pt - 18.0 * ptt - 62.3 * inr(pt) - 1.7 *","problem":[],"test":["inr(pt)","pt","ptt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,38,51],"test_indices_end":[28,41,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mild tricuspid regurgitation .","problem":["mild tricuspid regurgitation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"trivial mr .","problem":["trivial mr"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was then transferred to the hospital for orthopedics for surgical intervention .","problem":[],"test":[],"treatment":["surgical intervention"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61],"treatment_indices_end":[82]}
{"text":"abd : soft , nt\/nt + bs","problem":["nt\/nt"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. aspirin 81 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po daily ( daily ).","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"neck : supple , - jvd , - bruits","problem":["jvd","bruits"],"test":[],"treatment":[],"problem_indices_start":[18,26],"problem_indices_end":[21,32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lungs : ctab , coarse","problem":["coarse"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. levothyroxine 125 mcg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["levothyroxine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"2. pantoprazole 40 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po q24h ( every 24 hours ).","problem":[],"test":[],"treatment":["pantoprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"ct was negative and she returned to baseline neuro status without deficits by arrival to csru .","problem":["deficits"],"test":["ct"],"treatment":[],"problem_indices_start":[66],"problem_indices_end":[74],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ms. bridge was admitted from osh for coronary artery bypass surgery .","problem":[],"test":[],"treatment":["coronary artery bypass surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37],"treatment_indices_end":[67]}
{"text":"left-sided subclavian line is unchanged in position .","problem":[],"test":[],"treatment":["left-sided subclavian line"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[26]}
{"text":"early on post-op day two ms. bridge had an episode of aphasia .","problem":["aphasia"],"test":[],"treatment":[],"problem_indices_start":[54],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-11-13 06:15 am blood plt ct - 583 *","problem":[],"test":["plt ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neurology concluded episode was most concerning for tia .","problem":["tia","episode"],"test":[],"treatment":[],"problem_indices_start":[20,52],"problem_indices_end":[27,55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bibasilar subsegmental atelectasis together with bilateral pleural effusions appear relatively unchanged .","problem":["bibasilar subsegmental atelectasis","bilateral pleural effusions"],"test":[],"treatment":[],"problem_indices_start":[0,49],"problem_indices_end":[34,76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mri would be more sensitive for the detection of acute infarction .","problem":["acute infarction"],"test":["mri"],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[65],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on post-op day one chest tubes were removed and beta blockers and diuretics were initiated .","problem":[],"test":[],"treatment":["diuretics","beta blockers","chest tubes"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,48,66],"treatment_indices_end":[30,61,75]}
{"text":"2015-11-13 06:15 am blood glucose - 96 urean - 20 creat - 1.6 * na - 141 k - 4.3 cl - 106 hco3 - 24 angap - 15","problem":[],"test":["creat","angap","hco3","urean","k","na","glucose","cl"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,39,50,64,73,81,90,100],"test_indices_end":[33,44,55,66,74,83,94,105],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest discomfort","problem":["chest discomfort"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"findings consistent with small vessel ischemic changes .","problem":["small vessel ischemic changes"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"normal contrast enhancement seen in the left common\/internal carotid artery stent .","problem":[],"test":[],"treatment":["the left common\/internal carotid artery stent"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36],"treatment_indices_end":[81]}
{"text":"slight irregularity of the origin of the right vertebral artery may be atherosclerotic in nature .","problem":["slight irregularity","atherosclerotic"],"test":[],"treatment":[],"problem_indices_start":[0,71],"problem_indices_end":[19,86],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the absence of history of malignancy , this is statistically benign .","problem":["malignancy"],"test":[],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4 mm left upper lobe lung nodule .","problem":["4 mm left upper lobe lung nodule"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mild stenosis of the proximal right internal carotid artery .","problem":["mild stenosis of the proximal right internal carotid artery"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"14. lasix 40 mg tablet sig : one ( 1 ) tablet po once a day : 40 mg daily x 1 week then 40 mg every other day as prior to surgery .","problem":[],"test":[],"treatment":["lasix","surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4,122],"treatment_indices_end":[9,129]}
{"text":"3. community-acquired pneumonia .","problem":["community-acquired pneumonia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. bronchitis .","problem":["bronchitis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"briefly , this is a 57-year-old gentleman with a history of copd , status post intubation six years ago but not on home 02 with recent fev1 27% of predicted value , and fev1\/fvc ratio 56% of hypercholesterolemia , who was admitted for copd exacerbation and worsening of upper respiratory tract infection symptoms for a week prior to admission .","problem":["hypercholesterolemia","copd","copd exacerbation","upper respiratory tract infection symptoms"],"test":["fev1","fev1\/fvc ratio"],"treatment":["intubation","home 02"],"problem_indices_start":[60,191,235,270],"problem_indices_end":[64,211,252,312],"test_indices_start":[135,169],"test_indices_end":[139,183],"treatment_indices_start":[79,115],"treatment_indices_end":[89,122]}
{"text":"he was also started on antibiotics for possible bronchitis or community-acquired pneumonia .","problem":["bronchitis","community-acquired pneumonia"],"test":[],"treatment":["antibiotics"],"problem_indices_start":[48,62],"problem_indices_end":[58,90],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[34]}
{"text":"he was started on p.o. steroids and to cmed for management of copd exacerbation but he appeared in more respiratory distress overnight and was started on iv solu-medrol and more frequent nebulizers for copd .","problem":["copd","copd exacerbation","more respiratory distress"],"test":[],"treatment":["management","p.o. steroids","more frequent nebulizers","iv solu-medrol"],"problem_indices_start":[62,99,202],"problem_indices_end":[79,124,206],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18,48,154,173],"treatment_indices_end":[31,58,168,197]}
{"text":"he was afebrile with stable vital signs on presentation to","problem":["afebrile"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. chronic obstructive pulmonary disease exacerbation .","problem":["chronic obstructive pulmonary disease exacerbation"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"therefore , home 02 was recommended on discharge .","problem":[],"test":[],"treatment":["home 02"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[19]}
{"text":"6. oxygen 2 liters nasal cannula with ambulating as needed .","problem":[],"test":[],"treatment":["oxygen 2 liters nasal cannula"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[32]}
{"text":"he was continued on p.o. prednisone and frequent nebulizers for copd .","problem":["copd"],"test":[],"treatment":["frequent nebulizers","p.o. prednisone"],"problem_indices_start":[64],"problem_indices_end":[68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20,40],"treatment_indices_end":[35,59]}
{"text":"given his tenuous respiratory status , he was transferred to the ficu with closer observation .","problem":["his tenuous respiratory status"],"test":["closer observation"],"treatment":[],"problem_indices_start":[6],"problem_indices_end":[36],"test_indices_start":[75],"test_indices_end":[93],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. salmeterol one to two puffs b.i.d.","problem":[],"test":[],"treatment":["salmeterol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"he was evaluated by the physical therapist in the hospital and was found to desaturate to 84% with ambulating on room air .","problem":["desaturate"],"test":[],"treatment":[],"problem_indices_start":[76],"problem_indices_end":[86],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he did not require intubation and improved with q. two hour nebulizers and chest pt .","problem":[],"test":[],"treatment":["chest pt","intubation","nebulizers"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,60,75],"treatment_indices_end":[29,70,83]}
{"text":"1. flovent two puffs b.i.d.","problem":[],"test":[],"treatment":["flovent"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"he was again transferred to the cmed service for further management of his copd exacerbation .","problem":["his copd exacerbation"],"test":[],"treatment":["further management"],"problem_indices_start":[71],"problem_indices_end":[92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49],"treatment_indices_end":[67]}
{"text":"3. albuterol inhaler one to two puffs q. four to six hours p.r.n.","problem":[],"test":[],"treatment":["albuterol inhaler"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[20]}
{"text":"4. aspirin 81 mg p.o. q.d.","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"7. prednisone taper with 40 mg p.o. q.d. for two days , 30 mg p.o. q.d. for two days , 20 mg p.o. q.d. for two days , 10 mg p.o. q.d. for two days .","problem":[],"test":[],"treatment":["prednisone taper"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[19]}
{"text":"2. levofloxacin 500 mg p.o. q.d. for another 11 days for a total of a 14 day course .","problem":[],"test":[],"treatment":["levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"4. rule out myocardial infarction .","problem":["myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was admitted with concern for hepatorenal syndrome .","problem":["hepatorenal syndrome"],"test":[],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient received 5 liters of crystalloid , 9 units of fresh frozen plasma , 9 units of red cells , 6 units of platelets , as well as 1 liter of cell saver .","problem":[],"test":[],"treatment":["fresh frozen plasma","crystalloid","platelets","red cells","cell saver"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[33,58,91,114,148],"treatment_indices_end":[44,77,100,123,158]}
{"text":"the patient was on a lasix drip to aid in diuresis , and was ultimately converted to oral lasix on postop day 1 .","problem":[],"test":[],"treatment":["oral lasix","diuresis","a lasix drip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,42,85],"treatment_indices_end":[31,50,95]}
{"text":"his estimated blood loss was 2 liters .","problem":["his estimated blood loss"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in order to aid in optimization of the patient 's fluid status , the patient was on continuous baker baker dialysis during the procedure .","problem":[],"test":["the patient 's fluid status"],"treatment":["the procedure","continuous baker baker dialysis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[35],"test_indices_end":[62],"treatment_indices_start":[84,123],"treatment_indices_end":[115,136]}
{"text":"1. hepatitis c cirrhosis for which the patient was on the liver transplant list .","problem":["hepatitis c cirrhosis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 47 year old male , with end stage liver disease secondary to hepatitis c cirrhosis diagnosed about 5 years prior to admission .","problem":["end stage liver disease","hepatitis c cirrhosis"],"test":[],"treatment":[],"problem_indices_start":[41,78],"problem_indices_end":[64,99],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's inr on admission was 2.4 , with his pt level being 18.9 .","problem":[],"test":["the patient 's inr","his pt level"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,47],"test_indices_end":[18,59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. miconazole nitrate powder tid prn for groin rash .","problem":["groin rash"],"test":[],"treatment":["miconazole nitrate powder"],"problem_indices_start":[41],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[28]}
{"text":"liver transplant on 2013-05-25 .","problem":[],"test":[],"treatment":["liver transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"he had been admitted to the st. margaret 's center for women & infants multiple times early in 2013 for management of encephalopathy and ascites .","problem":["ascites","encephalopathy"],"test":[],"treatment":["management"],"problem_indices_start":[118,137],"problem_indices_end":[132,144],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[104],"treatment_indices_end":[114]}
{"text":"the patient was advanced per protocol to an immunosuppressive regimen of prednisone , neoral , and cellcept .","problem":[],"test":[],"treatment":["an immunosuppressive regimen","prednisone","neoral","cellcept"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[41,73,86,99],"treatment_indices_end":[69,83,92,107]}
{"text":"the patient required 2 units of fresh frozen plasma on the night following surgery , and 1 unit of platelets on postop day 1 , but otherwise required no blood products following the liver transplant .","problem":[],"test":[],"treatment":["the liver transplant","platelets","blood products","fresh frozen plasma","surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32,75,99,153,178],"treatment_indices_end":[51,82,108,167,198]}
{"text":"3.2 on 2013-05-08 , and was further elevated to 3.6 on 2013-05-09 .","problem":["further elevated"],"test":[],"treatment":[],"problem_indices_start":[28],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's serum creatinine on the day of discharge , on 2013-05-06 , was 1.9 , but was noted to increase to","problem":[],"test":["the patient 's serum creatinine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. vancomycin 1 gm iv bid .","problem":[],"test":[],"treatment":["vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"9. valcyte 450 mg po qod .","problem":[],"test":[],"treatment":["valcyte"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"he had no evidence of spontaneous bacterial peritonitis .","problem":["spontaneous bacterial peritonitis"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. neoral 500 mg po bid .","problem":[],"test":[],"treatment":["neoral"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"the procedure proceeded without complications , and the patient was transferred to the intensive care unit while still intubated following the procedure .","problem":["complications"],"test":[],"treatment":["intubated","the procedure","the procedure"],"problem_indices_start":[32],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,119,139],"treatment_indices_end":[13,128,152]}
{"text":"the patient 's nutrition was suboptimal , and the patient was started on tube feeding .","problem":[],"test":[],"treatment":["tube feeding"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[73],"treatment_indices_end":[85]}
{"text":"11. colace 100 mg po bid .","problem":[],"test":[],"treatment":["colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"10. lasix 40 mg bid x 21 days .","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[9]}
{"text":"as previously mentioned , the patient 's creatinine at the time of admission was up to 3.6 from 1.9 at the time of his discharge 3 days prior .","problem":[],"test":["the patient 's creatinine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26],"test_indices_end":[51],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. prednisone 20 mg po qd .","problem":[],"test":[],"treatment":["prednisone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"the patient had been discharged from the st. margaret 's center for women & infants on 2013-05-06 , but was readmitted on 2013-05-09 when noted to have worsening renal function .","problem":["worsening renal function"],"test":[],"treatment":[],"problem_indices_start":[152],"problem_indices_end":[176],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was taken to the operating room and underwent an orthotopic liver transplant .","problem":[],"test":[],"treatment":["an orthotopic liver transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[58],"treatment_indices_end":[88]}
{"text":"7. dilaudid prn .","problem":[],"test":[],"treatment":["dilaudid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"the patient 's pain control was with morphine .","problem":[],"test":[],"treatment":["morphine","the patient 's pain control"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,37],"treatment_indices_end":[27,45]}
{"text":"on 2013-05-25 , a liver became available for transplant to the patient .","problem":[],"test":[],"treatment":["transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[45],"treatment_indices_end":[55]}
{"text":"4. fluconazole 200 mg po qd .","problem":[],"test":[],"treatment":["fluconazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"the patient periodically required transfusions of fresh frozen plasma , as well as platelets and red cells .","problem":[],"test":[],"treatment":["red cells","platelets","fresh frozen plasma","transfusions"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34,50,83,97],"treatment_indices_end":[46,69,92,106]}
{"text":"3. metoprolol 25 mg po bid .","problem":[],"test":[],"treatment":["metoprolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"the patient 's surgical incision was also healing well by the time of discharge with no evidence of infection .","problem":["the patient 's surgical incision","infection"],"test":[],"treatment":[],"problem_indices_start":[0,100],"problem_indices_end":[32,109],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was thrombocytopenic with a platelet count of 49 on the 23 .","problem":["thrombocytopenic"],"test":["a platelet count"],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[32],"test_indices_start":[38],"test_indices_end":[54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. back surgery .","problem":[],"test":[],"treatment":["back surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"2. protonix 40 mg po qd .","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"the patient had undergone treatment with interferon and ribavirin .","problem":[],"test":[],"treatment":["interferon","ribavirin","treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,41,56],"treatment_indices_end":[35,51,65]}
{"text":"by postop day 1 , the patient was awake , in no distress , and appeared lucid prior to extubation .","problem":["distress"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. cellcept 1 gm po bid .","problem":[],"test":[],"treatment":["cellcept"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"the patient was continued on vancomycin therapy for his previously diagnosed methicillin resistant , coagulase negative staph bacteremia .","problem":["his previously diagnosed methicillin resistant , coagulase negative staph bacteremia"],"test":[],"treatment":["vancomycin therapy"],"problem_indices_start":[52],"problem_indices_end":[136],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[47]}
{"text":"the patient started ambulating with the assistance of physical therapy following transfer to the surgical floor .","problem":[],"test":[],"treatment":["physical therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[54],"treatment_indices_end":[70]}
{"text":"the patient 's appetite improved significantly , and at the time of discharge the patient was on a regular diet with no tube feed supplements deemed necessary .","problem":[],"test":[],"treatment":["tube feed supplements"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[120],"treatment_indices_end":[141]}
{"text":"over the following 5 days , the patient 's creatinine improved marginally to 2.7 .","problem":[],"test":["the patient 's creatinine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[28],"test_indices_end":[53],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's liver function tests all improved appropriately by the time of discharge .","problem":[],"test":["the patient 's liver function tests"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. knee surgeries .","problem":[],"test":[],"treatment":["knee surgeries"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[17]}
{"text":"1. bactrim single strength 1 tablet po qd .","problem":[],"test":[],"treatment":["bactrim single strength"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[26]}
{"text":"the patient was extubated on postop day 1 without any problems .","problem":["any problems"],"test":[],"treatment":[],"problem_indices_start":[50],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient underwent diagnostic and therapeutic paracentesis on 2013-05-16 , 2013-05-21 , and 2013-05-24 .","problem":[],"test":[],"treatment":["therapeutic paracentesis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37],"treatment_indices_end":[61]}
{"text":"optimization of his fluid balance was managed by the medical service in consultation with hepatology and renal .","problem":[],"test":["his fluid balance"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. lactulose 30 ml tid ( titrated to 4 to 5 bowel movements qd ) .","problem":[],"test":[],"treatment":["lactulose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"2. protonix 40 mg po bid .","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"4. hemorrhoids .","problem":["hemorrhoids"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. nephrolithiasis .","problem":["nephrolithiasis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cadaveric pancreas transplantation .","problem":[],"test":[],"treatment":["cadaveric pancreas transplantation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[34]}
{"text":"in addition , she will take valganciclovir for three months posttransplant .","problem":[],"test":[],"treatment":["valganciclovir"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28],"treatment_indices_end":[42]}
{"text":"she takes 14 units of nph insulin twice a day supplementing with a sliding scale .","problem":[],"test":[],"treatment":["a sliding scale","nph insulin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,65],"treatment_indices_end":[33,80]}
{"text":"she has undergone full teaching in regards to immunosuppressant medications .","problem":[],"test":[],"treatment":["immunosuppressant medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[46],"treatment_indices_end":[75]}
{"text":"the patient is a 37 year old lady with type 1 diabetes mellitus , who is four months postcadaveric kidney transplantation and now has good graft function .","problem":["type 1 diabetes mellitus"],"test":[],"treatment":["postcadaveric kidney transplantation"],"problem_indices_start":[39],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[85],"treatment_indices_end":[121]}
{"text":"she is to continue monitoring her blood sugar twice a day .","problem":[],"test":["her blood sugar"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[30],"test_indices_end":[45],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on examination , she is in no apparent distress and is alert and oriented .","problem":["apparent distress"],"test":["examination"],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[47],"test_indices_start":[3],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she is afebrile with stable vital signs .","problem":["afebrile"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. end stage renal disease , status post kidney transplantation .","problem":["end stage renal disease"],"test":[],"treatment":["kidney transplantation"],"problem_indices_start":[3],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[41],"treatment_indices_end":[63]}
{"text":"2. type 1 diabetes mellitus .","problem":["type 1 diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her abdomen is soft and nontender with a well healed left lower quadrant incision from her kidney transplantation .","problem":["a well healed left lower quadrant incision","nontender"],"test":[],"treatment":["her kidney transplantation"],"problem_indices_start":[24,39],"problem_indices_end":[33,81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[87],"treatment_indices_end":[113]}
{"text":"1. status post cadaveric pancreas transplant .","problem":[],"test":[],"treatment":["cadaveric pancreas transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[44]}
{"text":"she underwent cadaveric pancreas transplantation without complication .","problem":["complication"],"test":[],"treatment":["cadaveric pancreas transplantation"],"problem_indices_start":[57],"problem_indices_end":[69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[48]}
{"text":"her chest and cardiovascular examinations are unremarkable .","problem":[],"test":["her chest and cardiovascular examinations"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she presents for cadaveric pancreas transplantation .","problem":[],"test":[],"treatment":["cadaveric pancreas transplantation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17],"treatment_indices_end":[51]}
{"text":"she received induction therapy with thymoglobulin intraoperative and postoperatively for five days .","problem":[],"test":[],"treatment":["induction therapy","thymoglobulin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,36],"treatment_indices_end":[30,49]}
{"text":"her diabetes mellitus has been complicated by retinopathy and nephropathy as well as peripheral neuropathy .","problem":["her diabetes mellitus","retinopathy","nephropathy","peripheral neuropathy"],"test":[],"treatment":[],"problem_indices_start":[0,46,62,85],"problem_indices_end":[21,57,73,106],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was kept on a similar immunosuppressive regimen as with her kidney transplant .","problem":[],"test":[],"treatment":["a similar immunosuppressive regimen","her kidney transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16,60],"treatment_indices_end":[51,81]}
{"text":"rr nl s1 s2 no m","problem":["m"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"plastic did not feel that patient had any compartment syndrome and recommended aggresive upper extremity elevation for swelling reduction .","problem":["any compartment syndrome"],"test":[],"treatment":["swelling reduction","aggresive upper extremity elevation"],"problem_indices_start":[38],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[79,119],"treatment_indices_end":[114,137]}
{"text":"atnc , pupils dialted at 5 mm but minimally reactive , anicteric","problem":["atnc","anicteric","minimally reactive"],"test":[],"treatment":[],"problem_indices_start":[0,34,55],"problem_indices_end":[4,52,64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient was started on heparin drip and bilateral lower extremeties were done which were negative for dvt .","problem":["dvt"],"test":["bilateral lower extremeties"],"treatment":["heparin drip"],"problem_indices_start":[102],"problem_indices_end":[105],"test_indices_start":[40],"test_indices_end":[67],"treatment_indices_start":[23],"treatment_indices_end":[35]}
{"text":"wwp , multiple linear scars and burns on hands and arms","problem":["wwp","burns on hands and arms","multiple linear scars"],"test":[],"treatment":[],"problem_indices_start":[0,6,32],"problem_indices_end":[3,27,55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"soft , nd , hypoactive bowel sounds","problem":["nd","hypoactive bowel sounds"],"test":[],"treatment":[],"problem_indices_start":[7,12],"problem_indices_end":[9,35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2014-04-23 08:13 am urine bnzodzpn - pos barbitrt - neg opiates - neg cocaine - neg amphetmn - neg mthdone - neg","problem":[],"test":["opiates","cocaine","barbitrt","urine","bnzodzpn","mthdone","amphetmn"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,41,56,70,84,99],"test_indices_end":[25,34,49,63,77,92,106],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"overnight in the icu patient was noticed to have painful bullae on hands and arm along with swelling .","problem":["painful bullae on hands and arm","swelling"],"test":[],"treatment":[],"problem_indices_start":[49,92],"problem_indices_end":[80,100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"calcium - 9.7 phosphate - 3.7 magnesium - 2.1","problem":[],"test":["calcium","magnesium","phosphate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,14,30],"test_indices_end":[7,23,39],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"later patient told cmed ccu that she was feeling down and impulsively ingested 5 days worth of medications , she states that her intent at that time was to end her life .","problem":[],"test":[],"treatment":["medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[95],"treatment_indices_end":[106]}
{"text":"patient had cta which showed bilateral pulmonary embolisms .","problem":["bilateral pulmonary embolisms"],"test":["cta"],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[58],"test_indices_start":[12],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dermatology and plastic surgery were consulted who felt that symptoms were due to trauma ; it was not felt that patient had compartment syndrome .","problem":["compartment syndrome","symptoms","trauma"],"test":[],"treatment":[],"problem_indices_start":[61,82,124],"problem_indices_end":[69,88,144],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient has a history of suicidal ideations and self mutilation .","problem":["self mutilation","suicidal ideations"],"test":[],"treatment":[],"problem_indices_start":[25,48],"problem_indices_end":[43,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. gerd","problem":["gerd"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was promptly intubated for airway protection and in order to administer charcoal .","problem":[],"test":[],"treatment":["charcoal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[76],"treatment_indices_end":[84]}
{"text":"nsr r 60 normal axis , intervals , incomplete rbbb , flat t avl , v2 , twi v1","problem":["flat t avl","incomplete rbbb","twi v1"],"test":["r"],"treatment":[],"problem_indices_start":[35,53,71],"problem_indices_end":[50,63,77],"test_indices_start":[4],"test_indices_end":[5],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient was gradually put back on her outpatient xanax dose of 1 mg qid and clozaril was restarted .","problem":[],"test":[],"treatment":["her outpatient xanax dose","clozaril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34,76],"treatment_indices_end":[59,84]}
{"text":"ms. franklin is a 34 - year-old woman with bipolar disorder and group home resident who by way of ems for apparent alprazolam overdose .","problem":["apparent alprazolam overdose","bipolar disorder"],"test":[],"treatment":[],"problem_indices_start":[43,106],"problem_indices_end":[59,134],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"group home states that patient \" may have taken too many xanax .","problem":[],"test":[],"treatment":["xanax"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[57],"treatment_indices_end":[62]}
{"text":"in the st. margaret 's center for women & infants , the patient was lethargic and unable to give a history .","problem":["lethargic"],"test":[],"treatment":[],"problem_indices_start":[68],"problem_indices_end":[77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"intubated and sedated","problem":[],"test":[],"treatment":["intubated","sedated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,14],"treatment_indices_end":[9,21]}
{"text":"2. asthma .","problem":["asthma"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct chest - shows bilateral segmental , subsegmental pes","problem":["bilateral segmental , subsegmental pes"],"test":["ct chest"],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[55],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. posttraumatic stress disorder .","problem":["posttraumatic stress disorder"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"b\/l le lenis - negative","problem":[],"test":["b\/l le lenis"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"wbc - 9.4 # rbc - 4.75 hgb - 14.7 hct - 42.2 mcv - 89 mch - 30.9 mchc - 34.8 rdw - 13.6","problem":[],"test":["hct","hgb","rbc","mchc","mch","mcv","wbc","rdw"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,12,23,34,45,54,65,77],"test_indices_end":[3,15,26,37,48,57,69,80],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. lamotrigine 100 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["lamotrigine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"patient was found at group home in am laying on floor by bed unresponsive , last seen awake 8 hours prior at dinner .","problem":["unresponsive"],"test":[],"treatment":[],"problem_indices_start":[61],"problem_indices_end":[73],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vs 95.4 hr 62 bp 99\/70 rr 20 o2sat 100%","problem":[],"test":["hr","vs","o2sat","rr","bp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,8,14,23,29],"test_indices_end":[2,10,16,25,34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ekg :","problem":[],"test":["ekg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. bipolar disorder .","problem":["bipolar disorder"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. folic acid 1 mg tablet sig : one ( 1 ) tablet po daily ( daily ) .","problem":[],"test":[],"treatment":["folic acid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"patient was intubated in john for airway protection and administation of charcoal .","problem":[],"test":[],"treatment":["charcoal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[73],"treatment_indices_end":[81]}
{"text":"5. multivitamin capsule sig : one ( 1 ) cap po daily ( daily ) .","problem":[],"test":[],"treatment":["multivitamin capsule"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[23]}
{"text":"multivitamin","problem":[],"test":[],"treatment":["multivitamin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"probable ateletasis of lingula , consistent with pneumonitis","problem":["ateletasis of lingula","pneumonitis"],"test":[],"treatment":[],"problem_indices_start":[9,49],"problem_indices_end":[30,60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"alt ( sgpt )- 21 ast ( sgot )- 40 alk phos - 70 amylase - 59 tot bili - 0.4","problem":[],"test":["alk phos","ast ( sgot","amylase","tot bili","alt ( sgpt )-"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,17,34,48,61],"test_indices_end":[13,27,42,55,69],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cxr :","problem":[],"test":["cxr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"two sisters with h\/o depression and suicidality .","problem":["suicidality","depression"],"test":[],"treatment":[],"problem_indices_start":[21,36],"problem_indices_end":[31,47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"propanolol xl 80 mg qd","problem":[],"test":[],"treatment":["propanolol xl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"abg revealed widened a-a gradient so a d-dimer was sent which was elevated .","problem":["elevated","widened a-a gradient"],"test":["a d-dimer","abg"],"treatment":[],"problem_indices_start":[13,66],"problem_indices_end":[33,74],"test_indices_start":[0,37],"test_indices_end":[3,46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. chronic constipation from laxative abuse .","problem":["laxative abuse","chronic constipation"],"test":[],"treatment":[],"problem_indices_start":[3,29],"problem_indices_end":[23,43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no rashes or petechiae , linear and burn scars as above","problem":["rashes","linear and burn scars","petechiae"],"test":[],"treatment":[],"problem_indices_start":[3,13,25],"problem_indices_end":[9,22,46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sedated , dtrs :","problem":[],"test":["dtrs"],"treatment":["sedated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[14],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"senna","problem":[],"test":[],"treatment":["senna"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"toxicology consulted and felt that patient most likely had benzo overdose .","problem":["benzo overdose"],"test":[],"treatment":[],"problem_indices_start":[59],"problem_indices_end":[73],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient was put on coumadin that was bridged with lovenox unti linr theraputic 01-23 .","problem":[],"test":[],"treatment":["coumadin","linr theraputic","lovenox"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,50,63],"treatment_indices_end":[27,57,78]}
{"text":"while on the floor patient 's urinalysis suggestive of uti and was put on 6 day course of levofloxacin .","problem":["uti"],"test":["patient 's urinalysis"],"treatment":["levofloxacin"],"problem_indices_start":[55],"problem_indices_end":[58],"test_indices_start":[19],"test_indices_end":[40],"treatment_indices_start":[90],"treatment_indices_end":[102]}
{"text":"d-dimer - 7998 *","problem":[],"test":["d-dimer"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. warfarin sodium 3 mg tablet sig : one ( 1 ) tablet po at bedtime .","problem":[],"test":[],"treatment":["warfarin sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"clozapine 300 mg po qhs","problem":[],"test":[],"treatment":["clozapine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"asa - neg ethanol - neg acetmnphn - neg bnzodzpn - neg barbitrt - neg tricyclic - pos","problem":[],"test":["barbitrt","bnzodzpn","asa","tricyclic","ethanol","acetmnphn"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,24,40,55,70],"test_indices_end":[3,17,33,48,63,79],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"glucose - 116 * urea n - 14 creat - 1.0 sodium - 137 potassium - 4.5 chloride - 105 total co2 - 20 * anion gap - 17","problem":[],"test":["urea n","potassium","chloride","creat","sodium","anion gap","total co2","glucose"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,28,40,53,69,84,101],"test_indices_end":[7,22,33,46,62,77,93,110],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"folate 1 mg po qd","problem":[],"test":[],"treatment":["folate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"clomipramine 100 mg po qhs","problem":[],"test":[],"treatment":["clomipramine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"pantopraozle 40 mg po qd","problem":[],"test":[],"treatment":["pantopraozle"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"intubation for airway protection","problem":[],"test":[],"treatment":["intubation for airway protection"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[32]}
{"text":"trazadone 200 mg po qhs","problem":[],"test":[],"treatment":["trazadone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"benzo overdose","problem":["benzo overdose"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lithium - less than","problem":[],"test":["lithium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lamictal 100 mg po bid","problem":[],"test":[],"treatment":["lamictal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"6. senna 8.6 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["senna"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"penicillins \/ sulfonamides","problem":[],"test":[],"treatment":["sulfonamides","penicillins"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,14],"treatment_indices_end":[11,26]}
{"text":"alprazolam 1 mg po qid","problem":[],"test":[],"treatment":["alprazolam"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"please continue to take antibiotics as directed for urinary tract infection for 3 more days .","problem":["urinary tract infection"],"test":[],"treatment":["antibiotics"],"problem_indices_start":[52],"problem_indices_end":[75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[35]}
{"text":"9. docusate sodium 100 mg capsule sig : one ( 1 ) capsule po bid ( 2 times a day ) .","problem":[],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"11. alprazolam 1 mg tablet sig : one ( 1 ) tablet po qid ( 4 times a day ) .","problem":[],"test":[],"treatment":["alprazolam"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[14]}
{"text":"blood - neg nitrite - neg protein - neg glucose - neg ketone - tr bilirubin - neg urobilngn - neg ph - 6.5 leuk - neg","problem":[],"test":["leuk","blood","nitrite","ph","bilirubin","urobilngn","ketone","protein","glucose"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,12,26,40,54,66,82,98,107],"test_indices_end":[5,19,33,47,60,75,91,100,111],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"plt count - 330","problem":[],"test":["plt count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neuts - 73.0 * lymphs - 21.8 monos - 3.8 eos - 1.1 basos - 0.3","problem":[],"test":["neuts","lymphs","monos","eos","basos"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,15,29,41,51],"test_indices_end":[5,21,34,44,56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"digoxin -< 0.2 *","problem":[],"test":["digoxin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please continue to take coumadin as directed by your doctors until told to stop for clots found in your lungs .","problem":["clots"],"test":[],"treatment":["coumadin"],"problem_indices_start":[84],"problem_indices_end":[89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[32]}
{"text":"7. clozapine 25 mg tablet sig : one ( 1 ) tablet po hs ( at bedtime ) .","problem":[],"test":[],"treatment":["clozapine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"stable - swelling in hands reduced and range of motion continue to improve .","problem":["swelling in hands"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. pantoprazole sodium 40 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po q24h ( every 24 hours ) .","problem":[],"test":[],"treatment":["pantoprazole sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"2014-04-23 03:45 pm urine","problem":[],"test":["urine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ucg - negative","problem":[],"test":["ucg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. acetaminophen 325 mg tablet sig : 1-2 tablets po q4-6h ( every 4 to 6 hours ) as needed .","problem":[],"test":[],"treatment":["acetaminophen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"ck ( cpk )- 4713 *","problem":[],"test":["ck ( cpk )-"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10. trazodone hcl 100 mg tablet sig : two ( 2 ) tablet po hs ( at bedtime ) as needed .","problem":[],"test":[],"treatment":["trazodone hcl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[17]}
{"text":"bipolar disorder","problem":["bipolar disorder"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient seen by pt and ot who recommended hand exercises and splints for patient .","problem":[],"test":[],"treatment":["hand exercises","splints"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[42,61],"treatment_indices_end":[56,68]}
{"text":"2014-04-23 08:00 am urine","problem":[],"test":["urine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"x-ray of the hands and wrist were obtained which were negative .","problem":[],"test":["x-ray of the hands and wrist"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"while on the floor patient 's hands improved with good range of motion of left hand , however jones some poor range of motion of right .","problem":["some poor range of motion"],"test":[],"treatment":[],"problem_indices_start":[100],"problem_indices_end":[125],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lipase - 66 *","problem":[],"test":["lipase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"benzodiazapine overdose","problem":["benzodiazapine overdose"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"14. nicotine 14 mg \/ 24 hr patch 24 hr sig : one ( 1 ) patch 24 hr transdermal daily ( daily ) .","problem":[],"test":[],"treatment":["nicotine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"12. levofloxacin 500 mg tablet sig : one ( 1 ) tablet po q24h ( every 24 hours ) for 3 days .","problem":[],"test":[],"treatment":["levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[16]}
{"text":"modifinal 100 mg po qd","problem":[],"test":[],"treatment":["modifinal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"13. bisacodyl 5 mg tablet , delayed release ( e.c. ) sig : two ( 2 ) tablet , delayed release ( e.c. ) po daily ( daily ) as needed .","problem":[],"test":[],"treatment":["bisacodyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"patient conitnued to have si while on floor and was transferred to psychiatry .","problem":["si"],"test":[],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"traumatic \/ pressure bullae","problem":["traumatic \/ pressure bullae"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"review of systems was significant for progressive abdominal discomfort , decreased oral intake , and weakness in the past nine weeks .","problem":["progressive abdominal discomfort","decreased oral intake","weakness"],"test":["review of systems"],"treatment":[],"problem_indices_start":[38,73,101],"problem_indices_end":[70,94,109],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"father had coronary artery disease .","problem":["coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mother had adrenal cancer .","problem":["adrenal cancer"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"colace , senna , dulcolax , tylenol , oxycodone as needed , ambien , and protonix .","problem":[],"test":[],"treatment":["protonix","colace","senna","dulcolax","tylenol","oxycodone","ambien"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,9,17,28,38,60,73],"treatment_indices_end":[6,14,25,35,47,66,81]}
{"text":"physical examination revealed temperature was 96.9 , heart rate was 121 , blood pressure was 122\/86 , respiratory rate was 22 , and oxygen saturation was 96% on room air .","problem":[],"test":["blood pressure","heart rate","temperature","physical examination","oxygen saturation","respiratory rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,30,53,74,102,132],"test_indices_end":[20,41,63,88,118,149],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was placed on flagyl and levaquin for treatment of pneumonia .","problem":["pneumonia"],"test":[],"treatment":["treatment","flagyl","levaquin"],"problem_indices_start":[63],"problem_indices_end":[72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,37,50],"treatment_indices_end":[32,45,59]}
{"text":"a thoracentesis was done with removal of 1.5 liters of fluid .","problem":["fluid"],"test":[],"treatment":["removal","a thoracentesis"],"problem_indices_start":[55],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,30],"treatment_indices_end":[15,37]}
{"text":"a paracentesis was repeated with removal of 2.5 liters of fluid .","problem":["fluid"],"test":[],"treatment":["removal","a paracentesis"],"problem_indices_start":[58],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,33],"treatment_indices_end":[14,40]}
{"text":"lungs revealed decreased breath sounds and dullness to percussion in the left lung base .","problem":["decreased breath sounds","dullness"],"test":["percussion"],"treatment":[],"problem_indices_start":[15,43],"problem_indices_end":[38,51],"test_indices_start":[55],"test_indices_end":[65],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no murmurs , rubs , or gallops .","problem":["murmurs","gallops","rubs"],"test":[],"treatment":[],"problem_indices_start":[3,13,23],"problem_indices_end":[10,17,30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiovascular examination revealed tachycardic first heart sound and second heart sound .","problem":["tachycardic first heart sound and second heart sound"],"test":["cardiovascular examination"],"treatment":[],"problem_indices_start":[36],"problem_indices_end":[88],"test_indices_start":[0],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head , eyes , ears , nose , and throat examination revealed the oropharynx was clear .","problem":[],"test":["head , eyes , ears , nose , and throat examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[50],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the abdomen was distended and firm .","problem":["distended","firm"],"test":[],"treatment":[],"problem_indices_start":[16,30],"problem_indices_end":[25,34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sclerae were anicteric .","problem":["anicteric"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was a 55 - year-old gentleman with recently diagnosed abdominal carcinomatosis admitted with increased abdominal pain and poor oral intake .","problem":["increased abdominal pain","recently diagnosed abdominal carcinomatosis","poor oral intake"],"test":[],"treatment":[],"problem_indices_start":[40,98,127],"problem_indices_end":[83,122,143],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was admitted to the o-cmed service for further management .","problem":[],"test":[],"treatment":["further management"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[51],"treatment_indices_end":[69]}
{"text":"he was placed on a patient-controlled analgesia for pain control .","problem":[],"test":[],"treatment":["pain control","a patient-controlled analgesia"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17,52],"treatment_indices_end":[47,64]}
{"text":"in general , the patient looked acutely and chronically ill .","problem":["acutely and chronically ill"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extremity examination revealed no clubbing , cyanosis , or edema .","problem":["cyanosis","clubbing","edema"],"test":["extremity examination"],"treatment":[],"problem_indices_start":[34,45,59],"problem_indices_end":[42,53,64],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 05-03 the patient underwent an abdominal ultrasound with paracentesis , and 5 liters of fluid were removed .","problem":["fluid"],"test":["an abdominal ultrasound"],"treatment":["paracentesis"],"problem_indices_start":[91],"problem_indices_end":[96],"test_indices_start":[31],"test_indices_end":[54],"treatment_indices_start":[60],"treatment_indices_end":[72]}
{"text":"he was continued on heparin for treatment of the pulmonary emboli .","problem":["the pulmonary emboli"],"test":[],"treatment":["treatment","heparin"],"problem_indices_start":[45],"problem_indices_end":[65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20,32],"treatment_indices_end":[27,41]}
{"text":"the patient is a 55 - year-old male with recently diagnosed abdominal carcinomatosis .","problem":["recently diagnosed abdominal carcinomatosis"],"test":[],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he also complained of increased shortness of breath and \" difficulty catching his breath .\"","problem":["increased shortness of breath","difficulty catching his breath"],"test":[],"treatment":[],"problem_indices_start":[22,58],"problem_indices_end":[51,88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his saturation increased to 87% on a nonrebreather .","problem":[],"test":["his saturation"],"treatment":["a nonrebreather"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[35],"treatment_indices_end":[50]}
{"text":"the patient presented with abdominal pain and bloating and was found to have a large omental mass .","problem":["abdominal pain","bloating","a large omental mass"],"test":[],"treatment":[],"problem_indices_start":[27,46,77],"problem_indices_end":[41,54,97],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on room air , the patient 's oxygen saturation was 80% .","problem":[],"test":["the patient 's oxygen saturation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14],"test_indices_end":[46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"biopsy revealed adenocarcinoma .","problem":["adenocarcinoma"],"test":["biopsy"],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[30],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a chest x-ray disclosed a left pleural effusion .","problem":["a left pleural effusion"],"test":["a chest x-ray"],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[47],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an angiogram was done which disclosed possible subsegmental pulmonary emboli of the upper lobes as well as infiltrates consistent with aspiration pneumonia .","problem":["subsegmental pulmonary emboli of the upper lobes","infiltrates","aspiration pneumonia"],"test":["an angiogram"],"treatment":[],"problem_indices_start":[47,107,135],"problem_indices_end":[95,118,155],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient became more comfortable being seated upright with nebulizer treatments .","problem":[],"test":[],"treatment":["nebulizer treatments"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[62],"treatment_indices_end":[82]}
{"text":"endoscopies were negative except for an extrinsic mass present on the stomach .","problem":["an extrinsic mass present on the stomach"],"test":["endoscopies"],"treatment":[],"problem_indices_start":[37],"problem_indices_end":[77],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"histochemical stains are consistent with hepatobiliary origin .","problem":[],"test":["histochemical stains"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient presents with increased abdominal pain and poor oral intake as well as generalized weakness .","problem":["increased abdominal pain","poor oral intake","generalized weakness"],"test":[],"treatment":[],"problem_indices_start":[26,55,83],"problem_indices_end":[50,71,103],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was bolused with intravenous heparin due to concern for pulmonary embolism .","problem":["pulmonary embolism"],"test":[],"treatment":["intravenous heparin"],"problem_indices_start":[68],"problem_indices_end":[86],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[48]}
{"text":"while in the intensive care unit , the patient was noted to have increasing abdominal distention .","problem":["increasing abdominal distention"],"test":[],"treatment":[],"problem_indices_start":[65],"problem_indices_end":[96],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on presentation , the patient denied chest pain , shortness of breath , and cough .","problem":["chest pain","shortness of breath","cough"],"test":[],"treatment":[],"problem_indices_start":[37,50,76],"problem_indices_end":[47,69,81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"octreotide was initiated in an attempt to decrease the gastric secretions .","problem":["the gastric secretions"],"test":[],"treatment":["octreotide"],"problem_indices_start":[51],"problem_indices_end":[73],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"he was noted not have an increasing left-sided pleural effusion .","problem":["an increasing left-sided pleural effusion"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"due to persistent gastric secretions , an nasogastric tube was placed for decompression .","problem":["persistent gastric secretions"],"test":[],"treatment":["an nasogastric tube","decompression"],"problem_indices_start":[7],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39,74],"treatment_indices_end":[58,87]}
{"text":"1. benign prostatic hypertrophy .","problem":["benign prostatic hypertrophy"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was administered intravenous fluids and oral diet as tolerated .","problem":[],"test":[],"treatment":["intravenous fluids"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[38]}
{"text":"2. osteoarthritis .","problem":["osteoarthritis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on the night of 05-01 , the patient complained of increased vomiting .","problem":["increased vomiting"],"test":[],"treatment":[],"problem_indices_start":[50],"problem_indices_end":[68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. gastrointestinal adenocarcinoma ( as noted in history of present illness ) .","problem":["gastrointestinal adenocarcinoma"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. hypoxia .","problem":["hypoxia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. dehydration .","problem":["dehydration"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the family decided to pursue comfort measures .","problem":[],"test":[],"treatment":["comfort measures"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[45]}
{"text":"morphine was administered to insure patient 's comfort .","problem":[],"test":[],"treatment":["morphine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"1. gastrointestinal adenocarcinoma ; primary unknown ( likely hepatobiliary ) .","problem":["gastrointestinal adenocarcinoma"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. ileus .","problem":["ileus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. aspiration pneumonia .","problem":["aspiration pneumonia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. pulmonary emboli .","problem":["pulmonary emboli"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he remained hemodynmically stable throughout his hospitalization and did not have an oxygen requirement upon discharge .","problem":["an oxygen requirement"],"test":[],"treatment":[],"problem_indices_start":[82],"problem_indices_end":[103],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"complex tear involving the posterior ellison and body .","problem":["complex tear"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the mri of your knee showed a meniscal tear .","problem":["a meniscal tear"],"test":["the mri of your knee"],"treatment":[],"problem_indices_start":[28],"problem_indices_end":[43],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he received lovenox 91 mg sc prior to transport and was transferred to arbour hospital for further care .","problem":[],"test":[],"treatment":["lovenox"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[19]}
{"text":"there is no pericardial effusion .","problem":["pericardial effusion"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- sinus tach , normal axis hr 119 st depression v3-v5 ; s1q3t3 , p-pulmonale .","problem":["p-pulmonale","s1q3t3","st depression v3-v5","sinus tach"],"test":["hr"],"treatment":[],"problem_indices_start":[2,34,56,65],"problem_indices_end":[12,53,62,76],"test_indices_start":[27],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vs were with stable bps , tachy to 110-120 , sat 98% ra .","problem":["tachy"],"test":["sat","vs"],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[31],"test_indices_start":[0,45],"test_indices_end":[2,48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at springfield , ct chest was positive for saddle pe .","problem":["saddle pe"],"test":["ct chest"],"treatment":[],"problem_indices_start":[43],"problem_indices_end":[52],"test_indices_start":[17],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is moderate pulmonary artery systolic hypertension .","problem":["moderate pulmonary artery systolic hypertension"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you must have your inr ( blood levels ) checked on a regular basis until your inr levels remain 01-19 .","problem":[],"test":["your inr levels","blood levels","your inr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14,25,73],"test_indices_end":[22,37,88],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"osh imaging :","problem":[],"test":["osh imaging"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"immediately there after he was very short of breath , felt lightheaded again and called 911 .","problem":["lightheaded","very short of breath"],"test":[],"treatment":[],"problem_indices_start":[31,59],"problem_indices_end":[51,70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no evidence of dvt in either lower limb .","problem":["dvt in either lower limb"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please continue to take this medication as prescribed .","problem":[],"test":[],"treatment":["this medication"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[39]}
{"text":"3. bilateral leni 's","problem":[],"test":["bilateral leni 's"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he denies loc .","problem":["loc"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left ventricular systolic function is hyperdynamic ( ef > 75% ) .","problem":["hyperdynamic"],"test":["ef","left ventricular systolic function"],"treatment":[],"problem_indices_start":[38],"problem_indices_end":[50],"test_indices_start":[0,53],"test_indices_end":[34,55],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right ventricular systolic function is borderline normal .","problem":[],"test":["right ventricular systolic function"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"impression : mildly dilated right ventricle ; small , hyperdynamic left ventricle ; at least moderate pulmonary hypertension","problem":["small , hyperdynamic left ventricle","mildly dilated right ventricle","moderate pulmonary hypertension"],"test":[],"treatment":[],"problem_indices_start":[13,46,93],"problem_indices_end":[43,81,124],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please return to the hospital if you experience chest pain , shortness of breath , lightheadedness or dizziness .","problem":["lightheadedness","dizziness","shortness of breath","chest pain"],"test":[],"treatment":[],"problem_indices_start":[48,61,83,102],"problem_indices_end":[58,80,98,111],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt was preparing lunch when suddenly felt lightheaded \/ faint and immediately fell to the kitchen floor face first .","problem":["faint","lightheaded"],"test":[],"treatment":[],"problem_indices_start":[42,56],"problem_indices_end":[53,61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the left ventricular cavity is small .","problem":[],"test":["the left ventricular cavity"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no mitral valve prolapse .","problem":["mitral valve prolapse"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the right ventricular cavity is mildly dilated .","problem":["mildly dilated"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left ventricular wall thicknesses are normal .","problem":[],"test":["left ventricular wall thicknesses"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"45m w\/no pmh presented to chelseahospital after a syncopal episode on the morning of admission .","problem":["a syncopal episode"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the aortic valve leaflets ( 3 ) appear structurally normal with good leaflet excursion and no aortic regurgitation .","problem":["aortic regurgitation"],"test":[],"treatment":[],"problem_indices_start":[94],"problem_indices_end":[114],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please schedule an appointment with your orthopedic surgeon to determine a plan for treatment .","problem":[],"test":[],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[84],"treatment_indices_end":[93]}
{"text":"syncope .","problem":["syncope"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"erythromycin base","problem":[],"test":[],"treatment":["erythromycin base"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[17]}
{"text":"there is no ventricular septal defect .","problem":["ventricular septal defect"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he will need to follow up with hematology for an outpatient thrombophilia work-up ( not done as inpatient as results would not change acute management of pe ).","problem":["pe"],"test":["an outpatient thrombophilia work-up"],"treatment":["acute management"],"problem_indices_start":[154],"problem_indices_end":[156],"test_indices_start":[46],"test_indices_end":[81],"treatment_indices_start":[134],"treatment_indices_end":[150]}
{"text":"1. ct of head without contrast :","problem":[],"test":["ct of head without contrast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"given his history and physical exam , mr. anders presented with an injury most consistent with meniscal tear .","problem":["meniscal tear","an injury"],"test":["physical exam"],"treatment":[],"problem_indices_start":[64,95],"problem_indices_end":[73,108],"test_indices_start":[22],"test_indices_end":[35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no evidence of acute intracranial hemorrhage or fractures .","problem":["acute intracranial hemorrhage","fractures"],"test":[],"treatment":[],"problem_indices_start":[15,48],"problem_indices_end":[44,57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ext : l leg\/calf swollen , + johnson sign , not tense , no cord palpable , l knee w\/ medial meniscus area inflammed , not warm , no crepitus , feet-2+dp pulses b\/l","problem":["l leg\/calf swollen","crepitus","tense","medial meniscus area inflammed","warm"],"test":["feet-2+dp pulses","johnson sign"],"treatment":[],"problem_indices_start":[6,48,85,122,132],"problem_indices_end":[24,53,115,126,140],"test_indices_start":[29,143],"test_indices_end":[41,159],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"#. hematocrit :","problem":[],"test":["hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"duration of his coumadin therapy to be determined by hematology , but likely to be at least 6 months in duration .","problem":[],"test":[],"treatment":["his coumadin therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[32]}
{"text":"2. echo","problem":[],"test":["echo"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was anticoagulated with heparin and coumadin .","problem":[],"test":[],"treatment":["coumadin","heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,39],"treatment_indices_end":[34,47]}
{"text":"the estimated right atrial pressure is 16-20 mmhg .","problem":[],"test":["the estimated right atrial pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his tronponin quickly trended down and he did not have ekg evidence of ischemia .","problem":["ischemia"],"test":["ekg","his tronponin"],"treatment":[],"problem_indices_start":[71],"problem_indices_end":[79],"test_indices_start":[0,55],"test_indices_end":[13,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you have been started on an oral blood thinner called coumadin ( warfarin ).","problem":[],"test":[],"treatment":["coumadin ( warfarin","an oral blood thinner"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25,54],"treatment_indices_end":[46,73]}
{"text":"mr. anders was admitted for anticoagulation and hemodynamic monitoring in the setting of saddle pulmonary embolus and left knee injury .","problem":["saddle pulmonary embolus","left knee injury"],"test":["hemodynamic monitoring"],"treatment":["anticoagulation"],"problem_indices_start":[89,118],"problem_indices_end":[113,134],"test_indices_start":[48],"test_indices_end":[70],"treatment_indices_start":[28],"treatment_indices_end":[43]}
{"text":"abd : soft nd\/nt +bs","problem":["nd\/nt"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he has no known clotting disorder but did have trauma to leg prompting immobility and stasis .","problem":["known clotting disorder","stasis","immobility","trauma to leg"],"test":[],"treatment":[],"problem_indices_start":[10,47,71,86],"problem_indices_end":[33,60,81,92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you were treated with blood thinners .","problem":[],"test":[],"treatment":["blood thinners"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[36]}
{"text":"in order to facilitate therapy and to promote mobility , an mri of the knee was done .","problem":[],"test":["an mri of the knee"],"treatment":["therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[57],"test_indices_end":[75],"treatment_indices_start":[23],"treatment_indices_end":[30]}
{"text":"#. l knee injury :","problem":["l knee injury"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"given no evidence of hemodynamic instability , lysis was not required .","problem":["hemodynamic instability"],"test":[],"treatment":["lysis"],"problem_indices_start":[21],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47],"treatment_indices_end":[52]}
{"text":"he will also require close follow up with his primary care provider for coumadin management .","problem":[],"test":[],"treatment":["coumadin management"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[72],"treatment_indices_end":[91]}
{"text":"left knee meniscal tear","problem":["left knee meniscal tear"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent : mmm , op clear , dried blood in nasal mucosa","problem":["dried blood in nasal mucosa"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"resp : ctabl , no crackles , no wheezing or rhonchi","problem":["wheezing","crackles","rhonchi"],"test":[],"treatment":[],"problem_indices_start":[18,32,44],"problem_indices_end":[26,40,51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"#. syncope :","problem":["syncope"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"htn , dm","problem":["htn","dm"],"test":[],"treatment":[],"problem_indices_start":[0,6],"problem_indices_end":[3,8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in setting of pe .","problem":["pe"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you were admitted to the hospital for a pulmonary embolism .","problem":["a pulmonary embolism"],"test":[],"treatment":[],"problem_indices_start":[38],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"#. pe :","problem":["pe"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[5],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt asymptomatic .","problem":["asymptomatic"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dropped from 42.7 to 36 in setting of anticoagulation for saddle pe and iv fluids .","problem":["saddle pe"],"test":[],"treatment":["iv fluids","anticoagulation"],"problem_indices_start":[58],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38,72],"treatment_indices_end":[53,81]}
{"text":"cv : reg , tachy nml s1 , s2 , no m\/r\/g","problem":["m\/r\/g","tachy"],"test":[],"treatment":[],"problem_indices_start":[11,34],"problem_indices_end":[16,39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he did have a small troponin leak , felt to be related to right heart strain in the setting of p-pulmonale related to clot burden .","problem":["p-pulmonale","clot burden","a small troponin leak","right heart strain"],"test":[],"treatment":[],"problem_indices_start":[12,58,95,118],"problem_indices_end":[33,76,106,129],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no active bleeding noted .","problem":["active bleeding"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"copd , prostate ca","problem":["prostate ca","copd"],"test":[],"treatment":[],"problem_indices_start":[0,7],"problem_indices_end":[4,18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- grandfather died of mi at age 75","problem":["mi"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an echo did not reveal any wall motion abnormalities related to ischemia .","problem":["ischemia","any wall motion abnormalities"],"test":["an echo"],"treatment":[],"problem_indices_start":[23,64],"problem_indices_end":[52,72],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vs : 99.4 hr 111 bp 110\/64 rr16 97% 2lnc","problem":[],"test":["hr","rr16","bp","vs"],"treatment":["2lnc"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,17,27],"test_indices_end":[2,12,19,31],"treatment_indices_start":[36],"treatment_indices_end":[40]}
{"text":"remainder of his cardiac workup was negative .","problem":[],"test":["his cardiac workup"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13],"test_indices_end":[31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gen : nad , pleasant speaking in full sentences","problem":["nad"],"test":[],"treatment":[],"problem_indices_start":[6],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in this 2 week interval he denied having cp \/ chest discomfort or difficulty breathing , no cough or hemoptysis .","problem":["hemoptysis","cp","chest discomfort","difficulty breathing","cough"],"test":[],"treatment":[],"problem_indices_start":[41,46,66,92,101],"problem_indices_end":[43,62,86,97,111],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. bucket handle medial meniscal tear with flipped fragment in the intercondylar notch .","problem":["flipped fragment in the intercondylar notch","bucket handle medial meniscal tear"],"test":[],"treatment":[],"problem_indices_start":[3,43],"problem_indices_end":[37,86],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no f\/c\/ sweats .","problem":["f\/c\/","sweats"],"test":[],"treatment":[],"problem_indices_start":[3,8],"problem_indices_end":[7,14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt denied any bleeding or clotting disorders and has never had a clot in the past .","problem":["any bleeding or clotting disorders","a clot"],"test":[],"treatment":[],"problem_indices_start":[10,63],"problem_indices_end":[44,69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. moderate knee joint effusion with possible ganglion cyst at the insertion of the pcl .","problem":["moderate knee joint effusion","ganglion cyst at the insertion of the pcl"],"test":[],"treatment":[],"problem_indices_start":[3,46],"problem_indices_end":[31,87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ekg :","problem":[],"test":["ekg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left knee injury .","problem":["left knee injury"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- saddle pe , no cd or report sent","problem":["saddle pe"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"01-11 mri left knee w\/o contrast","problem":[],"test":["mri left knee w\/o contrast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[6],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"given no other risk factors or likely causes , the most likely etiology for his embolus is dvt from the left leg .","problem":["dvt from the left leg","his embolus"],"test":[],"treatment":[],"problem_indices_start":[76,91],"problem_indices_end":[87,112],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was essentially bed bound for 3 days prior to admission , unable to ambulate .","problem":["unable to ambulate","essentially bed bound"],"test":[],"treatment":[],"problem_indices_start":[7,61],"problem_indices_end":[28,79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- claritin prn","problem":[],"test":[],"treatment":["claritin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[10]}
{"text":"he was seen by physical therapy and will need to follow up with orthopaedics upon discharge for repeat evaluation .","problem":[],"test":["repeat evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[96],"test_indices_end":[113],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he started to notice inflammation of his l calf \/ leg worse 2 days prior to presentation .","problem":["inflammation of his l calf \/ leg"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- flonase prn","problem":[],"test":[],"treatment":["flonase"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[9]}
{"text":"seasonal allergies .","problem":["seasonal allergies"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. discoid lateral meniscus .","problem":["discoid lateral meniscus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pulmonary embolus","problem":["pulmonary embolus"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"12. protonix 20 mg p.o. b.i.d.","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"chest x-ray was remarkable for a questionable left lower lobe infiltrate .","problem":["left lower lobe infiltrate"],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[46],"problem_indices_end":[72],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. montelukast sodium 10 mg p.o. q.h.s.","problem":[],"test":[],"treatment":["montelukast sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[21]}
{"text":"11. ativan 2 mg p.r.n.","problem":[],"test":[],"treatment":["ativan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"the patient has a history of neurogenic bladder and , therefore , she required a foley catheterization .","problem":["neurogenic bladder"],"test":[],"treatment":["a foley catheterization"],"problem_indices_start":[29],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[79],"treatment_indices_end":[102]}
{"text":"6. buspirone 10 mg p.o. t.i.d.","problem":[],"test":[],"treatment":["buspirone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"10. lipitor 10 mg q.p.m.","problem":[],"test":[],"treatment":["lipitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[11]}
{"text":"the patient was maintained on ppi for reflux disease and known gastritis .","problem":["known gastritis","reflux disease"],"test":[],"treatment":["ppi"],"problem_indices_start":[38,57],"problem_indices_end":[52,72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30],"treatment_indices_end":[33]}
{"text":"the patient received nebulizer treatment with oxygen saturations increasing up to 98 percent on room air .","problem":[],"test":["oxygen saturations"],"treatment":["nebulizer treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[46],"test_indices_end":[64],"treatment_indices_start":[21],"treatment_indices_end":[40]}
{"text":"9. singulair 10 mg q.p.m.","problem":[],"test":[],"treatment":["singulair"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"15. pamidronate 30 mg iv every month .","problem":[],"test":[],"treatment":["pamidronate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[15]}
{"text":"the patient was transferred on the evening of 2012-05-22 to the icu given persistent carbon dioxide retention and respiratory acidosis and the intermittent mental status changes .","problem":["persistent carbon dioxide retention","respiratory acidosis","the intermittent mental status changes"],"test":[],"treatment":[],"problem_indices_start":[74,114,139],"problem_indices_end":[109,134,177],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. clonazepam 1 mg p.o. t.i.d.","problem":[],"test":[],"treatment":["clonazepam"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"4. baclofen 10 mg p.o. t.i.d.","problem":[],"test":[],"treatment":["baclofen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"14. albuterol nebulizer q.03-14 h. p.r.n.","problem":[],"test":[],"treatment":["albuterol nebulizer"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[23]}
{"text":"asthma \/ copd on bipap , history of intubation .","problem":["asthma","copd"],"test":[],"treatment":["intubation","bipap"],"problem_indices_start":[0,9],"problem_indices_end":[6,13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17,36],"treatment_indices_end":[22,46]}
{"text":"3. levothyroxine 50 mcg p.o. q.d.","problem":[],"test":[],"treatment":["levothyroxine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"13. sucralfate 2 mg b.i.d.","problem":[],"test":[],"treatment":["sucralfate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[14]}
{"text":"11. tizanidine 8 mg p.o. q.6 h.","problem":[],"test":[],"treatment":["tizanidine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[14]}
{"text":"the patient describes chest discomfort without any significant ekg changes .","problem":["any significant ekg changes","chest discomfort"],"test":[],"treatment":[],"problem_indices_start":[22,47],"problem_indices_end":[38,74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. vitamin d .","problem":[],"test":[],"treatment":["vitamin d"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"9. protonix 40 mg p.o. q.d.","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"in the emergency department , the patient received zithromax , ceftriaxone , and flagyl .","problem":[],"test":[],"treatment":["ceftriaxone","zithromax","flagyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[51,63,81],"treatment_indices_end":[60,74,87]}
{"text":"the patient was maintained on albuterol nebulizer treatments and ipratropium nebulizer treatments , as this was apparently thought to be related to her chronic obstructive pulmonary disease .","problem":["her chronic obstructive pulmonary disease"],"test":[],"treatment":["albuterol nebulizer treatments","ipratropium nebulizer treatments"],"problem_indices_start":[148],"problem_indices_end":[189],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30,65],"treatment_indices_end":[60,97]}
{"text":"12. acetaminophen p.r.n.","problem":[],"test":[],"treatment":["acetaminophen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[17]}
{"text":"13. prednisone taper for 3 days .","problem":[],"test":[],"treatment":["prednisone taper"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[20]}
{"text":"15. florinef acetate 0.1 mg p.o. q.d.","problem":[],"test":[],"treatment":["florinef acetate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[20]}
{"text":"shortness of breath .","problem":["shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"14. levofloxacin 500 mg p.o. q.d. for 10 more days .","problem":[],"test":[],"treatment":["levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[16]}
{"text":"10. albuterol sulfate solution q.05-15 h. p.r.n. for shortness of breath .","problem":["shortness of breath"],"test":[],"treatment":["albuterol sulfate solution"],"problem_indices_start":[53],"problem_indices_end":[72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[30]}
{"text":"given the presence of consolidation on chest x-ray , however , and previous history of pneumonia , the patient was maintained on antibiotics of zithromax 500 mg daily and ceftriaxone .","problem":["pneumonia","consolidation"],"test":["chest x-ray"],"treatment":["zithromax","ceftriaxone","antibiotics"],"problem_indices_start":[22,87],"problem_indices_end":[35,96],"test_indices_start":[39],"test_indices_end":[50],"treatment_indices_start":[129,144,171],"treatment_indices_end":[140,153,182]}
{"text":"abdominal exam :","problem":[],"test":["abdominal exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was maintained on percocet p.r.n. for pain relief .","problem":[],"test":[],"treatment":["pain relief","percocet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30,50],"treatment_indices_end":[38,61]}
{"text":"8. atorvastatin 10 mg p.o. q.h.s.","problem":[],"test":[],"treatment":["atorvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"pulmonary exam :","problem":[],"test":["pulmonary exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"adrenal insufficiency .","problem":["adrenal insufficiency"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"diffuse bronchial breath sounds , no wheezes .","problem":["wheezes","diffuse bronchial breath sounds"],"test":[],"treatment":[],"problem_indices_start":[0,37],"problem_indices_end":[31,44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has a history of high mcv and megaloblastic cells on smear in the setting of anemia ; question b12 deficiency , the patient also has a history of borderline low b12 levels .","problem":["megaloblastic cells","anemia","high mcv","b12 deficiency","borderline low b12 levels"],"test":["smear"],"treatment":[],"problem_indices_start":[29,42,89,107,158],"problem_indices_end":[37,61,95,121,183],"test_indices_start":[65],"test_indices_end":[70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coronary artery disease status post negative stress echo on 10-12 .","problem":["coronary artery disease"],"test":["stress echo"],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[45],"test_indices_end":[56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chronic abdominal pain .","problem":["chronic abdominal pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gastritis and duodenitis .","problem":["duodenitis","gastritis"],"test":[],"treatment":[],"problem_indices_start":[0,14],"problem_indices_end":[9,24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her ph was 7.23 , pco2 73 , po2 146 on a nonrebreather .","problem":[],"test":["pco2","po2","her ph"],"treatment":["a nonrebreather"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,18,28],"test_indices_end":[6,22,31],"treatment_indices_start":[39],"treatment_indices_end":[54]}
{"text":"mucomyst was also considered as a mucolytic component towards secretions .","problem":["secretions"],"test":[],"treatment":["mucomyst","a mucolytic component"],"problem_indices_start":[62],"problem_indices_end":[72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,32],"treatment_indices_end":[8,53]}
{"text":"neurogenic bladder .","problem":["neurogenic bladder"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chronic muscle spasms .","problem":["chronic muscle spasms"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chronic inflammatory demyelinating polyradiculopathy .","problem":["chronic inflammatory demyelinating polyradiculopathy"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after bipap was initiated , the patient became hypotensive down to 75\/28 and bradycardiac , responding to 3 fluid boluses over the course of the night .","problem":["bradycardiac","hypotensive"],"test":[],"treatment":["bipap","3 fluid boluses"],"problem_indices_start":[47,77],"problem_indices_end":[58,89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6,106],"treatment_indices_end":[11,121]}
{"text":"anemia of chronic disease .","problem":["chronic disease","anemia"],"test":[],"treatment":[],"problem_indices_start":[0,10],"problem_indices_end":[6,25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no evidence of acute rib factors on her chest x-ray .","problem":["acute rib factors"],"test":["her chest x-ray"],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[42],"test_indices_start":[46],"test_indices_end":[61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had bipap initiated once she reached the unit , but did not tolerate it , becoming apneic and obstructing .","problem":["apneic","obstructing"],"test":[],"treatment":["bipap"],"problem_indices_start":[95,106],"problem_indices_end":[101,117],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[21]}
{"text":"question of tyrone esophagus .","problem":["tyrone esophagus"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"restrictive lung disease .","problem":["restrictive lung disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hyperthyroidism .","problem":["hyperthyroidism"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was maintained on supplemental oxygen and sputum production was maximized with the help of an acapella device and respiratory therapy .","problem":[],"test":[],"treatment":["respiratory therapy","an acapella device","supplemental oxygen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30,103,126],"treatment_indices_end":[49,121,145]}
{"text":"depression and anxiety .","problem":["anxiety","depression"],"test":[],"treatment":[],"problem_indices_start":[0,15],"problem_indices_end":[10,22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"igg deficiency .","problem":["igg deficiency"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is a 55-year-old female with multiple prior admissions for pneumonia , copd , asthma exacerbation , over 3 weeks of upper respiratory like infection unremitting with increased nebulizer treatments at home .","problem":["pneumonia","copd","asthma exacerbation","upper respiratory like infection"],"test":[],"treatment":["increased nebulizer treatments"],"problem_indices_start":[64,76,83,121],"problem_indices_end":[73,80,102,153],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[171],"treatment_indices_end":[201]}
{"text":"it was thought that the patient may have been mucous plugging during her stay in the icu .","problem":["mucous plugging"],"test":[],"treatment":[],"problem_indices_start":[46],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"status post cholecystectomy and appendectomy .","problem":[],"test":[],"treatment":["cholecystectomy","appendectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12,32],"treatment_indices_end":[27,44]}
{"text":"the patient had had abg on the floor , which prompted her to transfer to the icu .","problem":[],"test":["abg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"history of syncope .","problem":["syncope"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient saw her pcp and was known to have an oxygen saturation of 82 to 85 percent on room air .","problem":[],"test":["an oxygen saturation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[46],"test_indices_end":[66],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was switched to 2 liters nasal cannula and oxygen saturating at 98 to 100 percent .","problem":[],"test":[],"treatment":["2 liters nasal cannula"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28],"treatment_indices_end":[50]}
{"text":"the patient was started on florinef for concern of adrenal insufficiency ; however , she was hemodynamically stable that morning and was transferred back out to the floor .","problem":["adrenal insufficiency"],"test":[],"treatment":["florinef"],"problem_indices_start":[51],"problem_indices_end":[72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[35]}
{"text":"the patient was on levoxyl at home as her home dose for hyperthyroidism .","problem":["hyperthyroidism"],"test":[],"treatment":["levoxyl"],"problem_indices_start":[56],"problem_indices_end":[71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[26]}
{"text":"the patient was maintained on iv solu - medrol 60 mg q. 8 h.","problem":[],"test":[],"treatment":["iv solu - medrol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30],"treatment_indices_end":[46]}
{"text":"chest soreness .","problem":["chest soreness"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hypercholesterolemia .","problem":["hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"asthma flare and bronchitis .","problem":["bronchitis","asthma flare"],"test":[],"treatment":[],"problem_indices_start":[0,17],"problem_indices_end":[12,27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"adrenal insufficiency .","problem":["adrenal insufficiency"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. zanaflex 8 mg q.4 h.","problem":[],"test":[],"treatment":["zanaflex"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"from admission , vital signs 98.3 , blood pressure 128\/74 , 68 to 112 is her heart rate , respiratory rate 24 , 100 percent on room air .","problem":[],"test":["blood pressure","her heart rate","respiratory rate","vital signs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17,36,73,90],"test_indices_end":[28,50,87,106],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was diagnosed for b12 deficiency due to her long history of poor p.o. intake .","problem":["b12 deficiency","poor p.o. intake"],"test":[],"treatment":[],"problem_indices_start":[30,72],"problem_indices_end":[44,88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. buspar 10 mg t.i.d.","problem":[],"test":[],"treatment":["buspar"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"she is a chronically ill-appearing female , in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[50],"problem_indices_end":[64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. oxazepam 30 mg p.r.n.","problem":[],"test":[],"treatment":["oxazepam"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"methylmalonic acid levels were sent , the results are pending at the time of discharge .","problem":[],"test":["methylmalonic acid levels"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. florinef 0.1 mg p.o. q.a.m.","problem":[],"test":[],"treatment":["florinef"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"cardiac exam :","problem":[],"test":["cardiac exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. baclofen 20 mg p.o. t.i.d.","problem":[],"test":[],"treatment":["baclofen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"5. klonopin 2 mg t.i.d.","problem":[],"test":[],"treatment":["klonopin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"chronic obstructive pulmonary disease .","problem":["chronic obstructive pulmonary disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"azmacort , clindamycin , versed , fentanyl , and morphine .","problem":[],"test":[],"treatment":["azmacort","versed","clindamycin","fentanyl","morphine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,11,25,34,49],"treatment_indices_end":[8,22,31,42,57]}
{"text":"demyelinating polyradiculopathy .","problem":["demyelinating polyradiculopathy"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left lower extremity and left upper extremity weaker at 3\/5 compared to right upper extremity and right lower extremity , chronic according to the patient .","problem":["left lower extremity and left upper extremity weaker"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. levoxyl 50 mcg q.d.","problem":[],"test":[],"treatment":["levoxyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"anxiety disorder .","problem":["anxiety disorder"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was also started on solu-medrol iv for active airway disease component of her shortness of breath .","problem":["her shortness of breath","active airway disease component"],"test":[],"treatment":["solu-medrol iv"],"problem_indices_start":[51,86],"problem_indices_end":[82,109],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32],"treatment_indices_end":[46]}
{"text":"1. vitamin d 400 mg q.d.","problem":[],"test":[],"treatment":["vitamin d"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"chronic abdominal pain .","problem":["chronic abdominal pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extremity exam :","problem":[],"test":["extremity exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is stable without an oxygen requirement .","problem":["an oxygen requirement"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"married with children , wheelchair bound mostly .","problem":["wheelchair bound"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no edema .","problem":["edema"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. cholecalciferol .","problem":[],"test":[],"treatment":["cholecalciferol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"2019-06-19 07:20 am blood glucose - 73 urean - 20 creat - 1.1 na - 136 k - 5.0 cl - 101 hco3 - 27 angap - 13","problem":[],"test":["angap","na","cl","hco3","glucose","urean","k","creat"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,39,50,62,71,79,88,98],"test_indices_end":[33,44,55,64,72,81,92,103],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"as a result , you were started on thyroid supplements .","problem":[],"test":[],"treatment":["thyroid supplements"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[53]}
{"text":"vitals : t 96.9 , bp 110\/70 , hr 84 , rr 20 , sat 97% on 4l .","problem":[],"test":["sat","hr","rr","bp","t","vitals"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,9,18,30,38,46],"test_indices_end":[6,10,20,32,40,49],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you should have follow-up blood tests by your primary care physician b 3 months .","problem":[],"test":["follow-up blood tests"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16],"test_indices_end":[37],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-14 10:30 am blood alt - 34 ast - 167 * ck(cpk) - 313 * alkphos - 383 * amylase - 44 totbili - 0.7","problem":[],"test":["alt","ast","ck(cpk)","alkphos","amylase","totbili"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,35,47,63,79,92],"test_indices_end":[29,38,54,70,86,99],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6) if you experience any fevers , chills , chest pain , shortness of breath , dizziness or any other concerning symptoms please return to the emergency department .","problem":["fevers","chills","chest pain","shortness of breath","dizziness","any other concerning symptoms"],"test":[],"treatment":[],"problem_indices_start":[25,34,43,56,78,91],"problem_indices_end":[31,40,53,75,87,120],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neck : jvp not elevated .","problem":["elevated"],"test":["jvp"],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[23],"test_indices_start":[7],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent : flushed cheeks .","problem":["flushed cheeks"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"slightly dry mm .","problem":["slightly dry mm"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. morphine 15 mg tablet sustained release sig : three ( 3 ) tablet sustained release po q12h ( every 12 hours ).","problem":[],"test":[],"treatment":["morphine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"he continued to have an oxygen requirement and ct scan suggested ground glass opacities , suggestive of an underlying infectious process .","problem":["ground glass opacities","an underlying infectious process","an oxygen requirement"],"test":["ct scan"],"treatment":[],"problem_indices_start":[21,65,104],"problem_indices_end":[42,87,136],"test_indices_start":[47],"test_indices_end":[54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1) pneumonia","problem":["pneumonia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he later presented with increasing back pain , and metastatic disease was documented .","problem":["increasing back pain","metastatic disease"],"test":[],"treatment":[],"problem_indices_start":[24,51],"problem_indices_end":[44,69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no s3 , s4 .","problem":["s3","s4"],"test":[],"treatment":[],"problem_indices_start":[3,8],"problem_indices_end":[5,10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lymphovascular invasion was present .","problem":["lymphovascular invasion"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2) acute renal failure","problem":["acute renal failure"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"resp : decreased air entry and crackles at both lung bases .","problem":["decreased air entry","crackles at both lung bases"],"test":[],"treatment":[],"problem_indices_start":[7,31],"problem_indices_end":[26,58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"+ egophony .","problem":["egophony"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no murmur or rub .","problem":["murmur","rub"],"test":[],"treatment":[],"problem_indices_start":[3,13],"problem_indices_end":[9,16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you should resume this medication starting wallace , 06-24 .","problem":[],"test":[],"treatment":["this medication"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[33]}
{"text":"4) during your hospital stay you were also found to have low thyroid hormone levels .","problem":["low thyroid hormone levels"],"test":[],"treatment":[],"problem_indices_start":[57],"problem_indices_end":[83],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5) l femur xray ( 06-18 ): predominantly sclerotic lesion with interval periosteal new bone formation involving the intertrochanteric and subtrochanteric regions .","problem":["interval periosteal new bone formation","predominantly sclerotic lesion"],"test":["l femur xray"],"treatment":[],"problem_indices_start":[27,63],"problem_indices_end":[57,101],"test_indices_start":[3],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he is status post avastin plus sorafenib , protocol #04-393 , discontinued in the setting of","problem":[],"test":[],"treatment":["sorafenib","avastin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18,31],"treatment_indices_end":[25,40]}
{"text":"patient was also found to have abnormal tfts on sutent and was started on replacement","problem":["abnormal tfts"],"test":[],"treatment":["replacement","sutent"],"problem_indices_start":[31],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48,74],"treatment_indices_end":[54,85]}
{"text":"1. metastatic renal cell carcinoma , diagnosed in 2018-03-21 , status post left radical nephrectomy at st. margaret's center for women & infants in 03\/2006 .","problem":["metastatic renal cell carcinoma"],"test":[],"treatment":["left radical nephrectomy"],"problem_indices_start":[3],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[75],"treatment_indices_end":[99]}
{"text":"ongoing grade iii rash , involving the hands and feet in addition proteinuria secondary to the avastin .","problem":["ongoing grade iii rash","proteinuria"],"test":[],"treatment":["avastin"],"problem_indices_start":[0,66],"problem_indices_end":[22,77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[95],"treatment_indices_end":[102]}
{"text":"his bp decreased to 100 systolic despite hydration with 2l of ns .","problem":[],"test":["his bp"],"treatment":["hydration","ns"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[41,62],"treatment_indices_end":[50,64]}
{"text":"he has been maintained on single timlin therapy with sutent 50 mg daily as of 2018-12-21 and has completed nearly 6 cycles .","problem":[],"test":[],"treatment":["sutent","single timlin therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,53],"treatment_indices_end":[47,59]}
{"text":"path consistent with renal cell carcinoma of chromophobe type with carter nuclear grade of 4\/4 .","problem":["renal cell carcinoma of chromophobe type","carter nuclear grade"],"test":[],"treatment":[],"problem_indices_start":[21,67],"problem_indices_end":[61,87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1) bibasilar pneumonia : patient was treated for community-acquired pneumonia .","problem":["bibasilar pneumonia","community-acquired pneumonia"],"test":[],"treatment":[],"problem_indices_start":[3,49],"problem_indices_end":[22,77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. seasonal allergies","problem":["seasonal allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the lung volumes are slightly increased .","problem":["slightly increased"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he has mild renal insufficiency in the setting of sutent .","problem":["mild renal insufficiency"],"test":[],"treatment":["sutent"],"problem_indices_start":[7],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[50],"treatment_indices_end":[56]}
{"text":"patient recorded as having no known allergies to drugs","problem":["known allergies"],"test":[],"treatment":["drugs"],"problem_indices_start":[30],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49],"treatment_indices_end":[54]}
{"text":"mild posterior mitral valve prolapse with mild mitral regurgitation .","problem":["mild posterior mitral valve prolapse","mild mitral regurgitation"],"test":[],"treatment":[],"problem_indices_start":[0,42],"problem_indices_end":[36,67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"together with the interval development of bilateral pleural effusions , this indicates cardiac insufficiency ( or alternatively volume overload ) and an echocardiogram may be indicated for further evaluation .","problem":["bilateral pleural effusions","cardiac insufficiency","volume overload"],"test":["further evaluation","an echocardiogram"],"treatment":[],"problem_indices_start":[42,87,128],"problem_indices_end":[69,108,143],"test_indices_start":[150,189],"test_indices_end":[167,207],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mr. mcelveen 51 year-old male with metastatic rcc on sutent since 2018-12-21 , admitted with fever , hypoxemia , and bibasilar pneumonia .","problem":["fever","hypoxemia","bibasilar pneumonia","metastatic rcc"],"test":[],"treatment":["sutent"],"problem_indices_start":[35,93,101,117],"problem_indices_end":[49,98,110,136],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[53],"treatment_indices_end":[59]}
{"text":"gen : in nad .","problem":["nad"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"therapy .","problem":[],"test":[],"treatment":["therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"3) renal insufficiency : creatinine improved from 2.1 to 1.3 at time of discharge .","problem":["renal insufficiency"],"test":["creatinine"],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[25],"test_indices_end":[35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the deanna , tmax 102.8 , bp 100 - 140\/60 s, hr 80 s, rr 20 s, sat 75% on ra in triage , up to 100% on nrb .","problem":[],"test":["sat","rr","hr","bp","tmax"],"treatment":["ra","nrb"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16,29,48,57,66],"test_indices_end":[20,31,50,59,69],"treatment_indices_start":[77,106],"treatment_indices_end":[79,109]}
{"text":"2. levofloxacin 500 mg tablet sig : one ( 1 ) tablet po q24h ( every 24 hours ) for 4 days : last dose will be nolen , 06-23 .","problem":[],"test":[],"treatment":["levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"1) bilateral le doppler ( 06-14 ): no evidence of deep venous thrombosis in the lower extremities bilaterally .","problem":["deep venous thrombosis in the lower extremities bilaterally"],"test":["bilateral le doppler"],"treatment":[],"problem_indices_start":[50],"problem_indices_end":[109],"test_indices_start":[3],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2) cxray ( 06-14 ): new bibasilar consolidations are demonstrated accompanied by bilateral small pleural effusion .","problem":["bilateral small pleural effusion","new bibasilar consolidations"],"test":["cxray"],"treatment":[],"problem_indices_start":[20,81],"problem_indices_end":[48,113],"test_indices_start":[3],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. levothyroxine 50 mcg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["levothyroxine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"mr. mcelveen is a 51 year-old male with metastatic rcc status post left radical nephrectomy in 2018-03-21 , status post avastin and sorafenib , most recently on sutent monotherapy since 2018-12-21 , with mild renal insufficiency , who presented from home on 2019-06-14 with shortness of breath and fever .","problem":["fever","metastatic rcc","shortness of breath","mild renal insufficiency"],"test":[],"treatment":["sorafenib","avastin","sutent monotherapy","left radical nephrectomy"],"problem_indices_start":[40,204,274,298],"problem_indices_end":[54,228,293,303],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[67,120,132,161],"treatment_indices_end":[91,127,141,179]}
{"text":"medicine","problem":[],"test":[],"treatment":["medicine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"1. marked interval enlargement of the cardiac silhouette .","problem":["marked interval enlargement of the cardiac silhouette"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"of note , he was hospitalized at dana-farber cancer institute from 9\/25-10\/6 with chest pain , at which time he reportedly had cardiac enzymes , an echocardiogram and a pharmacological stress test performed .","problem":["chest pain"],"test":["cardiac enzymes","an echocardiogram","a pharmacological stress test"],"treatment":[],"problem_indices_start":[82],"problem_indices_end":[92],"test_indices_start":[127,145,167],"test_indices_end":[142,162,196],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient was instructed to restart sutent next monday .","problem":[],"test":[],"treatment":["sutent"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[40]}
{"text":"3) when you were admitted to the hospital your sutent was stopped .","problem":[],"test":[],"treatment":["your sutent"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[42],"treatment_indices_end":[53]}
{"text":"likely related to underlying malignancy as well as prerenal component given improvement with gentle hydration .","problem":["prerenal component","underlying malignancy"],"test":[],"treatment":["gentle hydration"],"problem_indices_start":[18,51],"problem_indices_end":[39,69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[93],"treatment_indices_end":[109]}
{"text":"4. sutent 50 mg capsule sig : one ( 1 ) capsule po every other day : please restart on wallace , 06-24 .","problem":[],"test":[],"treatment":["sutent"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"there is no pneumothorax identified .","problem":["pneumothorax"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"fluticasone propionate 110mcg 2 puff ih bid","problem":[],"test":[],"treatment":["fluticasone propionate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[22]}
{"text":"3) ct torso ( 06-17 ):","problem":[],"test":["ct torso"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you should continue taking this medication and your last day will be nolen , 06-23 .","problem":[],"test":[],"treatment":["this medication"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[42]}
{"text":"recent ct scan showed destruction of l femoral neck .","problem":["destruction of l femoral neck"],"test":["recent ct scan"],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[51],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it is unclear from history what these studies revealed .","problem":[],"test":["these studies"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[32],"test_indices_end":[45],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-19 07:20 am blood glucose - 73 urean - 20 creat - 1.1 na - 136 k - 5.0 cl - 101 hco3 - 27 angap - 13","problem":[],"test":["creat","angap","hco3","k","na","cl","urean","glucose"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,39,50,62,71,79,88,98],"test_indices_end":[33,44,55,64,72,81,92,103],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he reports that he felt fatigued during the week prior to the current admission .","problem":["fatigued"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2) you were admitted to the hospital and started on an antibiotic called levaquin for a pneumonia .","problem":["a pneumonia"],"test":[],"treatment":["levaquin","an antibiotic"],"problem_indices_start":[86],"problem_indices_end":[97],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[52,73],"treatment_indices_end":[65,81]}
{"text":"2019-06-19 07:20 am blood calcium - 8.0 * phos - 3.3 mg - 2.0","problem":[],"test":["phos","mg","calcium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,42,53],"test_indices_end":[33,46,55],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1) please take all medications as listed in the discharge instructions .","problem":[],"test":[],"treatment":["all medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[30]}
{"text":"on the day of admission , he felt \" congested \" in his chest , and had a new fever .","problem":["a new fever","congested"],"test":[],"treatment":[],"problem_indices_start":[36,71],"problem_indices_end":[45,82],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he will need follow-up bloodwork as an outpatient .","problem":[],"test":["follow-up bloodwork"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he underwent an xray of the l femur which did not suggest an acute fracture .","problem":["an acute fracture"],"test":["an xray of the l femur"],"treatment":[],"problem_indices_start":[58],"problem_indices_end":[75],"test_indices_start":[13],"test_indices_end":[35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patrick reports a mild cough for 2 days pta , non-productive .","problem":["a mild cough","non-productive"],"test":[],"treatment":[],"problem_indices_start":[16,46],"problem_indices_end":[28,60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you should take this medication every other day .","problem":[],"test":[],"treatment":["this medication"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[31]}
{"text":"he denies a history of aspiration events or choking with food intake .","problem":["aspiration events","choking"],"test":[],"treatment":[],"problem_indices_start":[23,44],"problem_indices_end":[40,51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. docusate sodium 100 mg capsule sig : one ( 1 ) capsule po bid ( 2 times a day ): take as necessary for constipation .","problem":["constipation"],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[106],"problem_indices_end":[118],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"cxr with bibasilar consolidations .","problem":["bibasilar consolidations"],"test":["cxr"],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[33],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pantoprazole 40 mg po q24h","problem":[],"test":[],"treatment":["pantoprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"4. new jejunal wall thickening with persistent distal ileal wall thickening and diffuse mesenteric stranding , most likely reflecting an infectious etiology .","problem":["diffuse mesenteric stranding","new jejunal wall thickening","persistent distal ileal wall thickening","an infectious etiology"],"test":[],"treatment":[],"problem_indices_start":[3,36,80,134],"problem_indices_end":[30,75,108,156],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"docusate sodium 100 mg po bid","problem":[],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"ipratropium bromide neb 1 neb ih q6h","problem":[],"test":[],"treatment":["ipratropium bromide neb"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[23]}
{"text":"5. morphine 15 mg tablet sig : one ( 1 ) tablet po q4-6h ( every 4 to 6 hours ) as needed for pain .","problem":["pain"],"test":[],"treatment":["morphine"],"problem_indices_start":[94],"problem_indices_end":[98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"3) metastatic renal cell carcinoma","problem":["metastatic renal cell carcinoma"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4) hypoxemia","problem":["hypoxemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he denies chills , no chest pain , no le swelling .","problem":["chills","chest pain","le swelling"],"test":[],"treatment":[],"problem_indices_start":[10,22,38],"problem_indices_end":[16,32,49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"further ros reveals mild sob in the days preceding admission , but he tells me that he was surprised to find out about his low oxygen saturation because he did not feel that bad .","problem":["his low oxygen saturation","mild sob"],"test":["further ros"],"treatment":[],"problem_indices_start":[20,119],"problem_indices_end":[28,144],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. bilateral basilar compressive atelectasis .","problem":["bilateral basilar compressive atelectasis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"medications on admission : he takes imodium and lomotil while on sutent for diarrhea .","problem":["diarrhea"],"test":[],"treatment":["imodium","sutent","lomotil"],"problem_indices_start":[76],"problem_indices_end":[84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36,48,65],"treatment_indices_end":[43,55,71]}
{"text":"albuterol 0.083% neb soln 1 neb ih q6h","problem":[],"test":[],"treatment":["albuterol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"drug toxicity would be a consideration , although somewhat less likely given the unilaterality of the findings .","problem":["drug toxicity"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heparin 5000 unit sc tid","problem":[],"test":[],"treatment":["heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"he is also on ms contin 45 mg po q12 hours ( confirmed with wife ) and msir 15 mg every 4 hours as needed .","problem":[],"test":[],"treatment":["msir","ms contin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14,71],"treatment_indices_end":[23,75]}
{"text":"shortness of breath , fever","problem":["fever","shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[0,22],"problem_indices_end":[19,27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4) echo ( 06-18 ): mild symmetric left ventricular hypertrophy with preserved biventricular systolic function .","problem":["mild symmetric left ventricular hypertrophy"],"test":["echo"],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[62],"test_indices_start":[3],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"morphine sulfate 2-4 mg iv q4h : prn","problem":[],"test":[],"treatment":["morphine sulfate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"levofloxacin 500 mg po q24h","problem":[],"test":[],"treatment":["levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"ceftriaxone 1 gm iv q24h","problem":[],"test":[],"treatment":["ceftriaxone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"azithromycin & ctx at time of transfer to the oncology service .","problem":[],"test":[],"treatment":["azithromycin","ctx"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,15],"treatment_indices_end":[12,18]}
{"text":"3. interval development of tree-in-eric nodular opacities and scattered ground glass opacities involving the right lung , concerning for an infectious process .","problem":["an infectious process","scattered ground glass opacities involving the right lung","tree-in-eric nodular opacities"],"test":[],"treatment":[],"problem_indices_start":[27,62,137],"problem_indices_end":[57,119,158],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a cosyntropin stimulation test revealed cortisol 32.1 --> 36.4 .","problem":[],"test":["a cosyntropin stimulation test","cortisol"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,40],"test_indices_end":[30,48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the differential diagnosis of this is wide including viral , fungal and atypical mycobacterial infections .","problem":["viral , fungal and atypical mycobacterial infections"],"test":[],"treatment":[],"problem_indices_start":[53],"problem_indices_end":[105],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was initially placed on ceftriaxone , levaquin , and flagyl in the icu but then changed to","problem":[],"test":[],"treatment":["ceftriaxone","levaquin","flagyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,41,56],"treatment_indices_end":[38,49,62]}
{"text":"he is being transferred to the floor for ongoing care .","problem":[],"test":[],"treatment":["ongoing care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[41],"treatment_indices_end":[53]}
{"text":"he was given levo 750 mg po x1 , and flagyl 500 mg po x1 .","problem":[],"test":[],"treatment":["levo","flagyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,37],"treatment_indices_end":[17,43]}
{"text":"2019-06-16 07:35 am blood free t4 - 0.36 *","problem":[],"test":["free t4"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-19 07:20 am blood wbc - 11.1 * rbc - 3.47 * hgb - 10.9 * hct - 34.1 * mcv - 98 mch - 31.3 mchc - 31.9 rdw - 16.7 * plt ct - 604 *","problem":[],"test":["wbc","rdw","mchc","plt ct","mcv","hct","mch","hgb","rbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,39,52,65,78,87,98,110,123],"test_indices_end":[29,42,55,68,81,90,102,113,129],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-16 07:35 am blood tsh - 43 *","problem":[],"test":["tsh"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-18 07:55 am blood caltibc - 229 ferritn - greater th trf - 176 *","problem":[],"test":["ferritn","caltibc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,40],"test_indices_end":[33,47],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-14 06:03 pm blood calcium - 8.3 * phos - 4.3 mg - 1.9","problem":[],"test":["mg","phos","calcium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,42,53],"test_indices_end":[33,46,55],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he underwent a staging ct scan torso which suggested no significant increase in tumor burden .","problem":["significant increase in tumor burden"],"test":["a staging ct scan torso"],"treatment":[],"problem_indices_start":[56],"problem_indices_end":[92],"test_indices_start":[13],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-14 10:30 am blood wbc - 8.0 rbc - 4.22 * hgb - 12.9 * hct - 41.7 mcv - 99 * mch - 30.5 mchc - 30.8 * rdw - 16.8 * plt ct - 797 *#","problem":[],"test":["rdw","mchc","mch","plt ct","hct","mcv","hgb","wbc","rbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,36,49,62,73,84,95,109,122],"test_indices_end":[29,39,52,65,76,87,99,112,128],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-19 07:20 am blood wbc - 11.1 * rbc - 3.47 * hgb - 10.9 * hct - 34.1 * mcv - 98 mch - 31.3 mchc - 31.9 rdw - 16.7 * plt ct - 604 *","problem":[],"test":["wbc","hgb","rbc","hct","mcv","mch","rdw","mchc","plt ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,39,52,65,78,87,98,110,123],"test_indices_end":[29,42,55,68,81,90,102,113,129],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2) metastatic rcc : sutent was held on admission in light of acute infection .","problem":["acute infection","metastatic rcc"],"test":[],"treatment":["sutent"],"problem_indices_start":[3,61],"problem_indices_end":[17,76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[26]}
{"text":"2019-06-17 05:30 am blood probnp - 258 *","problem":[],"test":["probnp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his respiratory status improved slowly , oxygen was weaned off , and he was discharged on course of levaquin .","problem":[],"test":[],"treatment":["oxygen","levaquin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[41,100],"treatment_indices_end":[47,108]}
{"text":"he was subsquently admitted to the icu for further care .","problem":[],"test":[],"treatment":["further care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[43],"treatment_indices_end":[55]}
{"text":"echo was done and confirmed normal ejection fraction .","problem":[],"test":["echo"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-14 10:30 am blood ck-mb - 3 ctropnt - 0.05 *","problem":[],"test":["ctropnt","ck-mb"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,36],"test_indices_end":[31,43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was placed on levo and ceftriaxone .","problem":[],"test":[],"treatment":["ceftriaxone","levo"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17,26],"treatment_indices_end":[21,37]}
{"text":"2019-06-14 06:03 pm blood ck-mb -4 ctropnt - 0.03 *","problem":[],"test":["ck-mb","ctropnt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,35],"test_indices_end":[31,42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-14 06:03 pm blood ck(cpk) - 194 *","problem":[],"test":["ck(cpk)"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his oxygen requirement decreased , and his overall status improved quickly .","problem":["his oxygen requirement"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-14 10:30 am blood plt ct - 797 *#","problem":[],"test":["plt ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-14 10:30 am blood pt - 11.2 ptt - 23.9 inr(pt) - 0.9","problem":[],"test":["pt","ptt","inr(pt)"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,36,47],"test_indices_end":[28,39,54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-14 10:30 am blood glucose - 134 * urean - 39 * creat - 2.1 * na - 133 k - 7.9 * cl - 94 * hco3 - 28 angap - 19","problem":[],"test":["na","urean","glucose","k","hco3","creat","angap","cl"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,42,55,69,78,88,98,108],"test_indices_end":[33,47,60,71,79,90,102,113],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-18 07:55 am blood pt - 11.5 inr(pt) - 1.0","problem":[],"test":["inr(pt)","pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,36],"test_indices_end":[28,43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-06-19 07:20 am blood neuts - 77.0 * bands - 5.0 lymphs - 11.0 * monos - 3.0 eos - 0 baso - 0 atyps - 1.0 * metas - 2.0 * myelos - 1.0 *","problem":[],"test":["metas","myelos","eos","monos","atyps","baso","neuts","lymphs","bands"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26,41,53,69,81,89,98,112,126],"test_indices_end":[31,46,59,74,84,93,103,117,132],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ext : without edema .","problem":["edema"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen soft and non-tender .","problem":["non-tender"],"test":[],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he describes mild reflux symptoms at night .","problem":["mild reflux symptoms"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no displaced fracture is demonstrated .","problem":["displaced fracture"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"small ( 0.6 cm ) circumferential pericardial effusion , largest around the left atrium .","problem":["small ( 0.6 cm ) circumferential pericardial effusion"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. overall stability in metastatic burden .","problem":["metastatic burden"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"superimposed infectious consolidation is likely .","problem":["superimposed infectious consolidation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"discharge was delayed by one day to ensure patient could tolerate p.o. which patient did without difficulty .","problem":["difficulty"],"test":[],"treatment":[],"problem_indices_start":[97],"problem_indices_end":[107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please see original discharge summary for discharge medications .","problem":[],"test":[],"treatment":["discharge medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[42],"treatment_indices_end":[63]}
{"text":"patient was discharged to rehabilitation on 2013-06-25 .","problem":[],"test":[],"treatment":["rehabilitation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[40]}
{"text":"1. left transverse mid shaft radial fracture with ulnar displacement status post left radial open reduction and internal fixation .","problem":["left transverse mid shaft radial fracture","ulnar displacement"],"test":[],"treatment":["internal fixation","left radial open reduction"],"problem_indices_start":[3,50],"problem_indices_end":[44,68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[81,112],"treatment_indices_end":[107,129]}
{"text":"the patient 's pelvis was stable to ap and lateral compression .","problem":[],"test":["ap and lateral compression"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[36],"test_indices_end":[62],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white blood cell 12.9 , hemoglobin 11.5 , hematocrit 32.8 , platelet count 197,000 , sodium 141 , potassium 3.6 , chloride 110 , bicarbonate 21 , bun 20 , creatinine 0.7 , glucose 189 , pt 13.3 , inr 1.2 , ptt 30.0 , amylase 57 , arterial blood gas 7.32 , 35 , 159 , 19 , -7 .","problem":[],"test":["bun","glucose","bicarbonate","creatinine","inr","ptt","pt","arterial blood gas","amylase","hematocrit","white blood cell","hemoglobin","chloride","potassium","sodium","platelet count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,24,42,60,85,98,114,129,146,155,172,186,196,206,217,230],"test_indices_end":[16,34,52,74,91,107,122,140,149,165,179,188,199,209,224,248],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's right anterior tibial wound was noted to be clean , dry , and intact with sutures intact and no erythema or purulence noted .","problem":["erythema","purulence","the patient 's right anterior tibial wound"],"test":[],"treatment":["sutures"],"problem_indices_start":[0,111,123],"problem_indices_end":[42,119,132],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[89],"treatment_indices_end":[96]}
{"text":"the patient was alert and oriented times three in no apparent distress .","problem":["apparent distress"],"test":[],"treatment":[],"problem_indices_start":[53],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a 5 cm laceration was noted over the patient 's occiput on further inspection with no exposed underlying bone .","problem":["a 5 cm laceration","exposed underlying bone"],"test":["further inspection"],"treatment":[],"problem_indices_start":[0,86],"problem_indices_end":[17,109],"test_indices_start":[59],"test_indices_end":[77],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 06-30 , the patient was evaluated by occupational therapy and fitted for a left upper extremity splint .","problem":[],"test":[],"treatment":["a left upper extremity splint"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[76],"treatment_indices_end":[105]}
{"text":"on 06-28 , the patient was also cleared for removal of her c-spine collar and deemed stable for transfer to the orthopedic service under the direction of dr. ronda lopez .","problem":[],"test":[],"treatment":["her c-spine collar"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[55],"treatment_indices_end":[73]}
{"text":"the patient remained stable through 2010-06-29 at which point she was sent to the operating room to undergo a left radial fracture open reduction and internal fixation procedure .","problem":[],"test":[],"treatment":["a left radial fracture open reduction","internal fixation procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[108,150],"treatment_indices_end":[145,177]}
{"text":"there was no erythema or purulence .","problem":["erythema","purulence"],"test":[],"treatment":[],"problem_indices_start":[13,25],"problem_indices_end":[21,34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left upper extremity examination demonstrated no gross deformities , tenderness to palpation in the mid forearm , intact motor function in the median , radial , and ulnar nerve distributions , intact sensation to light touch in the median and radial nerve distributions , decreased sensation in the ulnar-nerve distribution , warm and well perfused limb with 2+ radial pulses .","problem":["decreased sensation in the ulnar-nerve distribution","gross deformities","tenderness"],"test":["left upper extremity examination","radial pulses","palpation in the mid forearm","light touch"],"treatment":[],"problem_indices_start":[49,69,272],"problem_indices_end":[66,79,323],"test_indices_start":[0,83,213,362],"test_indices_end":[32,111,224,375],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition , the patient received the above-described diagnostic procedures , which demonstrated injuries limited to a posterior scalp laceration , left fractured clavicle , left fractured radius , right thigh hematoma , and right leg laceration .","problem":["right thigh hematoma","right leg laceration","injuries","a posterior scalp laceration","left fractured clavicle","left fractured radius"],"test":["diagnostic procedures"],"treatment":[],"problem_indices_start":[98,118,149,175,199,226],"problem_indices_end":[106,146,172,196,219,246],"test_indices_start":[55],"test_indices_end":[76],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"given the patient 's right thigh hematoma , a duplex evaluation of the right lower extremity was performed on 2010-06-28 and demonstrated no evidence of major arterial or venous injury in the level of","problem":["major arterial or venous injury","the patient 's right thigh hematoma"],"test":["a duplex evaluation of the right lower extremity"],"treatment":[],"problem_indices_start":[6,153],"problem_indices_end":[41,184],"test_indices_start":[44],"test_indices_end":[92],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac examination demonstrated regular rate and rhythm , no murmurs , rubs , or gallops .","problem":["rubs","gallops","murmurs"],"test":["cardiac examination"],"treatment":[],"problem_indices_start":[62,72,82],"problem_indices_end":[69,76,89],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was also administered adaptive training for activities of daily life and advised regarding wound care .","problem":[],"test":[],"treatment":["wound care","adaptive training","activities of daily life"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34,56,103],"treatment_indices_end":[51,80,113]}
{"text":"the patient tolerated the procedure well and demonstrated a postoperative hematocrit of 40.9 .","problem":[],"test":["a postoperative hematocrit"],"treatment":["the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[58],"test_indices_end":[84],"treatment_indices_start":[22],"treatment_indices_end":[35]}
{"text":"right lower extremity examination demonstrated mild swelling and ecchymosis of the right posterior thigh and approximately a 3 cm laceration in the lower leg , expressive of moderate amounts of standard sterile","problem":["mild swelling","ecchymosis of the right posterior thigh","a 3 cm laceration in the lower leg"],"test":["right lower extremity examination"],"treatment":[],"problem_indices_start":[47,65,123],"problem_indices_end":[60,104,157],"test_indices_start":[0],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"examination was guaiac negative with good rectal tone .","problem":[],"test":["examination","guaiac"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16],"test_indices_end":[11,22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's lung examination revealed the lungs to be clear to auscultation bilaterally , no crepitus , and a left clavicular deformity was grossly apparent on examination .","problem":["crepitus","a left clavicular deformity"],"test":["the patient 's lung examination","examination","auscultation"],"treatment":[],"problem_indices_start":[96,111],"problem_indices_end":[104,138],"test_indices_start":[0,66,163],"test_indices_end":[31,78,174],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"examination on presentation to the emergency room revealed the following :","problem":[],"test":["examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"by report , the patient was noted to be awake , but confused at the scene of the accident with no memory of the incident .","problem":["confused"],"test":[],"treatment":[],"problem_indices_start":[52],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head ct demonstrated no evidence of intracranial bleeding .","problem":["intracranial bleeding"],"test":["head ct"],"treatment":[],"problem_indices_start":[36],"problem_indices_end":[57],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition , the patient was also fitted with a figure-of-eight clavicular splint and instructed in its","problem":[],"test":[],"treatment":["a figure-of-eight clavicular splint"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47],"treatment_indices_end":[82]}
{"text":"percocet for pain as needed .","problem":["pain"],"test":[],"treatment":["percocet"],"problem_indices_start":[13],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"fingers were warm and well perfused with capillary refill less than 3 seconds .","problem":[],"test":["capillary refill"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[41],"test_indices_end":[57],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is to followup with an orthopedist in the united kingdom fourteen days following discharge at which point repeat x-rays of her left forearm should be obtained and her left forearm scalp and right lower leg sutures and staples may be removed .","problem":[],"test":["repeat x-rays of her left forearm"],"treatment":["her left forearm scalp and right lower leg sutures","staples"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[118],"test_indices_end":[151],"treatment_indices_start":[175,230],"treatment_indices_end":[225,237]}
{"text":"right upper extremity examination demonstrated intact motor , sensory , and vascular function .","problem":[],"test":["right upper extremity examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"crystalloid and four units packed red blood cells with good response .","problem":[],"test":[],"treatment":["packed red blood cells","crystalloid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,27],"treatment_indices_end":[11,49]}
{"text":"left lower extremity examination demonstrated no gross deformities and intact motor , sensory , and vascular examinations in all distributions .","problem":["gross deformities"],"test":["left lower extremity examination"],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[66],"test_indices_start":[0],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mild swelling was noted in the left hand .","problem":["mild swelling"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. left midclavicular fracture managed nonoperatively .","problem":["left midclavicular fracture"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"motor , sensory , and vascular examinations were intact in all distributions .","problem":[],"test":["motor , sensory , and vascular examinations"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the left forearm dressing was noted to be in place , clean , dry , and intact with no saturation .","problem":["saturation"],"test":[],"treatment":["the left forearm dressing"],"problem_indices_start":[86],"problem_indices_end":[96],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[25]}
{"text":"soft , nontender , nondistended .","problem":["nontender","nondistended"],"test":[],"treatment":[],"problem_indices_start":[7,19],"problem_indices_end":[16,31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"temperature 35.4 celsius , blood pressure 116\/63 , pulse 105 , respiratory rate 18 , oxygen saturation 98% on room air .","problem":[],"test":["blood pressure","oxygen saturation","respiratory rate","temperature","pulse"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,27,51,63,85],"test_indices_end":[11,41,56,79,102],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"trauma series demonstrated no evidence of a pelvic fracture .","problem":["a pelvic fracture"],"test":["trauma series"],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[59],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"of note , the scalp and right lower leg lacerations were closed primarily by the trauma team on admission and on hospital day #1 were noted to be clean , dry , and intact .","problem":["the scalp and right lower leg lacerations"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the left forearm and right lower leg wound should be kept clean and dry with regular dressing changes with dry gauze once per day .","problem":["the left forearm and right lower leg wound"],"test":[],"treatment":["dry gauze","regular dressing changes"],"problem_indices_start":[0],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[77,107],"treatment_indices_end":[101,116]}
{"text":"no gross deformities .","problem":["gross deformities"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"radiographic studies demonstrated an inferior displaced left midclavicular fracture , no evidence of","problem":["an inferior displaced left midclavicular fracture"],"test":["radiographic studies"],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[83],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pneumothorax .","problem":["pneumothorax"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cervical spine imaging demonstrated no evidence of cervical spine injury .","problem":["cervical spine injury"],"test":["cervical spine imaging"],"treatment":[],"problem_indices_start":[51],"problem_indices_end":[72],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"scalp laceration should be kept clean and dry for five days following discharge after which point the patient may once wash her hair .","problem":["scalp laceration"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the left clavicle was noted to have continued ecchymosis decreased from prior examination with a minor stepoff and mild tenderness to palpation decreased from prior examinations .","problem":["mild tenderness","a minor stepoff","continued ecchymosis"],"test":["palpation","prior examinations","prior examination"],"treatment":[],"problem_indices_start":[36,95,115],"problem_indices_end":[56,110,130],"test_indices_start":[72,134,159],"test_indices_end":[89,143,177],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is to maintain her figure-of-eight clavicular splint and left posterior forearm splint in place for fourteen days following discharge .","problem":[],"test":[],"treatment":["left posterior forearm splint","her figure-of-eight clavicular splint"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,69],"treatment_indices_end":[64,98]}
{"text":"percocet one to two tablets po q.4h. to 6h.p.r.n. pain .","problem":["pain"],"test":[],"treatment":["percocet"],"problem_indices_start":[50],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"4. right anterior tibial laceration .","problem":["right anterior tibial laceration"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. occipital scalp laceration .","problem":["occipital scalp laceration"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urinalysis was within normal limits with 6 to 10 red blood cells .","problem":[],"test":["urinalysis","red blood cells"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,49],"test_indices_end":[10,64],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right foot and femur series demonstrated no evidence of fracture displacement .","problem":["fracture displacement"],"test":["right foot and femur series"],"treatment":[],"problem_indices_start":[56],"problem_indices_end":[77],"test_indices_start":[0],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"toxicology screen was negative .","problem":[],"test":["toxicology screen"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"trauma ct demonstrated mild pulmonary contusions , but no pelvic fracture .","problem":["pelvic fracture","mild pulmonary contusions"],"test":["trauma ct"],"treatment":[],"problem_indices_start":[23,58],"problem_indices_end":[48,73],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left forearm and wrist series demonstrated transverse mid shaft radial fracture with ulnar displacement .","problem":["transverse mid shaft radial fracture","ulnar displacement"],"test":["left forearm and wrist series"],"treatment":[],"problem_indices_start":[43,85],"problem_indices_end":[79,103],"test_indices_start":[0],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"diagnosis peritoneum lavage times two was negative for any signs of intra-abdominal bleeding .","problem":["intra-abdominal bleeding"],"test":["diagnosis peritoneum lavage"],"treatment":[],"problem_indices_start":[68],"problem_indices_end":[92],"test_indices_start":[0],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"boston coma scale of 15 .","problem":[],"test":["boston coma scale"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right tibial-fibular film series demonstrated no evidence of fracture displacement .","problem":["fracture displacement"],"test":["right tibial-fibular film series"],"treatment":[],"problem_indices_start":[61],"problem_indices_end":[82],"test_indices_start":[0],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left humerus film series demonstrated no evidence of fracture or displacement .","problem":["displacement","fracture"],"test":["left humerus film series"],"treatment":[],"problem_indices_start":[53,65],"problem_indices_end":[61,77],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was immobilized in the c-spine collar at the scene of the accident and subsequently transported by ems to the new england sinai hospital & rehab center emergency department for further management .","problem":[],"test":[],"treatment":["the c-spine collar","further management"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23,181],"treatment_indices_end":[41,199]}
{"text":"nonoperative treatment was elected for the patient 's left clavicular fracture .","problem":["the patient 's left clavicular fracture"],"test":[],"treatment":["nonoperative treatment"],"problem_indices_start":[39],"problem_indices_end":[78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[22]}
{"text":"studies on admission revealed the following :","problem":[],"test":["studies"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's head wound laceration was noted to be clean and dry with intact staples .","problem":["the patient 's head wound laceration"],"test":[],"treatment":["intact staples"],"problem_indices_start":[0],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[72],"treatment_indices_end":[86]}
{"text":"on postoperative day #1 , 2010-06-30 , the patient was noted to be clinically stable , tolerating oral intake , and expressive of adequate amounts of urine independent of a foley catheter .","problem":[],"test":[],"treatment":["a foley catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[171],"treatment_indices_end":[187]}
{"text":"8. ferrous sulfate 325 ( 65 ) mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["ferrous sulfate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"15. clopidogrel 75 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["clopidogrel"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[15]}
{"text":"10. ipratropium bromide 0.02 % solution sig : one ( 1 ) inhalation q6h ( every 6 hours ).","problem":[],"test":[],"treatment":["ipratropium bromide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[23]}
{"text":"14. isosorbide dinitrate 20 mg tablet sig : one ( 1 ) tablet po tid ( 3 times a day ).","problem":[],"test":[],"treatment":["isosorbide dinitrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[24]}
{"text":"5. terazosin 1 mg capsule sig : two ( 2 ) capsule po hs ( at bedtime ).","problem":[],"test":[],"treatment":["terazosin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"7. nimodipine 30 mg capsule sig : two ( 2 ) capsule po q4h ( every 4 hours ) for 2 weeks .","problem":[],"test":[],"treatment":["nimodipine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"12. hydralazine 25 mg tablet sig : 1.5 tablets po tid ( 3 times a day ).","problem":[],"test":[],"treatment":["hydralazine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[15]}
{"text":"4. fluticasone-salmeterol 250-50 mcg \/ dose disk with device sig : one ( 1 ) disk with device inhalation bid ( 2 times a day ).","problem":[],"test":[],"treatment":["fluticasone-salmeterol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[25]}
{"text":"6. acetaminophen 325 mg tablet sig : 1-2 tablets po q4-6h ( every 4 to 6 hours ) as needed .","problem":[],"test":[],"treatment":["acetaminophen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"3. albuterol-ipratropium 103-18 mcg \/ actuation aerosol sig : 02-26 puffs inhalation q6h ( every 6 hours ) as needed .","problem":[],"test":[],"treatment":["albuterol-ipratropium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[24]}
{"text":"16. glipizide 5 mg tablet sig : one ( 1 ) tablet po once a day .","problem":[],"test":[],"treatment":["glipizide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"explained to pt which of the meds he should no longer take that he was taking pre-admission .","problem":[],"test":[],"treatment":["the meds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25],"treatment_indices_end":[33]}
{"text":"2. simvastatin 40 mg tablet sig: one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["simvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"13. metoprolol tartrate 25 mg tablet sig : 1.5 tablets po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["metoprolol tartrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[23]}
{"text":"9. aspirin 81 mg tablet , chewable sig : one ( 1 ) tablet , chewable po daily ( daily ).","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"1. diltiazem hcl 240 mg capsule , sustained release sig : one ( 1 ) capsule , sustained release po daily ( daily ).","problem":[],"test":[],"treatment":["diltiazem"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"also , explained which meds are new .","problem":[],"test":[],"treatment":["meds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[27]}
{"text":"11. simvastatin 40 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["simvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[15]}
{"text":"patient recorded as having no known allergies to drugs","problem":["known allergies to drugs"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"platelet count was 759,000 .","problem":[],"test":["platelet count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"over the following days until discharge , the patient remained afebrile and on 2012-03-09 , in fact all the patient 's antibiotics were discontinued .","problem":["afebrile"],"test":[],"treatment":["the patient 's antibiotics"],"problem_indices_start":[63],"problem_indices_end":[71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[104],"treatment_indices_end":[130]}
{"text":"the patient had no further complaints and on 2012-03-10 , his white blood cell count was 2.3 , neutrophils 50% , bands 2% , lymphocytes 5% , monocytes 40% , and blasts 1% .","problem":["further complaints"],"test":["his white blood cell count","blasts","monocytes","lymphocytes","bands","neutrophils"],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[37],"test_indices_start":[58,95,113,124,141,161],"test_indices_end":[84,106,118,135,150,167],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"as for the patient 's all and aml , the patient was started on a new chemotherapy protocol called hyper-cvad on 2012-03-06 .","problem":["aml","all"],"test":[],"treatment":["hyper-cvad","a new chemotherapy protocol"],"problem_indices_start":[22,30],"problem_indices_end":[25,33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[63,98],"treatment_indices_end":[90,108]}
{"text":"after the patient began on this protocol , his white blood cell count steadily began to climb .","problem":[],"test":["his white blood cell count"],"treatment":["this protocol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[43],"test_indices_end":[69],"treatment_indices_start":[27],"treatment_indices_end":[40]}
{"text":"the patient 's hsv antibody titer was found to be negative and the patient 's acyclovir was not restarted .","problem":[],"test":["the patient 's hsv antibody titer"],"treatment":["acyclovir"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[33],"treatment_indices_start":[78],"treatment_indices_end":[87]}
{"text":"the patient 's also began to climb and the percent blasts in his differential decreased significantly .","problem":[],"test":["his differential","the percent blasts"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[39,61],"test_indices_end":[57,77],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. bactrim double strength one tablet q. monday , wednesday and friday .","problem":[],"test":[],"treatment":["bactrim double strength"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[26]}
{"text":"the patient was also told to continue on a neutropenic diet .","problem":[],"test":[],"treatment":["a neutropenic diet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[41],"treatment_indices_end":[59]}
{"text":"the patient was discharged to home with instructions to return to the hospital on monday , 2012-03-12 , for follow-up and laboratory checks .","problem":[],"test":["laboratory checks"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[122],"test_indices_end":[139],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was also told that he would have to be admitted for several days during his next cycle of cvad .","problem":[],"test":[],"treatment":["his next cycle of cvad"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[84],"treatment_indices_end":[106]}
{"text":"2. compazine 10 mg p.o. q 6hours p.r.n. nausea .","problem":["nausea"],"test":[],"treatment":["compazine"],"problem_indices_start":[40],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"the patient was initially on several antibiotics included cefepime , vancomycin , ciprofloxacin , ambazone and flagyl .","problem":[],"test":[],"treatment":["several antibiotics","ambazone","ciprofloxacin","vancomycin","flagyl","cefepime"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29,58,69,82,98,111],"treatment_indices_end":[48,66,79,95,106,117]}
{"text":"3. anzemet 100 mg p.o. once daily p.r.n. nausea .","problem":["nausea"],"test":[],"treatment":["anzemet"],"problem_indices_start":[41],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"infectious disease continued to follow and on 2012-02-29 , the patient spiked again which at that time was felt to be due to his central line and the central line was resited on the left side and the patient was started on intravenous vancomycin .","problem":[],"test":[],"treatment":["his central line","the central line","intravenous vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[125,146,223],"treatment_indices_end":[141,162,245]}
{"text":"the patient became no longer neutropenic .","problem":["neutropenic"],"test":[],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"other concerns during his stay was his kidney function , due to his renal transplant in 2003 .","problem":[],"test":["his kidney function"],"treatment":["his renal transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[35],"test_indices_end":[54],"treatment_indices_start":[64],"treatment_indices_end":[84]}
{"text":"5. mass effect was considered , although no focal deficits were ever noted on examination and due to the fluctuating sensorium , it was determined that there was no severe underlying structural abnormality .","problem":["focal deficits","mass effect","the fluctuating sensorium","severe underlying structural abnormality"],"test":["examination"],"treatment":[],"problem_indices_start":[3,44,101,165],"problem_indices_end":[14,58,126,205],"test_indices_start":[78],"test_indices_end":[89],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"while the patient was in restraints , gentle hydration was initiated since p.o. intake was not adequate .","problem":["not adequate"],"test":["p.o. intake"],"treatment":["gentle hydration","restraints"],"problem_indices_start":[91],"problem_indices_end":[103],"test_indices_start":[75],"test_indices_end":[86],"treatment_indices_start":[25,38],"treatment_indices_end":[35,54]}
{"text":"the likely cause of the delirium was a combination of surgery and intensive care unit stay in addition to poly-pharmacy .","problem":["the delirium"],"test":[],"treatment":["surgery","poly-pharmacy"],"problem_indices_start":[20],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[54,106],"treatment_indices_end":[61,119]}
{"text":"no definite evidence for significant myocardial ischemia , although cardiac enzymes were sent and he ruled out for myocardial infarction .","problem":["significant myocardial ischemia","myocardial infarction"],"test":["cardiac enzymes"],"treatment":[],"problem_indices_start":[25,115],"problem_indices_end":[56,136],"test_indices_start":[68],"test_indices_end":[83],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"12. regular insulin 5 units q. a.m. and 3 to 5 units q. p.m.","problem":[],"test":[],"treatment":["regular insulin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[19]}
{"text":"a lumbar puncture was considered , although not performed due to the fact that the cerebrospinal fluid was not breached during the procedure .","problem":[],"test":["a lumbar puncture"],"treatment":["the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[127],"treatment_indices_end":[140]}
{"text":"the etiology for his congestive heart failure was determined likely to be diastolic dysfunction from increased heart rate as well as excess volume .","problem":["diastolic dysfunction","increased heart rate","excess volume","his congestive heart failure"],"test":[],"treatment":[],"problem_indices_start":[17,74,101,133],"problem_indices_end":[45,95,121,146],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he has a history of peripheral neuropathy , kidney transplantation in 2003 secondary to diabetic nephropathy , as well as throat cancer in 2004 treated with local resection and radical neck dissection on the left as well as postoperative radiation .","problem":["peripheral neuropathy","diabetic nephropathy","throat cancer"],"test":[],"treatment":["kidney transplantation","postoperative radiation","local resection","radical neck dissection on the left"],"problem_indices_start":[20,88,122],"problem_indices_end":[41,108,135],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[44,157,177,224],"treatment_indices_end":[66,172,212,247]}
{"text":"he was febrile in the intensive care unit to 101.0 f. ; yet , chest x-ray , blood cultures , urinalysis and urine cultures were all negative for sources .","problem":["febrile"],"test":["urine cultures","urinalysis","chest x-ray","blood cultures"],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[14],"test_indices_start":[62,76,93,108],"test_indices_end":[73,90,103,122],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the only other complaints from mr. mackey during his stay were :","problem":["other complaints"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was attributed to postoperative swelling and changes from his diskectomy performed 2010-08-27 .","problem":["postoperative swelling"],"test":[],"treatment":["his diskectomy"],"problem_indices_start":[23],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[63],"treatment_indices_end":[77]}
{"text":"rpr evaluating for possible neurologic syphilis was also checked .","problem":["neurologic syphilis"],"test":["rpr evaluating"],"treatment":[],"problem_indices_start":[28],"problem_indices_end":[47],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mr. mackey also had signs and symptoms consistent with cervical myelopathy ; a cervical mri scan showed very impressive disc herniations at c5-c6 , less so at c4-c5 , with clear cut cord compression , particularly on the right side c5-c6 .","problem":["clear cut cord compression","cervical myelopathy","impressive disc herniations at c5-c6","signs and symptoms"],"test":["a cervical mri scan"],"treatment":[],"problem_indices_start":[20,55,109,172],"problem_indices_end":[38,74,145,198],"test_indices_start":[77],"test_indices_end":[96],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his respiratory rate was 30 on face mask .","problem":[],"test":["his respiratory rate"],"treatment":["face mask"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[31],"treatment_indices_end":[40]}
{"text":"tsh was within normal limits as was b12 and folate .","problem":[],"test":["folate","b12","tsh"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,36,44],"test_indices_end":[3,39,50],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he responded to intravenous lasix with 3.2 liters of urine output as well as marked clinical improvement .","problem":[],"test":["urine output"],"treatment":["intravenous lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[53],"test_indices_end":[65],"treatment_indices_start":[16],"treatment_indices_end":[33]}
{"text":"there were no electrolytes or mineral abnormalities that could explain his delirium .","problem":["his delirium","electrolytes or mineral abnormalities"],"test":[],"treatment":[],"problem_indices_start":[14,71],"problem_indices_end":[51,83],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"therefore , he was admitted for c4-c5 and c5-c6 anterior diskectomy with autologous bone graft and instrumented fusion .","problem":[],"test":[],"treatment":["autologous bone graft","c4-c5 and c5-c6 anterior diskectomy","instrumented fusion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32,73,99],"treatment_indices_end":[67,94,118]}
{"text":"the patient was found out of bed but no signs of head trauma , no loss of consciousness .","problem":["head trauma","loss of consciousness"],"test":[],"treatment":[],"problem_indices_start":[49,66],"problem_indices_end":[60,87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"interoperatively , he was positive two liters with a stable blood pressure and heart rate , although requiring some neo-synephrine interoperatively .","problem":[],"test":["heart rate"],"treatment":["some neo-synephrine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[79],"test_indices_end":[89],"treatment_indices_start":[111],"treatment_indices_end":[130]}
{"text":"the restraints were weaned off overnight although he became acutely agitated and they were replaced early on 08-31 .","problem":["acutely agitated"],"test":[],"treatment":["the restraints"],"problem_indices_start":[60],"problem_indices_end":[76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[14]}
{"text":"liver function tests were checked , only total bilirubin was slightly elevated at 1.6 .","problem":["slightly elevated"],"test":["liver function tests","total bilirubin"],"treatment":[],"problem_indices_start":[61],"problem_indices_end":[78],"test_indices_start":[0,41],"test_indices_end":[20,56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was awake , alert , uncomfortable secondary to incisional tenderness at neck site as well as right iliac graft site .","problem":["uncomfortable","incisional tenderness","neck site","right iliac graft site"],"test":[],"treatment":[],"problem_indices_start":[23,50,75,96],"problem_indices_end":[36,71,84,118],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"throughout his stay , chem-10 was monitored .","problem":[],"test":["chem-10"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an eeg was also considered to rule out non-convulsive status epilepticus , although again this did not seem to be a likely cause .","problem":["non-convulsive status epilepticus"],"test":["an eeg"],"treatment":[],"problem_indices_start":[39],"problem_indices_end":[72],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"postoperative physical examination demonstrated that he was afebrile at 97 degrees ; blood pressure 145\/80 ; pulse 60 ; respiratory rate 10 ; 100% on a non-rebreather .","problem":["afebrile"],"test":["blood pressure","respiratory rate","postoperative physical examination","pulse"],"treatment":["a non-rebreather"],"problem_indices_start":[60],"problem_indices_end":[68],"test_indices_start":[0,85,109,120],"test_indices_end":[34,99,114,136],"treatment_indices_start":[150],"treatment_indices_end":[166]}
{"text":"no acute intracranial hemorrhages or midline shifts were noted , although a soft tissue mass was noted at the level of c2 .","problem":["midline shifts","acute intracranial hemorrhages","a soft tissue mass"],"test":[],"treatment":[],"problem_indices_start":[3,37,74],"problem_indices_end":[33,51,92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the wounds were clean , dry and intact , and flat .","problem":["the wounds"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the assay was nonreactive .","problem":[],"test":["the assay"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a head and neck ct scan , non-contrast , were ordered though to evaluate for such processes .","problem":["such processes"],"test":["a head and neck ct scan , non-contrast"],"treatment":[],"problem_indices_start":[77],"problem_indices_end":[91],"test_indices_start":[0],"test_indices_end":[38],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"soreness at his operative sites , for which he was given p.r.n. tylenol once his delirium had resolved .","problem":["his operative sites","soreness","his delirium"],"test":[],"treatment":["p.r.n. tylenol"],"problem_indices_start":[0,12,77],"problem_indices_end":[8,31,89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[57],"treatment_indices_end":[71]}
{"text":"haldol as well as the restraints were not required after the morning of the 23rd .","problem":[],"test":[],"treatment":["haldol","the restraints"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,18],"treatment_indices_end":[6,32]}
{"text":"intramuscular as well as intravenous haldol were ordered p.r.n. for emergency use should he become acutely agitated .","problem":["acutely agitated"],"test":[],"treatment":["intravenous haldol","intramuscular"],"problem_indices_start":[99],"problem_indices_end":[115],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,25],"treatment_indices_end":[13,43]}
{"text":"the patient continued to do well and did not require restraints after that event .","problem":["that event"],"test":[],"treatment":["restraints"],"problem_indices_start":[70],"problem_indices_end":[80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[53],"treatment_indices_end":[63]}
{"text":"he was also put on lopressor 150 mg twice a day .","problem":[],"test":[],"treatment":["lopressor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[28]}
{"text":"on the evening of the 22nd , the patient became acutely agitated , threatening to leave , and also threatening to harm those nurses and physicians that were attempting to prevent him from leaving .","problem":["acutely agitated"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"later in the morning on 08-31 , the patient was more oriented and alert , and asked to have the restraints removed .","problem":[],"test":[],"treatment":["the restraints"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[92],"treatment_indices_end":[106]}
{"text":"restraints , for the safety of both the patient and the staff of the hospital .","problem":[],"test":[],"treatment":["restraints"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"he was given lasix to continue to diurese the excess volume .","problem":["the excess volume"],"test":[],"treatment":["lasix"],"problem_indices_start":[42],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[18]}
{"text":"each progressive day, mr. donald delirium abated with return to baseline mental status early on 09-01 .","problem":["delirium"],"test":[],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his immunosuppressive therapy was continued throughout his stay ; his creatinine remained approximately 2.3 to 2.4 ; he has a baseline renal insufficiency .","problem":["a baseline renal insufficiency"],"test":["his creatinine"],"treatment":["his immunosuppressive therapy"],"problem_indices_start":[124],"problem_indices_end":[154],"test_indices_start":[66],"test_indices_end":[80],"treatment_indices_start":[0],"treatment_indices_end":[29]}
{"text":"3. pyelonephritis .","problem":["pyelonephritis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. zithropren 50 mg q. day .","problem":[],"test":[],"treatment":["zithropren"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"the patient became agitated with both tent and bi-pap machine , although continued to saturate well .","problem":["agitated"],"test":[],"treatment":["tent","bi-pap machine"],"problem_indices_start":[19],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38,47],"treatment_indices_end":[42,61]}
{"text":"5. cyclosporin microemulsion .","problem":[],"test":[],"treatment":["cyclosporin microemulsion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[28]}
{"text":"also in the intensive care unit , o2 saturation was closely monitored .","problem":[],"test":["o2 saturation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[34],"test_indices_end":[47],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mr. robert mackey is a 49 year old gentleman with a 22 year history of diabetes mellitus .","problem":["diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[71],"problem_indices_end":[88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. nitroglycerin sublingual 0.3 mg p.r.n.","problem":[],"test":[],"treatment":["nitroglycerin sublingual"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[27]}
{"text":"with this in mind , when obtaining a ct scan it was determined that contrast would not be the best option .","problem":[],"test":["a ct scan"],"treatment":["contrast"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[35],"test_indices_end":[44],"treatment_indices_start":[68],"treatment_indices_end":[76]}
{"text":"he was transferred to medicine the morning of 2010-08-30 , for continued medical management post surgery .","problem":[],"test":[],"treatment":["continued medical management"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[63],"treatment_indices_end":[91]}
{"text":"5. right coronary artery stent in 2008 ; ejection fraction 60 to 65% .","problem":[],"test":["ejection fraction"],"treatment":["right coronary artery stent"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[41],"test_indices_end":[58],"treatment_indices_start":[3],"treatment_indices_end":[30]}
{"text":"10. prilosec 20 mg q. day .","problem":[],"test":[],"treatment":["prilosec"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"on the day of transfer , the patient was noted to be confused with waxing and waning sensorium ; thus , a delirium work-up was initiated looking for precipitants .","problem":["confused","waxing and waning sensorium"],"test":["a delirium work-up"],"treatment":[],"problem_indices_start":[53,67],"problem_indices_end":[61,94],"test_indices_start":[104],"test_indices_end":[122],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. prednisone 10 mg q. day .","problem":[],"test":[],"treatment":["prednisone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"1. when his o2 saturation was monitored , his pulse oximetry remained in the 90s during his stay .","problem":[],"test":["his pulse oximetry","his o2 saturation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[8,42],"test_indices_end":[25,60],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. neoral 100 mg twice a day .","problem":[],"test":[],"treatment":["neoral"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"2. his non-essential medications that may have been contributing to his change in mental status were discontinued ; those included temocillin , nortriptyline , haldol , lorazepam , venlafaxine , bupropion , and gabapentin .","problem":["his change in mental status"],"test":[],"treatment":["his non-essential medications","temocillin","nortriptyline","lorazepam","haldol","venlafaxine","bupropion","gabapentin"],"problem_indices_start":[68],"problem_indices_end":[95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,131,144,160,169,181,195,211],"treatment_indices_end":[32,141,157,166,178,192,204,221]}
{"text":"7. benign prostatic hypertrophy status post transurethral resection of the prostate ; self catheterization .","problem":["benign prostatic hypertrophy"],"test":[],"treatment":["transurethral resection of the prostate","self catheterization"],"problem_indices_start":[3],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[44,86],"treatment_indices_end":[83,106]}
{"text":"11. nph 30 units q. a.m. , 5 to 6 units q. p.m.","problem":[],"test":[],"treatment":["nph"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[7]}
{"text":"9. minoxidil 10 mg twice a day .","problem":[],"test":[],"treatment":["minoxidil"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"while in the pacu , anesthesia was called because the patient became dyspneic and tachypneic and his sao2 dropped to 89% .","problem":["tachypneic","dyspneic"],"test":["his sao2"],"treatment":[],"problem_indices_start":[69,82],"problem_indices_end":[77,92],"test_indices_start":[97],"test_indices_end":[105],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"12. cerebral aneurysm .","problem":["cerebral aneurysm"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"as for his diabetes mellitus , the mahoney team provided updated recommendations each day , adjusting for the changing p.o. intake .","problem":["his diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. trauma was also considered .","problem":["trauma"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. creatinine 2.2 to 2.5 .","problem":[],"test":["creatinine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nortriptyline 10 mg q. h.s. ; flomax 0.4 mg q. h.s. ; neurontin 600 mg three times a day .","problem":[],"test":[],"treatment":["nortriptyline","flomax","neurontin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,30,54],"treatment_indices_end":[13,36,63]}
{"text":"3. he was also discharged home with visiting nurse association for physical therapy evaluation of home safety .","problem":[],"test":["physical therapy evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[67],"test_indices_end":[94],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"13. wellbutrin 100 mg q. day .","problem":[],"test":[],"treatment":["wellbutrin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[14]}
{"text":"gentamicin , and ibuprofen .","problem":[],"test":[],"treatment":["ibuprofen","gentamicin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,17],"treatment_indices_end":[10,26]}
{"text":"15. nitroglycerin sr 2.5 mg twice a day .","problem":[],"test":[],"treatment":["nitroglycerin sr"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[20]}
{"text":"6. type 1 diabetes mellitus with triopathy , retinopathy , neuropathy , nephropathy .","problem":["neuropathy","nephropathy","retinopathy","triopathy","type 1 diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[3,33,45,59,72],"problem_indices_end":[27,42,56,69,83],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was instructed to hold the following three medications that he took prior to admission :","problem":[],"test":[],"treatment":["medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[46],"treatment_indices_end":[57]}
{"text":"14. zocor 60 mg q. day .","problem":[],"test":[],"treatment":["zocor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[9]}
{"text":"in addition , his cyclosporin levels were checked .","problem":[],"test":["his cyclosporin levels"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. c4-c5 , c5-c6 , anterior microdiscectomy and fusion with right iliac bone graft .","problem":[],"test":[],"treatment":["c4-c5 , c5-c6 , anterior microdiscectomy and fusion","right iliac bone graft"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,60],"treatment_indices_end":[54,82]}
{"text":"3. hypo or hyperglycemia :","problem":["hypo or hyperglycemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition , he also complained of difficulty with swallowing , necessitating only soft and liquid diet .","problem":["difficulty with swallowing"],"test":[],"treatment":["soft and liquid diet"],"problem_indices_start":[36],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[84],"treatment_indices_end":[104]}
{"text":"finger sticks were in the 150 s when acutely agitated , therefore , it was not determined that glucose levels were contributory .","problem":["acutely agitated"],"test":["finger sticks","glucose levels"],"treatment":[],"problem_indices_start":[37],"problem_indices_end":[53],"test_indices_start":[0,95],"test_indices_end":[13,109],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mahoney had been following with their appreciated recommendations on glucose control .","problem":[],"test":[],"treatment":["glucose control"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[69],"treatment_indices_end":[84]}
{"text":"11. throat cancer status post right neck dissection and xrt in 2004 .","problem":["throat cancer"],"test":[],"treatment":["xrt","right neck dissection"],"problem_indices_start":[4],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30,56],"treatment_indices_end":[51,59]}
{"text":"1. end-stage renal disease secondary to type 1 diabetes mellitus ; status post renal transplant in 2003 .","problem":["end-stage renal disease","type 1 diabetes mellitus"],"test":[],"treatment":["renal transplant"],"problem_indices_start":[3,40],"problem_indices_end":[26,64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[79],"treatment_indices_end":[95]}
{"text":"13. left prosthetic cmed ccu .","problem":[],"test":[],"treatment":["left prosthetic"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[19]}
{"text":"8. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. hypercholesterolemia .","problem":["hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. infectious causes were evaluated .","problem":["infectious causes"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. metoprolol 100 mg twice a day .","problem":[],"test":[],"treatment":["metoprolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"10. hepatitis b .","problem":["hepatitis b"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. furosemide 20 mg q.o.d.","problem":[],"test":[],"treatment":["furosemide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"2. history of multiple urinary tract infections .","problem":["multiple urinary tract infections"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. venlafaxine xr 75 mg q. a.m.","problem":[],"test":[],"treatment":["venlafaxine xr"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[17]}
{"text":"a ct scan with po contrast showed dilation of intrahepatic common bile duct which is improved from previous studies .","problem":["dilation of intrahepatic common bile duct"],"test":["a ct scan with po contrast","previous studies"],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[75],"test_indices_start":[0,99],"test_indices_end":[26,115],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rectal exam showed no masses and is guaiac negative .","problem":["masses"],"test":["guaiac","rectal exam"],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[28],"test_indices_start":[0,36],"test_indices_end":[11,42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his creatinine levels trended toward normal and the fractional excretion of sodium also increased indicating a resolution of the prerenal kidney failure .","problem":["the prerenal kidney failure"],"test":["his creatinine levels","the fractional excretion of sodium"],"treatment":[],"problem_indices_start":[125],"problem_indices_end":[152],"test_indices_start":[0,48],"test_indices_end":[21,82],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was given zosyn for empiric treatment .","problem":[],"test":[],"treatment":["zosyn","empiric treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,23],"treatment_indices_end":[18,40]}
{"text":"the patient 's postoperative course was notable for an elevation in white blood cell count peaking at 30.0 on postoperative day number two .","problem":["an elevation"],"test":["white blood cell"],"treatment":[],"problem_indices_start":[52],"problem_indices_end":[64],"test_indices_start":[68],"test_indices_end":[84],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at the time an 8 caucasian catheter was placed in the common hepatic\/bioduct for external drainage .","problem":[],"test":[],"treatment":["an 8 caucasian catheter","external drainage"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12,81],"treatment_indices_end":[35,98]}
{"text":"the somatostatin and the midodrine were discontinued and the regimen of lasix and spironolactone was started for diuresis .","problem":[],"test":[],"treatment":["spironolactone","diuresis","the midodrine","lasix","the somatostatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,21,72,82,113],"treatment_indices_end":[16,34,77,96,121]}
{"text":"alt 106 , ast 149 , alkaline phosphatase 242 .","problem":[],"test":["ast","alt","alkaline phosphatase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,20],"test_indices_end":[3,13,40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on exploration of the abdomen revealed significant nodularity of the liver indicating of advanced cirrhosis .","problem":["advanced cirrhosis","significant nodularity of the liver"],"test":["exploration of the abdomen"],"treatment":[],"problem_indices_start":[39,89],"problem_indices_end":[74,107],"test_indices_start":[3],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"while in the hospital , the patient received initial work-up including echocardiogram , electrocardiogram and serology studies to be listed for liver transplant .","problem":[],"test":["initial work-up","electrocardiogram","serology studies","echocardiogram"],"treatment":["liver transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[45,71,88,110],"test_indices_end":[60,85,105,126],"treatment_indices_start":[144],"treatment_indices_end":[160]}
{"text":"and it is noted there was nodularity in the common bile duct which is worrisome for cholangiocarcinoma .","problem":["cholangiocarcinoma","nodularity in the common bile duct"],"test":[],"treatment":[],"problem_indices_start":[26,84],"problem_indices_end":[60,102],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"revealed greater than 24,000 white blood cell count in the ascites which is consistent with svt .","problem":["the ascites","svt"],"test":["white blood cell count"],"treatment":[],"problem_indices_start":[55,92],"problem_indices_end":[66,95],"test_indices_start":[29],"test_indices_end":[51],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he has a picc line in place for continued treatment with rocephin and he will have a visiting nurse to help him to administer these medications .","problem":[],"test":[],"treatment":["rocephin","a picc line","these medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[7,57,126],"treatment_indices_end":[18,65,143]}
{"text":"somatostatin and midodrine were also given for this condition and he also received packed red blood cells .","problem":["this condition"],"test":[],"treatment":["midodrine","packed red blood cells","somatostatin"],"problem_indices_start":[47],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,17,83],"treatment_indices_end":[12,26,105]}
{"text":"nodularities in the common bile duct visualized by endoscopic retrograde cholangiopancreatography was also worrisome for cholangiocarcinoma and the patient was admitted to the blue general surgery service for possible surgical interventions .","problem":["nodularities in the common bile duct","cholangiocarcinoma"],"test":["endoscopic retrograde cholangiopancreatography"],"treatment":["surgical interventions"],"problem_indices_start":[0,121],"problem_indices_end":[36,139],"test_indices_start":[51],"test_indices_end":[97],"treatment_indices_start":[218],"treatment_indices_end":[240]}
{"text":"fractional excretion of sodium was less than 1% suggesting a prerenal etiology .","problem":["a prerenal etiology"],"test":["fractional excretion of sodium"],"treatment":[],"problem_indices_start":[59],"problem_indices_end":[78],"test_indices_start":[0],"test_indices_end":[30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient tolerated the procedure well and he was sent to the floor in stable condition .","problem":[],"test":[],"treatment":["the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[35]}
{"text":"mr. cordano is a 58-year-old gentlemen with a past medical history significant for primary sclerosing cholangitis who presented with a chief complaint of endoscopic retrograde cholangiopancreatography endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiogram .","problem":["primary sclerosing cholangitis"],"test":["percutaneous transhepatic cholangiogram","endoscopic retrograde cholangiopancreatography","endoscopic retrograde cholangiopancreatography"],"treatment":[],"problem_indices_start":[83],"problem_indices_end":[113],"test_indices_start":[154,201,252],"test_indices_end":[200,247,291],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cholangiogram on postoperative day number two showed no evidence of leakage at the anastomosis site .","problem":["leakage at the anastomosis site"],"test":["cholangiogram"],"treatment":[],"problem_indices_start":[68],"problem_indices_end":[99],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the head is normocephalic , atraumatic and eyes are icteric .","problem":["icteric","atraumatic"],"test":[],"treatment":[],"problem_indices_start":[28,52],"problem_indices_end":[38,59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gram stain and culture of the ascites failed to identify any organism .","problem":["the ascites","any organism"],"test":["culture","gram stain"],"treatment":[],"problem_indices_start":[26,57],"problem_indices_end":[37,69],"test_indices_start":[0,15],"test_indices_end":[10,22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a white blood cell count of 14.2 , hematocrit of 35.3 , platelet count of 449,000 .","problem":[],"test":["hematocrit","platelet count","a white blood cell count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,35,56],"test_indices_end":[24,45,70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest x-ray and sputum culture obtained at the time were negative and the patient was treated with 100% nonrebreather which improved his oxygenation .","problem":[],"test":["his oxygenation","chest x-ray","sputum culture"],"treatment":["100% nonrebreather"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,133],"test_indices_end":[11,30,148],"treatment_indices_start":[99],"treatment_indices_end":[117]}
{"text":"an endoscopic retrograde cholangiopancreatography also demonstrated similar findings","problem":[],"test":["an endoscopic retrograde cholangiopancreatography"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[49],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"therefore , the patient was taken to the operating room on 2009-08-24 for a whipple procedure versus hepaticojejunostomy .","problem":[],"test":[],"treatment":["a whipple procedure","hepaticojejunostomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[74,101],"treatment_indices_end":[93,120]}
{"text":"the endoscopic retrograde cholangiopancreatography also showed the presence proximal common bile duct .","problem":[],"test":["the endoscopic retrograde cholangiopancreatography"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[50],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sodium of 130 , potassium 3.5 , chloride 93 , bicarbonate 28 , bun 15 , creatinine 1.1, prothrombin time 14.1 , partial thrombin time 29.7 .","problem":[],"test":["chloride","sodium","potassium","creatinine","bicarbonate","bun","prothrombin time","partial thrombin time"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,32,46,63,72,88,112],"test_indices_end":[6,25,40,57,66,82,104,133],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"region nodularity , which is identified previously by endoscopic retrograde cholangiopancreatography , and regional lymph nodes were all sent to pathology .","problem":["region nodularity"],"test":["endoscopic retrograde cholangiopancreatography","pathology"],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[54,145],"test_indices_end":[100,154],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"they were all negative for malignancy and therefore a hepaticojejunostomy","problem":["malignancy"],"test":[],"treatment":["a hepaticojejunostomy"],"problem_indices_start":[27],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[52],"treatment_indices_end":[73]}
{"text":"on postoperative day number ten , the patient returned to the floor with improved renal function and without oxygen requirement .","problem":["oxygen requirement"],"test":[],"treatment":[],"problem_indices_start":[109],"problem_indices_end":[127],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"inr 1.4 .","problem":[],"test":["inr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a jaundiced looking gentlemen in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[51],"problem_indices_end":[65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was weaned from oxygen requirement and was continued on normal saline boluses and","problem":["oxygen requirement"],"test":[],"treatment":["normal saline boluses"],"problem_indices_start":[19],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[59],"treatment_indices_end":[80]}
{"text":"status post placement of percutaneous transhepatic biliary drainage with placement of 8 caucasian nephrostomy catheter in the common bile duct .","problem":[],"test":[],"treatment":["placement of percutaneous transhepatic biliary drainage","placement of 8 caucasian nephrostomy catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12,73],"treatment_indices_end":[67,118]}
{"text":"on postoperative day number eight , the patient 's oxygen saturation dropped to 85% on room air and he was transferred to the surgical intensive care unit for fluid management .","problem":[],"test":["the patient 's oxygen saturation"],"treatment":["fluid management"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[36],"test_indices_end":[68],"treatment_indices_start":[159],"treatment_indices_end":[175]}
{"text":"it is also noted that there was splenomegaly .","problem":["splenomegaly"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he also had significant lower extremity and scrotum edema .","problem":["significant lower extremity and scrotum edema"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mr. cordano was admitted on 2009-08-17 for a replacement of transhepatic biliary drainage catheter .","problem":[],"test":[],"treatment":["a replacement of transhepatic biliary drainage catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[43],"treatment_indices_end":[98]}
{"text":"at that time , cholangiogram confirmed that there was a distal stricture of the common bile duct .","problem":["a distal stricture of the common bile duct"],"test":["cholangiogram"],"treatment":[],"problem_indices_start":[54],"problem_indices_end":[96],"test_indices_start":[15],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. furosemide 10 mg q.d.","problem":[],"test":[],"treatment":["furosemide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"1. rocephin 1 gram q.d.","problem":[],"test":[],"treatment":["rocephin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"the neck is supple with no lymphadenopathy .","problem":["lymphadenopathy"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. ambien 5 mg q.h.s.","problem":[],"test":[],"treatment":["ambien"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"the abdomen was soft , nontender , no masses and nondistended .","problem":["nontender","masses","nondistended"],"test":[],"treatment":[],"problem_indices_start":[23,38,49],"problem_indices_end":[32,44,61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the chest is clear to auscultation bilaterally .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"while he is in the surgical intensive care unit , paracentesis was performed and it","problem":[],"test":["paracentesis"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[50],"test_indices_end":[62],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest x-ray revealed minimal left base atelectasis and elevation of left hemidiaphragm .","problem":["minimal left base atelectasis","elevation of left hemidiaphragm"],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[21,55],"problem_indices_end":[50,86],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neurological exam was grossly intact .","problem":[],"test":["neurological exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ulcerative colitis , primary sclerosing cholangitis .","problem":["ulcerative colitis","primary sclerosing cholangitis"],"test":[],"treatment":[],"problem_indices_start":[0,21],"problem_indices_end":[18,51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a chest x-ray was also negative for any pneumonia .","problem":["any pneumonia"],"test":["a chest x-ray"],"treatment":[],"problem_indices_start":[36],"problem_indices_end":[49],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"postoperatively , mr. cordano also suffered from low urine output ranges between 25 to 30 cc per hour .","problem":["low urine output"],"test":[],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"intravenous albumin for treatment of prerenal azotemia .","problem":["prerenal azotemia"],"test":[],"treatment":["intravenous albumin"],"problem_indices_start":[37],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[19]}
{"text":"he was given unasyn for empiric antibiotic treatment .","problem":[],"test":[],"treatment":["unasyn","empiric antibiotic treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,24],"treatment_indices_end":[19,52]}
{"text":"1. ursodiol 600 mg t.i.d.","problem":[],"test":[],"treatment":["ursodiol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"total bilirubin 10.1 , amylase 90 and lipase 112 .","problem":[],"test":["lipase","total bilirubin","amylase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,23,38],"test_indices_end":[15,30,44],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at the time , blood , urine and bile was sent for culture , which were all negative .","problem":[],"test":["culture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[50],"test_indices_end":[57],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no murmurs .","problem":["murmurs"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"psc , status post hepaticojejunostomy .","problem":["psc"],"test":[],"treatment":["hepaticojejunostomy"],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[37]}
{"text":"at the same time , the patient also developed distentions of the abdomen consistent with accumulation of ascitic fluid .","problem":["distentions of the abdomen","accumulation of ascitic fluid"],"test":[],"treatment":[],"problem_indices_start":[46,89],"problem_indices_end":[72,118],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. spironolactone 100 mg q.d.","problem":[],"test":[],"treatment":["spironolactone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[17]}
{"text":"the sodium creatinine peaked at 2.0 and the patient was treated with boluses of intravenous fluid and intravenous albumin infusion was also administered .","problem":[],"test":["the sodium creatinine"],"treatment":["boluses of intravenous fluid","intravenous albumin infusion"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[69,102],"treatment_indices_end":[97,130]}
{"text":"4. ursodiol 600 mg po t.i.d.","problem":[],"test":[],"treatment":["ursodiol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"there is no hepatosplenomegaly .","problem":["hepatosplenomegaly"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the most recent percutaneous transluminal coronary angioplasty was done in 2009-07-25 .","problem":[],"test":[],"treatment":["the most recent percutaneous transluminal coronary angioplasty"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[62]}
{"text":"he responded well to this regimen and made adequate urine output .","problem":[],"test":[],"treatment":["this regimen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[33]}
{"text":"cardiopulmonary bypass time was 234 minutes .","problem":[],"test":[],"treatment":["cardiopulmonary bypass"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[22]}
{"text":"aspirin 81 mg p.o. q. day .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"the patient has gastroesophageal reflux disease , for which he has been receiving zantac as an inpatient .","problem":["gastroesophageal reflux disease"],"test":[],"treatment":["zantac"],"problem_indices_start":[16],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[82],"treatment_indices_end":[88]}
{"text":"a psychiatric consult was also obtained due to his mental status and confusion postoperatively but his psychiatric issues are mostly related to his neurologic insults and he has no distinctive psychiatric disorder , except for perhaps postoperative delirium .","problem":["distinctive psychiatric disorder","postoperative delirium","confusion","his neurologic insults","his psychiatric issues"],"test":[],"treatment":[],"problem_indices_start":[69,99,144,181,235],"problem_indices_end":[78,121,166,213,257],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"metoprolol 75 mg p.o. twice a day .","problem":[],"test":[],"treatment":["metoprolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"nor does he have any history of stroke like symptoms .","problem":["stroke like symptoms"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition , over the last couple of days prior to discharge , the patient did appear a little bit icteric .","problem":["a little bit icteric"],"test":[],"treatment":[],"problem_indices_start":[87],"problem_indices_end":[107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"milrinone was continued until postoperative day number three , at which point he was having good enough cardiac output that he did not need these drips to help maintain his blood pressure anymore .","problem":[],"test":["his blood pressure"],"treatment":["these drips","milrinone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[169],"test_indices_end":[187],"treatment_indices_start":[0,140],"treatment_indices_end":[9,151]}
{"text":"liver function tests were obtained and they were slightly elevated liver function tests and alt was 44 , ast was 34 ; alkaline phosphatase was 199 , within normal limits .","problem":["slightly elevated liver function tests"],"test":["liver function tests","alt","ast","alkaline phosphatase"],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[87],"test_indices_start":[0,92,105,118],"test_indices_end":[20,95,108,138],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"briefly , the patient was taken to the operating room to repair his critical aortic stenosis , his coronary artery disease and his significantly dilated ascending aortic aneurysm .","problem":["his critical aortic stenosis","his coronary artery disease","his significantly dilated ascending aortic aneurysm"],"test":[],"treatment":["repair"],"problem_indices_start":[64,95,127],"problem_indices_end":[92,122,178],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[57],"treatment_indices_end":[63]}
{"text":"he has a recent history of dyspnea on exertion on exertional chest pain which has increased over the last several weeks and is relieved by sublingual nitroglycerin .","problem":["dyspnea","exertional chest pain"],"test":[],"treatment":["sublingual nitroglycerin"],"problem_indices_start":[27,50],"problem_indices_end":[34,71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[139],"treatment_indices_end":[163]}
{"text":"finally , a super coronary arch graft was implanted .","problem":[],"test":[],"treatment":["a super coronary arch graft"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10],"treatment_indices_end":[37]}
{"text":"the left internal mammary artery was connected to the proximal left anterior descending and saphenous vein grafts were connected to the posterior descending artery , diagonal branch , obtuse marginal and distal left anterior descending .","problem":[],"test":[],"treatment":["saphenous vein grafts"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[92],"treatment_indices_end":[113]}
{"text":"the patient remained intubated until postoperative day number five .","problem":[],"test":[],"treatment":["intubated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[30]}
{"text":"the procedure was an aortic valve replacement with a tissue valve , a coronary artery bypass graft procedure where five grafts were performed .","problem":[],"test":[],"treatment":["five grafts","the procedure","a coronary artery bypass graft procedure","a tissue valve","an aortic valve replacement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,18,51,68,115],"treatment_indices_end":[13,45,65,108,126]}
{"text":"this is a 56 year old man with history of hypercholesterolemia and type ii diabetes mellitus .","problem":["type ii diabetes mellitus","hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[42,67],"problem_indices_end":[62,92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the levophed drip was continued until postoperative day number one .","problem":[],"test":[],"treatment":["the levophed drip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[17]}
{"text":"he has no bleeding or clotting problems .","problem":["clotting problems","bleeding"],"test":[],"treatment":[],"problem_indices_start":[10,22],"problem_indices_end":[18,39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he does not have wheezing , claudication or gastrointestinal bleeding .","problem":["claudication","gastrointestinal bleeding","wheezing"],"test":[],"treatment":[],"problem_indices_start":[17,28,44],"problem_indices_end":[25,40,69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"plavix 75 mg p.o. q. day .","problem":[],"test":[],"treatment":["plavix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"the patient did receive a significant amount of diuresis postoperatively and is well below his baseline with weight , most likely because of his inability to eat because of his stroke .","problem":["his stroke","his inability to eat"],"test":["weight"],"treatment":["diuresis"],"problem_indices_start":[141,173],"problem_indices_end":[161,183],"test_indices_start":[109],"test_indices_end":[115],"treatment_indices_start":[48],"treatment_indices_end":[56]}
{"text":"he was admitted to the cardiac surgery service for an elected bental procedure with homograft and coronary artery bypass graft .","problem":[],"test":[],"treatment":["homograft","coronary artery bypass graft","an elected bental procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[51,84,98],"treatment_indices_end":[78,93,126]}
{"text":"recent pneumonia .","problem":["recent pneumonia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"once consent and preoperative evaluation was complete , he was taken to the operating room .","problem":[],"test":["preoperative evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17],"test_indices_end":[40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"total bilirubin was 2.8 .","problem":[],"test":["total bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"as the patient became more awake , he still remained somewhat confused and a little bit out of it .","problem":["somewhat confused","a little bit out of it"],"test":[],"treatment":[],"problem_indices_start":[53,75],"problem_indices_end":[70,97],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heparin 5000 units subcutaneous twice a day .","problem":[],"test":[],"treatment":["heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"on physical examination , the patient is afebrile .","problem":["afebrile"],"test":["physical examination"],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[49],"test_indices_start":[3],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"amylase was 108 and lipase was 213 .","problem":[],"test":["amylase","lipase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,20],"test_indices_end":[7,26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was seen on the cat scan on postoperative day number one , 12-31 .","problem":[],"test":["the cat scan"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"we will put him back on his nexium .","problem":[],"test":[],"treatment":["his nexium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[34]}
{"text":"hypercholesterolemia .","problem":["hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"humalog max 75\/25 , 20 units subcutaneous once a day in the morning .","problem":[],"test":[],"treatment":["humalog max"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"metformin 1000 mg extended release p.o. q. day .","problem":[],"test":[],"treatment":["metformin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"cardiovascularly , the patient did extremely well following the surgery .","problem":[],"test":[],"treatment":["the surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[60],"treatment_indices_end":[71]}
{"text":"at the time of discharge , mr. norman hematocrit is at 40.7 .","problem":[],"test":["hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[38],"test_indices_end":[48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chronic blood loss anemia and chronic rbc transfusion .","problem":["chronic blood loss anemia"],"test":[],"treatment":["chronic rbc transfusion"],"problem_indices_start":[0],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30],"treatment_indices_end":[53]}
{"text":"please stay on top of the sliding scale so that the patient can keep a euglycemic level .","problem":[],"test":[],"treatment":["the sliding scale"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[39]}
{"text":"perioperative stroke .","problem":["perioperative stroke"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his atrioventricular valve gradient was 27 with an av surface area of .91 .","problem":[],"test":["his atrioventricular valve gradient","an av surface area"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,48],"test_indices_end":[35,66],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"because of his confusion , a neurology consult was obtained and subsequent radiographic imaging revealed chronic appearing infarcts in the right occipital lobe as well as both cerebellar hemispheres , suggestive of more chronic infarcts , as well as an area in the left corona radiata , adjacent to the left lateral ventricle which may or may not be an acute infarct .","problem":["an acute infarct","chronic appearing infarcts in the right occipital lobe","more chronic infarcts","his confusion"],"test":["subsequent radiographic imaging"],"treatment":[],"problem_indices_start":[11,105,215,350],"problem_indices_end":[24,159,236,366],"test_indices_start":[64],"test_indices_end":[95],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition , mr. douglass is given trazodone to help him sleep at night .","problem":[],"test":[],"treatment":["trazodone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36],"treatment_indices_end":[45]}
{"text":"weight is 82 kilograms .","problem":[],"test":["weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was a .................... graft .","problem":[],"test":[],"treatment":["a .................... graft"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9],"treatment_indices_end":[37]}
{"text":"hypercholesterolemia .","problem":["hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he is going out on a cardiac healthy , diabetic diet , as tolerated with boost supplements .","problem":[],"test":[],"treatment":["boost supplements","a cardiac healthy , diabetic diet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,73],"treatment_indices_end":[52,90]}
{"text":"the patient tolerated the procedure well and was transferred to the unit , intubated on milrinone , levophed and propofol drips .","problem":[],"test":[],"treatment":["the procedure","milrinone","propofol drips","levophed","intubated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,75,88,100,113],"treatment_indices_end":[35,84,97,108,127]}
{"text":"no bruits appreciated .","problem":["bruits"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urinary tract infection .","problem":["urinary tract infection"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient , during this admission , required transfusion of three units of packed red blood cells to maintain adequate hematocrit .","problem":[],"test":[],"treatment":["packed red blood cells"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[77],"treatment_indices_end":[99]}
{"text":"his oxygen saturations remained good and he did not require supplemental oxygen more than a couple of days after his extubation .","problem":[],"test":["his oxygen saturations"],"treatment":["supplemental oxygen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[60],"treatment_indices_end":[79]}
{"text":"as mr. douglass has improved from his initial stroke , he has become more lucid","problem":["his initial stroke"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac catheterization at the end of october revealed a dilated aortic root to 4.4 cm and 80% stenosis of the mid left anterior descending at the bifurcation involving the diagonal branch , 70% stenoses of the left circumflex and oblique marginal artery and 90% stenosis of the posterior descending artery .","problem":["90% stenosis of the posterior descending artery","70% stenoses of the left circumflex and oblique marginal artery","a dilated aortic root","80% stenosis of the mid left anterior descending"],"test":["cardiac catheterization"],"treatment":[],"problem_indices_start":[55,91,191,259],"problem_indices_end":[76,139,254,306],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his aorta was cross clamped for 168 minutes .","problem":[],"test":[],"treatment":["cross clamped"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[27]}
{"text":"over his postoperative course , mr. douglass has gradually been able to utilize more and more of his right side and with the assistance of physical therapy and occupational therapy , he has 4 to 5 + strength in his right hand and arm and about 4 + strength in his right leg .","problem":[],"test":[],"treatment":["physical therapy","occupational therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[139,160],"treatment_indices_end":[155,180]}
{"text":"in addition , he was noted to have a right sided hemiplegia .","problem":["a right sided hemiplegia"],"test":[],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 01-08 , the patient 's central venous line was discontinued .","problem":[],"test":[],"treatment":["the patient 's central venous line"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[11],"treatment_indices_end":[45]}
{"text":"review of systems shows that the patient denies any orthopnea , paroxysmal nocturnal dyspnea .","problem":["paroxysmal nocturnal dyspnea","any orthopnea"],"test":["review of systems"],"treatment":[],"problem_indices_start":[48,64],"problem_indices_end":[61,92],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head and neck examination :","problem":[],"test":["head and neck examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"type ii diabetes .","problem":["type ii diabetes"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was started on oct. 25 for this bug .","problem":["this bug"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"juanita does not feel any palpitations .","problem":["any palpitations"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"captopril 12.5 mg p.o. three times a day .","problem":[],"test":[],"treatment":["captopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"the catheterization tip also grew out serratia .","problem":["serratia"],"test":["the catheterization tip"],"treatment":[],"problem_indices_start":[38],"problem_indices_end":[46],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gastroesophageal reflux disease .","problem":["gastroesophageal reflux disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on the 16th , a urine culture was obtained and did grow out greater than 100,000 colonies of e. coli which was intermittently resistant to ciprofloxacin .","problem":["e. coli","intermittently resistant"],"test":["a urine culture"],"treatment":["ciprofloxacin"],"problem_indices_start":[93,111],"problem_indices_end":[100,135],"test_indices_start":[14],"test_indices_end":[29],"treatment_indices_start":[139],"treatment_indices_end":[152]}
{"text":"blood pressure 126\/66 .","problem":[],"test":["blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gastroesophageal reflux disease .","problem":["gastroesophageal reflux disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coronary artery disease , status post coronary artery bypass graft .","problem":["coronary artery disease"],"test":[],"treatment":["coronary artery bypass graft"],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[66]}
{"text":"no hepatosplenomegaly and no cva tenderness .","problem":["hepatosplenomegaly","cva tenderness"],"test":[],"treatment":[],"problem_indices_start":[3,29],"problem_indices_end":[21,43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition , the patient did have slightly elevated blood sugars over the last couple of days and has required an insulin sliding scale and basal insulin to maintain his blood sugars at a more appropriate level .","problem":["slightly elevated blood sugars"],"test":["his blood sugars"],"treatment":["an insulin sliding scale","basal insulin"],"problem_indices_start":[35],"problem_indices_end":[65],"test_indices_start":[167],"test_indices_end":[183],"treatment_indices_start":[112,141],"treatment_indices_end":[136,154]}
{"text":"aortic arch aneurysm , status post aortic arch graft .","problem":["aortic arch aneurysm"],"test":[],"treatment":["aortic arch graft"],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[35],"treatment_indices_end":[52]}
{"text":"acute postoperative delirium .","problem":["acute postoperative delirium"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lipitor 10 mg once a day .","problem":[],"test":[],"treatment":["lipitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"please continue mr. david montero for one month to fight his blood borne infection , to prevent seeding of his aortic graft and continue bactrim for ten days after discharge to treat the e. coli in his urine .","problem":["the e. coli in his urine","his blood borne infection"],"test":[],"treatment":["bactrim","his aortic graft"],"problem_indices_start":[57,183],"problem_indices_end":[82,207],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[107,137],"treatment_indices_end":[123,144]}
{"text":"a right upper quadrant ultrasound did not reveal any gallstones or common bile duct dilatation indicative of cholecystitis or cholelithiasis .","problem":["cholecystitis","cholelithiasis","common bile duct dilatation","any gallstones"],"test":["a right upper quadrant ultrasound"],"treatment":[],"problem_indices_start":[49,67,109,126],"problem_indices_end":[63,94,122,140],"test_indices_start":[0],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"type ii diabetes .","problem":["type ii diabetes"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the major neurologic event of this hospital course was that the patient was slow to awake after his propofol drip was discontinued .","problem":["slow to awake","the major neurologic event"],"test":[],"treatment":["his propofol drip"],"problem_indices_start":[0,76],"problem_indices_end":[26,89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[96],"treatment_indices_end":[113]}
{"text":"he was started on bactrim for that .","problem":[],"test":[],"treatment":["bactrim"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[25]}
{"text":"critical aortic stenosis , status post aortic valve replacement .","problem":["critical aortic stenosis"],"test":[],"treatment":["aortic valve replacement"],"problem_indices_start":[0],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39],"treatment_indices_end":[63]}
{"text":"after an extended stay for hemodynamic monitoring and pressor support to maintain his perfusion .","problem":[],"test":["hemodynamic monitoring"],"treatment":["pressor support"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[27],"test_indices_end":[49],"treatment_indices_start":[54],"treatment_indices_end":[69]}
{"text":"and is less of an aspiration risk .","problem":["an aspiration risk"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"one aspirin a day .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[11]}
{"text":"3\/6 systolic ejection murmur throughout his precordium .","problem":["3\/6 systolic ejection murmur"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his abdomen is soft , nontender , nondistended .","problem":["nontender","nondistended"],"test":[],"treatment":[],"problem_indices_start":[22,34],"problem_indices_end":[31,46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"declared him at first an aspiration risk .","problem":["an aspiration risk"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after that , the patient had no major problems with his lungs .","problem":["major problems with his lungs"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nexium 40 mg a day .","problem":[],"test":[],"treatment":["nexium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"lungs are clear to auscultation bilaterally .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"trazodone 25 mg p.o. q h.s. as needed for sleep .","problem":[],"test":[],"treatment":["trazodone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"colace 100 mg p.o. twice a day .","problem":[],"test":[],"treatment":["colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"he had pharmacologic circulatory arrest for 18 minutes .","problem":[],"test":[],"treatment":["pharmacologic circulatory arrest"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[7],"treatment_indices_end":[39]}
{"text":"levofloxacin 500 mg p.o. q. day .","problem":[],"test":[],"treatment":["levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"no varicosities noted .","problem":["varicosities"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient remained intubated until postoperative day number five .","problem":[],"test":[],"treatment":["intubated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[30]}
{"text":"he has remained without any chest pain following this procedure and his sternal wound is clean , dry and intact at the end of the procedure .","problem":["his sternal wound","any chest pain"],"test":[],"treatment":["the procedure","this procedure"],"problem_indices_start":[24,68],"problem_indices_end":[38,85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49,126],"treatment_indices_end":[63,139]}
{"text":"the patient had positive blood and urine cultures on 01-05 for history of methicillin resistant staphylococcus aureus , which was pan sensitive .","problem":["positive blood and urine cultures","methicillin resistant staphylococcus aureus"],"test":["pan sensitive"],"treatment":[],"problem_indices_start":[16,74],"problem_indices_end":[49,117],"test_indices_start":[130],"test_indices_end":[143],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hold for loose stools .","problem":["loose stools"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bactrim ds tabs , one tablet p.o. q. day for ten days .","problem":[],"test":[],"treatment":["bactrim ds tabs"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"kcl 20 mg p.o. q. day for one week .","problem":[],"test":[],"treatment":["kcl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[3]}
{"text":"in addition , he has hypertension , for which he receives metoprolol and he has hypercholesterolemia , for which he receives nothing at this time .","problem":["hypertension","hypercholesterolemia"],"test":[],"treatment":["metoprolol"],"problem_indices_start":[21,80],"problem_indices_end":[33,100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[58],"treatment_indices_end":[68]}
{"text":"extremities are warm , well perfused , no cyanosis , clubbing or","problem":["clubbing","cyanosis"],"test":[],"treatment":[],"problem_indices_start":[42,53],"problem_indices_end":[50,61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lasix 20 mg p.o. q. day for one week .","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"carvedilol 6.125 mg a day .","problem":[],"test":[],"treatment":["carvedilol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"glucophage 25 mg once a day .","problem":[],"test":[],"treatment":["glucophage"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"nexium 40 mg p.o. q. day .","problem":[],"test":[],"treatment":["nexium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"on 2016-06-26 , he had a positive exercise tolerance test .","problem":["a positive exercise tolerance test"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"recent weight loss associated with the pneumonia .","problem":["recent weight loss","the pneumonia"],"test":[],"treatment":[],"problem_indices_start":[0,35],"problem_indices_end":[18,48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"edema .","problem":["edema"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[5],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2014-02-21 12:20 pm blood alt - 17 ast - 27 alkphos - 119 * amylase - 27 totbili - 0.9","problem":[],"test":["ast","alkphos","amylase","totbili","blood","alt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,35,44,60,73],"test_indices_end":[25,29,38,51,67,80],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ctab , mildly decreased breath sounds b\/l","problem":["mildly decreased breath sounds b\/l"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gastrointestinal : her initial ct scan showed dilated turner colon , wall thickening and pneumatosis see pertinent results .","problem":["pneumatosis","wall thickening","dilated turner colon"],"test":["her initial ct scan"],"treatment":[],"problem_indices_start":[46,69,89],"problem_indices_end":[66,84,100],"test_indices_start":[19],"test_indices_end":[38],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abd soft , nt\/nd , + bs , no masses , ostomy in rlq pink , with stool","problem":["masses","nt\/nd"],"test":[],"treatment":["ostomy in rlq"],"problem_indices_start":[11,29],"problem_indices_end":[16,35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[51]}
{"text":"she was transferred to arbour hospital on 2015-02-21 for bowel obstruction , ischemia and worsening abdominal distention and pain .","problem":["pain","worsening abdominal distention","ischemia","bowel obstruction"],"test":[],"treatment":[],"problem_indices_start":[57,77,90,125],"problem_indices_end":[74,85,120,129],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"s\/p exploratory laparotomy , resection of small intestine with primary anastomosis , sigmoid colectomy , repair of colovesicular fistula","problem":["colovesicular fistula"],"test":["exploratory laparotomy"],"treatment":["primary anastomosis","resection of small intestine","sigmoid colectomy","repair"],"problem_indices_start":[115],"problem_indices_end":[136],"test_indices_start":[4],"test_indices_end":[26],"treatment_indices_start":[29,63,85,105],"treatment_indices_end":[57,82,102,111]}
{"text":"she was initially treated nonoperatively with iv fluids , antibiotics , serial exams and ngt decompression .","problem":[],"test":["serial exams"],"treatment":["antibiotics","iv fluids","ngt decompression"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[72],"test_indices_end":[84],"treatment_indices_start":[46,58,89],"treatment_indices_end":[55,69,106]}
{"text":"afebrile , vss","problem":["afebrile"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2014-02-21 12:20 pm blood ck-mb - 7 ctropnt -< 0.01","problem":[],"test":["ctropnt","blood","ck-mb"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,36],"test_indices_end":[25,31,43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a&o x 3 , nad","problem":["nad"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2014-03-09 11:29 am blood ck-mb - 35 * mb indx - 25.5 * ctropnt - 0.45 *","problem":[],"test":["mb indx","ctropnt","blood","ck-mb"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,39,56],"test_indices_end":[25,31,46,63],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cad s\/p mi , htn , dmii","problem":["mi","cad","htn","dmii"],"test":[],"treatment":[],"problem_indices_start":[0,8,13,19],"problem_indices_end":[3,10,16,23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on hd#5 flexible sigmoidoscopy was performed for colonic decompression .","problem":[],"test":["flexible sigmoidoscopy"],"treatment":["colonic decompression"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[8],"test_indices_end":[30],"treatment_indices_start":[49],"treatment_indices_end":[70]}
{"text":"03-07 wound swab : vre","problem":["vre"],"test":["wound swab"],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[22],"test_indices_start":[6],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please call the surgeon or return to the emergency department if you develop chest pain , shortness of breath , fever greater than 101.5 , foul smelling or colorful drainage from your incisions , redness or swelling , severe abdominal pain or distention , persistent nausea or vomiting , inability to eat or drink , or any","problem":["inability to eat or drink","severe abdominal pain","redness","swelling","distention","shortness of breath","chest pain","fever greater than 101.5","vomiting","foul smelling or colorful drainage","persistent nausea","your incisions"],"test":[],"treatment":[],"problem_indices_start":[77,90,112,139,179,196,207,218,243,256,277,288],"problem_indices_end":[87,109,136,173,193,203,215,239,253,273,285,313],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on hd#6 , colonscopy was performed for decompression , and revealed pseudomembrane and friable colonic tissue .","problem":["friable colonic tissue","pseudomembrane"],"test":["colonscopy"],"treatment":["decompression"],"problem_indices_start":[68,87],"problem_indices_end":[82,109],"test_indices_start":[10],"test_indices_end":[20],"treatment_indices_start":[39],"treatment_indices_end":[52]}
{"text":"other symptoms which are concerning to you .","problem":["other symptoms"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2014-03-09 07:52 pm blood ck-mb - notdone ctropnt - 0.55 *","problem":[],"test":["ctropnt","ck-mb","blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,42],"test_indices_end":[25,31,49],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2014-03-19 01:33 pm blood ck-mb - notdone ctropnt - 0.17 *","problem":[],"test":["ctropnt","blood","ck-mb"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,42],"test_indices_end":[25,31,49],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her abdomen remained tender and distended despite attempted decompression .","problem":["tender","distended"],"test":[],"treatment":["decompression"],"problem_indices_start":[21,32],"problem_indices_end":[27,41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[60],"treatment_indices_end":[73]}
{"text":"2014-03-21 09:58 am blood ck-mb - notdone ctropnt - 0.06 *","problem":[],"test":["ctropnt","blood","ck-mb"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,42],"test_indices_end":[25,31,49],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she recieved further resection of remaining colon , repair of a leak from relaford pouch and repair of colovesicular fistula .","problem":["colovesicular fistula","a leak from relaford pouch"],"test":[],"treatment":["repair","further resection of remaining colon","repair"],"problem_indices_start":[62,103],"problem_indices_end":[88,124],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,52,93],"treatment_indices_end":[49,58,99]}
{"text":"she was treated in iuc for unstable angina with nitroglycerin .","problem":["unstable angina"],"test":[],"treatment":["nitroglycerin"],"problem_indices_start":[27],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48],"treatment_indices_end":[61]}
{"text":"16. miconazole nitrate 2 % cream sig : one ( 1 ) appl topical bid ( 2 times a day ).","problem":[],"test":[],"treatment":["miconazole nitrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[22]}
{"text":"1. markedly dilated colon throughout ascending , transverse , and descending colon with air-fluid levels , overall unchanged since prior study performed on the same day with pneumatosis in the ascending colon .","problem":["pneumatosis in the ascending colon","markedly dilated colon","air-fluid levels"],"test":["prior study"],"treatment":[],"problem_indices_start":[3,88,174],"problem_indices_end":[25,104,208],"test_indices_start":[131],"test_indices_end":[142],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"15. miconazole nitrate 2 % powder sig : one ( 1 ) appl topical bid ( 2 times a day ) as needed .","problem":[],"test":[],"treatment":["miconazole nitrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[22]}
{"text":"it was recommended to maximize her medical treatment with beta blockers , aspirin , a statin and an ace inhibitor .","problem":[],"test":[],"treatment":["beta blockers","aspirin","a statin","an ace inhibitor","her medical treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31,58,74,84,97],"treatment_indices_end":[52,71,81,92,113]}
{"text":"nutrition : she was held npo at admission , and initiated on tpn by hd#3 .","problem":[],"test":[],"treatment":["npo","tpn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25,61],"treatment_indices_end":[28,64]}
{"text":"17. ibuprofen 100 mg\/5 ml suspension sig : twenty ( 20 ) ml po q8h ( every 8 hours ) as needed .","problem":[],"test":[],"treatment":["ibuprofen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"leave white strips above your incisions in place , allow them to fall off on their own .","problem":["your incisions"],"test":[],"treatment":["white strips"],"problem_indices_start":[25],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6],"treatment_indices_end":[18]}
{"text":"sigmoid diverticulosis with focal narrowing of the sigmoid colon just distal to the dilatation with wall thickening , due to diverticulitis .","problem":["wall thickening","focal narrowing of the sigmoid colon","the dilatation","diverticulitis","sigmoid diverticulosis"],"test":[],"treatment":[],"problem_indices_start":[0,28,80,100,125],"problem_indices_end":[22,64,94,115,139],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"medications : resume your home medications .","problem":[],"test":[],"treatment":["home medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[42]}
{"text":"2014-03-19 07:13 am blood ck-mb - 3 ctropnt - 0.19 *","problem":[],"test":["ctropnt","ck-mb","blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,36],"test_indices_end":[25,31,43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"respiratory : she was intubated briefly post-op subtotal colectomy and again for several days after second surgery .","problem":[],"test":[],"treatment":["intubated","subtotal colectomy","second surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,48,100],"treatment_indices_end":[31,66,114]}
{"text":"s\/p subtotal colectomy , ileostomy , gastrostomy tube","problem":[],"test":[],"treatment":["subtotal colectomy","gastrostomy tube","ileostomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4,25,37],"treatment_indices_end":[22,34,53]}
{"text":"required diuresis of > 9 l while in the icu , after 2nd surgery .","problem":[],"test":[],"treatment":["diuresis","2nd surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9,52],"treatment_indices_end":[17,63]}
{"text":"4. bilateral renal cysts .","problem":["bilateral renal cysts"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hurtado colon","problem":["hurtado colon"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"18. debrox 6.5 % drops sig : five ( 5 ) drop otic bid ( 2 times a day ) for 5 days : both ears .","problem":[],"test":[],"treatment":["debrox"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"3. small amount of ascites , somewhat increased anterior to the liver .","problem":["small amount of ascites"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"13. potassium chloride 20 meq tab sust . rel . particle \/ crystal sig : one ( 1 ) tab sust . rel . particle \/ crystal po once a day .","problem":[],"test":[],"treatment":["potassium chloride"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[22]}
{"text":"ct abd 02-21 :","problem":[],"test":["ct abd"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. heavy calcification of the aorta and sma and its branches .","problem":["heavy calcification of the aorta and sma and its branches"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"12. docusate sodium 100 mg capsule sig : one ( 1 ) capsule po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[19]}
{"text":"11. oxycodone 5 mg tablet sig : one ( 1 ) tablet po q4-6h ( every 4 to 6 hours ) as needed for pain .","problem":["pain"],"test":[],"treatment":["oxycodone"],"problem_indices_start":[95],"problem_indices_end":[99],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"due to atherosclerosis , assessment of the intraluminal process of these branches is limited .","problem":["atherosclerosis"],"test":["assessment of the intraluminal process"],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[22],"test_indices_start":[25],"test_indices_end":[63],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. completion sigmoid colectomy , repair of colovesicular fistula , small bowel repair","problem":["colovesicular fistula"],"test":[],"treatment":["repair","small bowel repair","completion sigmoid colectomy"],"problem_indices_start":[44],"problem_indices_end":[65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,34,68],"treatment_indices_end":[31,40,86]}
{"text":"genitourinary : she had a foley catheter from the time of admission .","problem":[],"test":[],"treatment":["a foley catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[40]}
{"text":"ms crossman is an 84 year old female with complaints of abdominal pain , diarrhea , nausea and vomiting x 1 week , who presented to an outside hospital .","problem":["nausea","vomiting","abdominal pain","diarrhea"],"test":[],"treatment":[],"problem_indices_start":[56,73,84,95],"problem_indices_end":[70,81,90,103],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her incision has remained clean , dry , intact , with staples removed on pod# 27\/18 .","problem":["her incision"],"test":[],"treatment":["staples"],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[54],"treatment_indices_end":[61]}
{"text":"sulfa ( sulfonamides )","problem":[],"test":[],"treatment":["sulfa ( sulfonamides )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[22]}
{"text":"le trace edema","problem":["le trace edema"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her foley was subsequently dc 'd .","problem":[],"test":[],"treatment":["her foley"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"2014-02-21 12:20 pm blood wbc - 10.2 rbc - 5.32 hgb - 14.9 hct - 43.4 mcv - 82 mch - 28.0 mchc - 34.4 rdw - 16.0 * plt ct - 204","problem":[],"test":["blood","plt ct","mchc","hct","mcv","mch","rbc","hgb","rdw","wbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,37,48,59,70,79,90,102,115],"test_indices_end":[25,29,40,51,62,73,82,94,105,121],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pod# 23\/14 she recieved a cystoscopy which revealed no leak .","problem":["leak"],"test":["a cystoscopy"],"treatment":[],"problem_indices_start":[55],"problem_indices_end":[59],"test_indices_start":[24],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the other daughter was recently in a car accident and underwent surgery at saint vincent hospital .","problem":[],"test":[],"treatment":["surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[64],"treatment_indices_end":[71]}
{"text":"1. subtotal colectomy , end ileostomy , hartmann's pouch , g-tube","problem":[],"test":[],"treatment":["end ileostomy","hartmann's pouch","subtotal colectomy","g-tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,24,40,59],"treatment_indices_end":[21,37,56,65]}
{"text":"see pt note for further assessment and discussion .","problem":[],"test":["further assessment"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"musculoskeletal : has suffered significant deconditioning since admission , but has consisitently recieved pt .","problem":["significant deconditioning"],"test":[],"treatment":["pt"],"problem_indices_start":[31],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[107],"treatment_indices_end":[109]}
{"text":"by pod# 05-29 she was having high residuals on tf s, so tpn was reinitiated .","problem":["high residuals"],"test":[],"treatment":["tf s,","tpn"],"problem_indices_start":[29],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47,56],"treatment_indices_end":[52,59]}
{"text":"nausea , vomiting , abdominal pain , distention .","problem":["nausea","vomiting","distention","abdominal pain"],"test":[],"treatment":[],"problem_indices_start":[0,9,20,37],"problem_indices_end":[6,17,34,47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"post-operatively she began on tf s, and the tpn was weaned down .","problem":[],"test":[],"treatment":["tf s,","the tpn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30,40],"treatment_indices_end":[35,47]}
{"text":"2014-02-21 12:20 pm blood glucose - 345 * urean - 34 * creat - 1.0 na - 137 k - 4.3 cl - 99 hco3 - 24 angap - 18","problem":[],"test":["k","cl","urean","creat","hco3","angap","na","blood","glucose"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,42,55,67,76,84,92,102],"test_indices_end":[25,33,47,60,69,77,86,96,107],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was taken to the or for subtotal colectomy , g tube and ileostomy due to unresponsiveness to non-operative treatment .","problem":["unresponsiveness"],"test":[],"treatment":["g tube","subtotal colectomy","ileostomy","non-operative treatment"],"problem_indices_start":[77],"problem_indices_end":[93],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28,49,60,97],"treatment_indices_end":[46,55,69,120]}
{"text":"g-tube in place","problem":[],"test":[],"treatment":["g-tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"she was taken to the or for exploration and drainage .","problem":[],"test":["exploration"],"treatment":["drainage"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[28],"test_indices_end":[39],"treatment_indices_start":[44],"treatment_indices_end":[52]}
{"text":"after her 2nd surgery she returned to the icu and improved steadily .","problem":[],"test":[],"treatment":["her 2nd surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6],"treatment_indices_end":[21]}
{"text":"pain : her pain was controlled with iv pain medicines while in icu .","problem":["pain","her pain"],"test":[],"treatment":["iv pain medicines"],"problem_indices_start":[0,7],"problem_indices_end":[4,15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36],"treatment_indices_end":[53]}
{"text":"2014-02-21 12:20 pm blood pt - 12.9 ptt - 32.5 inr(pt) - 1.1","problem":[],"test":["ptt","inr(pt)","blood","pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,36,47],"test_indices_end":[25,28,39,54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she remained on iv antibiotics x 14 days and required pressors for the first few days post-op .","problem":[],"test":[],"treatment":["iv antibiotics","pressors"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16,54],"treatment_indices_end":[30,62]}
{"text":"this area can be a leading point of obstruction .","problem":["obstruction"],"test":[],"treatment":[],"problem_indices_start":[36],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen remained soft and nontender .","problem":["nontender"],"test":[],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. left lower quadrant thick-walled peripherally enhancing fluid collection , which appears to communicate with the sutured end of the proximal sigmoid colon via a small collection of extraluminal gas .","problem":["a small collection of extraluminal gas","left lower quadrant thick-walled peripherally enhancing fluid collection"],"test":[],"treatment":[],"problem_indices_start":[3,162],"problem_indices_end":[75,200],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has been adequately controlled with tylenol , motrin & oxycodone by mouth , per recommendations by geriatrics .","problem":[],"test":[],"treatment":["oxycodone","motrin","tylenol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40,50,59],"treatment_indices_end":[47,56,68]}
{"text":"on pod#8 a ct scan was obtained which revealed an abcess with a colovesicular fistula .","problem":["a colovesicular fistula","an abcess"],"test":["a ct scan"],"treatment":[],"problem_indices_start":[47,62],"problem_indices_end":[56,85],"test_indices_start":[9],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2014-03-10 05:25 pm blood ctropnt - 0.42 *","problem":[],"test":["ctropnt","blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26],"test_indices_end":[25,33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her hct dropped and she recieved 1 unit prbcs .","problem":[],"test":["her hct"],"treatment":["1 unit prbcs"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[33],"treatment_indices_end":[45]}
{"text":"she developed additional abdominal tenderness and distention .","problem":["distention","additional abdominal tenderness"],"test":[],"treatment":[],"problem_indices_start":[14,50],"problem_indices_end":[45,60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2014-03-09 02:59 am blood ctropnt - 0.21 *","problem":[],"test":["ctropnt","blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26],"test_indices_end":[25,33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was followed by cape cod hospital clinic for treatment of persistent hyperglycemia .","problem":["persistent hyperglycemia"],"test":[],"treatment":["treatment"],"problem_indices_start":[62],"problem_indices_end":[86],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49],"treatment_indices_end":[58]}
{"text":"at time of discharge she is tolerating a regular diet with tf 's at goal .","problem":[],"test":[],"treatment":["tf 's"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[59],"treatment_indices_end":[64]}
{"text":"tf goals were achieved and tpn dc 'ed.","problem":[],"test":[],"treatment":["tpn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[30]}
{"text":"ileostomy remains pink and intact , draining green-brown soft stool .","problem":[],"test":[],"treatment":["ileostomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"pod# 15\/6 , she resumed tf 's and tpn was tapered again .","problem":[],"test":[],"treatment":["tf 's","tpn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24,34],"treatment_indices_end":[29,37]}
{"text":"recieved nebulizer treatments post-op in the icu , after successfully extubated .","problem":[],"test":[],"treatment":["nebulizer treatments"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9],"treatment_indices_end":[29]}
{"text":"continues to have trace lower extremity edema , and recieves lasix po .","problem":["trace lower extremity edema"],"test":[],"treatment":["lasix po"],"problem_indices_start":[18],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61],"treatment_indices_end":[69]}
{"text":"2014-03-11 02:00 am blood ctropnt - 0.45 *","problem":[],"test":["blood","ctropnt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26],"test_indices_end":[25,33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tf 's were dc 'ed prior to second surgery .","problem":[],"test":[],"treatment":["second surgery","tf 's"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,27],"treatment_indices_end":[5,41]}
{"text":"unstable angina","problem":["unstable angina"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. status post ileostomy without evidence of small-bowel obstruction .","problem":["small-bowel obstruction"],"test":[],"treatment":["ileostomy"],"problem_indices_start":[45],"problem_indices_end":[68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[24]}
{"text":"diverticulitis","problem":["diverticulitis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. moderate intraabdominal ascites .","problem":["moderate intraabdominal ascites"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"19. trazodone 50 mg tablet sig : 1 \/ 2-1 tablet po hs ( at bedtime ).","problem":[],"test":[],"treatment":["trazodone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"an underlying mass lesion or cancer cannot be excluded in this area , and further clinical investigation is recommended .","problem":["an underlying mass lesion","cancer"],"test":["further clinical investigation"],"treatment":[],"problem_indices_start":[0,29],"problem_indices_end":[25,35],"test_indices_start":[74],"test_indices_end":[104],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"14. glargine sig : twenty two ( 22 ) units at bedtime .","problem":[],"test":[],"treatment":["glargine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"norvasc","problem":[],"test":[],"treatment":["norvasc"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"in the correct clincial setting , this could be consistent with an abscess .","problem":["an abscess"],"test":[],"treatment":[],"problem_indices_start":[64],"problem_indices_end":[74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. limited evaluation for known sigmoid-vesicle fistula .","problem":["known sigmoid-vesicle fistula"],"test":["limited evaluation"],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[55],"test_indices_start":[3],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pod# 22\/15 ms crossman was transferred to 3 north where she continued to progress well with pt , increasing po intake , tolerating tf s, and weaning from nasal cannula oxygen .","problem":[],"test":[],"treatment":["tf s,","nasal cannula oxygen","pt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[92,131,154],"treatment_indices_end":[94,136,174]}
{"text":"2014-02-21 12:20 pm blood lipase - 11","problem":[],"test":["blood","lipase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26],"test_indices_end":[25,32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you should take a stool softener , colace 100 mg twice daily as needed for constipation .","problem":["constipation"],"test":[],"treatment":["colace","a stool softener"],"problem_indices_start":[75],"problem_indices_end":[87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16,35],"treatment_indices_end":[32,41]}
{"text":"required restraints to prevent dc of pertinent therapies while in the icu .","problem":[],"test":[],"treatment":["restraints","pertinent therapies"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9,37],"treatment_indices_end":[19,56]}
{"text":"intermitent delirium throughout admission .","problem":["intermitent delirium"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you will be given pain medication which may make you drowsy .","problem":["drowsy"],"test":[],"treatment":["pain medication"],"problem_indices_start":[53],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[33]}
{"text":"neuro : developed confusion during her first 5 days in the icu .","problem":["confusion"],"test":[],"treatment":[],"problem_indices_start":[18],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if there is clear drainage from your incisions , cover with a dry dressing .","problem":["clear drainage","your incisions"],"test":[],"treatment":["a dry dressing"],"problem_indices_start":[12,32],"problem_indices_end":[26,46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[60],"treatment_indices_end":[74]}
{"text":"03-21 vcug - no leak","problem":["leak"],"test":["vcug"],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[20],"test_indices_start":[6],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has remained stable with no acute events .","problem":["acute events"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. diverticulosis within the right remnant sigmoid colon .","problem":["diverticulosis within the right remnant sigmoid colon"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"troponins remained mildly elevated as high as 0.6 throughout her admission , and most recent result now 0.1 .","problem":["mildly elevated"],"test":["troponins"],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[34],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lasix","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"insulin","problem":[],"test":[],"treatment":["insulin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"isosorbide","problem":[],"test":[],"treatment":["isosorbide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"she recieved serial enzymes and ekgs .","problem":[],"test":["ekgs","serial enzymes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13,32],"test_indices_end":[27,36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. metoprolol tartrate 25 mg tablet sig : one ( 1 ) tablet po tid ( 3 times a day ).","problem":[],"test":[],"treatment":["metoprolol tartrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"atenolol","problem":[],"test":[],"treatment":["atenolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"cardiovascular : complained of chest pain during first few days of admission , a cardiology consult was obtained .","problem":["chest pain"],"test":[],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. aspirin 81 mg tablet , chewable sig : one ( 1 ) tablet , chewable po daily ( daily ).","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"3. polyvinyl alcohol - povidone 1.4-0.6 % dropperette sig : 02-25 drops ophthalmic prn ( as needed ).","problem":[],"test":[],"treatment":["povidone","polyvinyl alcohol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,23],"treatment_indices_end":[20,31]}
{"text":"cta\/ct abd 03-07 :","problem":[],"test":["cta\/ct abd"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. acetaminophen 325 mg tablet sig : 1-2 tablets po q4-6h ( every 4 to 6 hours ) as needed .","problem":[],"test":[],"treatment":["acetaminophen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"1. heparin ( porcine ) 5,000 unit \/ ml solution sig : one ( 1 ) ml injection tid ( 3 times a day ).","problem":[],"test":[],"treatment":["heparin ( porcine )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"10. albuterol 90 mcg \/ actuation aerosol sig : 1-2 puffs inhalation q6h ( every 6 hours ) as needed .","problem":[],"test":[],"treatment":["albuterol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"9. ipratropium bromide 17 mcg \/ actuation aerosol sig : two ( 2 ) puff inhalation q4-6h ( every 4 to 6 hours ) as needed .","problem":[],"test":[],"treatment":["ipratropium bromide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"7. lisinopril 5 mg tablet sig : 0.5 tablet po daily ( daily ).","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"8. furosemide 40 mg tablet sig : 1.5 tablets po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["furosemide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"5. distended gallbladder .","problem":["distended gallbladder"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. atorvastatin 10 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["atorvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"patient is an insulin dependent diabetic .","problem":["an insulin dependent diabetic"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"small bilateral pleural effusions with compressive atelectasis .","problem":["small bilateral pleural effusions","compressive atelectasis"],"test":[],"treatment":[],"problem_indices_start":[0,39],"problem_indices_end":[33,62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. no evidence of pulmonary embolism .","problem":["pulmonary embolism"],"test":[],"treatment":[],"problem_indices_start":[18],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a\/p : 48yo man with h\/o hcv , bipolar do , h\/o suicide attempts , a\/w overdose of inderal , klonopin , geodon , s\/t jackson stay with intubation for airway protection , with question of l retrocardiac infiltrate , now doing well .","problem":["l retrocardiac infiltrate","hcv","overdose","bipolar do"],"test":[],"treatment":["airway protection","intubation","inderal","geodon","klonopin"],"problem_indices_start":[24,30,70,186],"problem_indices_end":[27,40,78,211],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[82,92,103,134,149],"treatment_indices_end":[89,100,109,144,166]}
{"text":"cv : rrr , nl s1 s2 , no m\/g\/r","problem":["m\/g\/r"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mr. vazquez is a 48 year old man with a history of hepatitis c , bipolar disorder with suicide attempts in the past , recent cmed admit earlier in 4\/05 who was found alert approximately one hour after taking an unspecified number of pills .","problem":["hepatitis c","bipolar disorder"],"test":[],"treatment":["pills"],"problem_indices_start":[51,65],"problem_indices_end":[62,81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[233],"treatment_indices_end":[238]}
{"text":"2012-06-07 09:55 pm blood wbc - 8.9 rbc - 4.94 hgb - 15.8 hct - 45.3 mcv - 92 mch - 31.9 mchc - 34.8 rdw - 12.4 plt ct - 175","problem":[],"test":["mcv","hct","hgb","rbc","plt ct","mch","wbc","blood","mchc","rdw"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,36,47,58,69,78,89,101,112],"test_indices_end":[25,29,39,50,61,72,81,93,104,118],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neck : supple , no lad , no jvd","problem":["jvd","lad"],"test":[],"treatment":[],"problem_indices_start":[19,28],"problem_indices_end":[22,31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"reports that he has suffered from anxiety since childhood and needed to drop out of college .","problem":["anxiety"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"overdose","problem":["overdose"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- watch for bzd withdrawal , agitation","problem":["agitation","bzd withdrawal"],"test":[],"treatment":[],"problem_indices_start":[12,29],"problem_indices_end":[26,38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2012-06-07 09:55 pm blood neuts - 49.9 * lymphs - 42.4 * monos - 5.5 eos - 1.6 baso - 0.6","problem":[],"test":["lymphs","monos","neuts","blood","eos","baso"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,41,57,69,79],"test_indices_end":[25,31,47,62,72,83],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abd : normal size , nd , no scars , nl bs , soft , nt , palp liver","problem":["scars","nd","nt"],"test":[],"treatment":[],"problem_indices_start":[20,28,51],"problem_indices_end":[22,33,53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient recorded as having no known allergies to drugs","problem":["known allergies to drugs"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bipolar disorder :","problem":["bipolar disorder"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lungs : ? decreased bs over left middle lung , otherwise cta","problem":["decreased bs over left middle lung"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- monitor on tele overnight","problem":[],"test":["tele"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was reportedly alert at scene , and then became unresponsive in route to the hospital .","problem":["unresponsive"],"test":[],"treatment":[],"problem_indices_start":[60],"problem_indices_end":[72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ext : no c\/c\/e , no edema","problem":["c\/c\/e","edema"],"test":[],"treatment":[],"problem_indices_start":[9,20],"problem_indices_end":[14,25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2012-06-08 09:30 am blood wbc - 10.1 rbc - 4.35 * hgb - 14.2 hct - 39.9 * mcv - 92 mch - 32.6 * mchc - 35.6 * rdw - 12.4 plt ct - 151","problem":[],"test":["hct","mch","hgb","rbc","mcv","blood","wbc","mchc","rdw","plt ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,37,50,61,74,83,96,110,121],"test_indices_end":[25,29,40,53,64,77,86,100,113,127],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hep c","problem":["hep c"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[5],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"folate 1 mg qd","problem":[],"test":[],"treatment":["folate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"lescol 40 qd","problem":[],"test":[],"treatment":["lescol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"2012-06-07 09:55 pm blood albumin - 3.9 calcium - 8.5 phos - 4.2 mg - 2.0","problem":[],"test":["albumin","mg","calcium","blood","phos"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,40,54,65],"test_indices_end":[25,33,47,58,67],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cmed : a+ox3 , mood \" great ,\" affect approp , speech stuttering , linear tp , no si or hi","problem":["speech stuttering","si","hi"],"test":[],"treatment":[],"problem_indices_start":[47,82,88],"problem_indices_end":[64,84,90],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was evidence of possible aspiration pneumonia on cxr , though he was extubated without incident on the am of transfer to the medicine floor .","problem":["aspiration pneumonia"],"test":["cxr"],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[51],"test_indices_start":[55],"test_indices_end":[58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neuro : no asterixis , cn ii-xii intact , 5\/5 strength throughout , sensation to lt intact throughout , gait deferred","problem":["asterixis"],"test":["lt"],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[20],"test_indices_start":[81],"test_indices_end":[83],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was admitted to the cmed , intubated for airway protection and started on both a calcium and glucagon drip .","problem":[],"test":[],"treatment":["a calcium and glucagon drip","airway protection"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[44,82],"treatment_indices_end":[61,109]}
{"text":"cxr :","problem":[],"test":["cxr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an endotracheal tube terminates just above the thoracic inlet approximately 6.5 cm above the carina .","problem":[],"test":[],"treatment":["an endotracheal tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[20]}
{"text":"2012-06-07 09:55 pm blood glucose - 108 * urean - 13 creat - 0.7 na - 146 * k - 3.7 cl - 109 * hco3 - 30 * angap - 11","problem":[],"test":["cl","hco3","angap","blood","glucose","urean","creat","na","k"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,42,53,65,76,84,95,107],"test_indices_end":[25,33,47,58,67,77,86,99,112],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is a patchy area of increased opacity in the left retrocardiac region , which was not seen on the earlier study .","problem":["a patchy area of increased opacity"],"test":["the earlier study"],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[43],"test_indices_start":[100],"test_indices_end":[117],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left costophrenic angle has been excluded from the study and cannot be assessed .","problem":[],"test":["the study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[47],"test_indices_end":[56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2012-06-08 09:30 am blood calcium - 10.4 * phos - 2.8 mg - 1.8","problem":[],"test":["phos","mg","blood","calcium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,43,54],"test_indices_end":[25,33,47,56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2012-06-07 09:55 pm blood alt - 44 * ast - 31 alkphos - 36 * totbili - 0.2","problem":[],"test":["alkphos","totbili","ast","blood","alt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,37,46,61],"test_indices_end":[25,29,40,53,68],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2012-06-07 09:55 pm blood plt ct - 175","problem":[],"test":["blood","plt ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26],"test_indices_end":[25,32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the nasogastric tube terminates within the stomach .","problem":[],"test":[],"treatment":["the nasogastric tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[20]}
{"text":"there is no evidence of right pleural effusion or right pneumothorax .","problem":["right pleural effusion","right pneumothorax"],"test":[],"treatment":[],"problem_indices_start":[24,50],"problem_indices_end":[46,68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"per report , there were empty bottles of inderal and klonopin found at bedside , as well as 02-26 full bottles of geodon , gabapentin , lescol and paroxitine .","problem":[],"test":[],"treatment":["gabapentin","geodon","klonopin","inderal","lescol","paroxitine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[41,53,114,123,136,147],"treatment_indices_end":[48,61,120,133,142,157]}
{"text":"2012-06-07 09:55 pm blood pt - 12.8 ptt - 25.7 inr(pt) - 1.0","problem":[],"test":["pt","blood","inr(pt)","ptt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,36,47],"test_indices_end":[25,28,39,54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ng tube","problem":[],"test":[],"treatment":["ng tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"1) endotracheal tube is slightly proximal in location , and could be advanced approximately 1.5 cm for more optimal placement .","problem":[],"test":[],"treatment":["endotracheal tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[20]}
{"text":"- suicide precautions","problem":[],"test":[],"treatment":["suicide precautions"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[21]}
{"text":"his initial bp was 60\/p with a pulse in the 60 s.","problem":[],"test":["his initial bp","a pulse"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,29],"test_indices_end":[14,36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2012-06-08 09:30 am blood glucose - 115 * urean - 14 creat - 0.8 na - 142 k - 4.1 cl - 112 * hco3 - 26 angap - 8","problem":[],"test":["urean","hco3","angap","cl","creat","na","k","blood","glucose"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,42,53,65,74,82,93,103],"test_indices_end":[25,33,47,58,67,75,84,97,108],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2012-06-07 09:55 pm blood asa - neg ethanol - neg acetmnp - neg bnzodzp - neg barbitr - neg tricycl - neg","problem":[],"test":["blood","asa","ethanol","acetmnp","bnzodzp","barbitr","tricycl"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,36,50,64,78,92],"test_indices_end":[25,29,43,57,71,85,99],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was given 4 amps of calcium gluconate , and started on a calcium gtt .","problem":[],"test":[],"treatment":["calcium gluconate","a calcium gtt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23,58],"treatment_indices_end":[40,71]}
{"text":"- if hr drops , restart glucagon gtt","problem":[],"test":["hr"],"treatment":["glucagon gtt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[5],"test_indices_end":[7],"treatment_indices_start":[24],"treatment_indices_end":[36]}
{"text":"2) patchy left retrocardiac opacity which may be due to patchy atelectasis , aspiration , or early pneumonia .","problem":["early pneumonia","patchy left retrocardiac opacity","aspiration","patchy atelectasis"],"test":[],"treatment":[],"problem_indices_start":[3,56,77,93],"problem_indices_end":[35,74,87,108],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the rita , the patient was intubated and given activated charcoal .","problem":[],"test":[],"treatment":["activated charcoal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[50],"treatment_indices_end":[68]}
{"text":"his urine and serum tox screens were notable only for benzos , otherwise negative .","problem":[],"test":["serum tox screens","his urine"],"treatment":["benzos"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,14],"test_indices_end":[9,31],"treatment_indices_start":[54],"treatment_indices_end":[60]}
{"text":"he was also given 5mg of glucagon and started on a glucagon drip with good response .","problem":[],"test":[],"treatment":["glucagon","a glucagon drip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25,49],"treatment_indices_end":[33,64]}
{"text":"narcissism","problem":["narcissism"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"depressed","problem":["depressed"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"panic disorder","problem":["panic disorder"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no history of head trauma or seizure disorder","problem":["head trauma","seizure disorder"],"test":[],"treatment":[],"problem_indices_start":[14,29],"problem_indices_end":[25,45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"depression","problem":["depression"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"paxil 30 mg qd","problem":[],"test":[],"treatment":["paxil"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"bipolar d\/o with one suicide attempt by overdose several years ago","problem":["bipolar d\/o","overdose"],"test":[],"treatment":[],"problem_indices_start":[0,40],"problem_indices_end":[11,48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"propanolol 20 mg tid","problem":[],"test":[],"treatment":["propanolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"followup radiograph suggested","problem":[],"test":["followup radiograph"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neurontin 800 mg tid","problem":[],"test":[],"treatment":["neurontin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"agoraphobia","problem":["agoraphobia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ziprasidone bid","problem":[],"test":[],"treatment":["ziprasidone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"ppx : sc heparin , bowel regimen , nicotine patch","problem":[],"test":[],"treatment":["sc heparin","bowel regimen","nicotine patch"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6,19,35],"treatment_indices_end":[16,32,49]}
{"text":"protonix 40 mg qd","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"heent : ncat , perrl , eomi , no icterus , op clear , mmm , no tongue fasciculations","problem":["tongue fasciculations","icterus"],"test":[],"treatment":[],"problem_indices_start":[33,63],"problem_indices_end":[40,84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"klonopin 2 mg tid","problem":[],"test":[],"treatment":["klonopin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"gen : caucasian man lying in bed , nad","problem":["nad"],"test":[],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vitals : 99.3 67 ( 60-70 ) 99\/53 ( 90-100 s) 96% on ra 3.7l + los","problem":[],"test":["vitals"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"femoral 2 + bilaterally , dorsalis pedis 1 + bilaterally , posterior tibial 1 + bilaterally , and radial 2 + bilaterally .","problem":[],"test":["dorsalis pedis","femoral","radial","posterior tibial"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,26,59,98],"test_indices_end":[7,40,75,104],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"weight preoperatively was 67 kg , at discharge is 70.9 kg .","problem":[],"test":["weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"temperature 98.4 , heart rate 78 and sinus rhythm , blood pressure 106\/50 , respiratory rate 18 , oxygen saturation 97% on room air .","problem":[],"test":["oxygen saturation","respiratory rate","temperature","heart rate","blood pressure","sinus rhythm"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,19,37,52,76,98],"test_indices_end":[11,29,49,66,92,115],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"supple , no lymphadenopathy , no jugular venous distention , no thyromegaly .","problem":["thyromegaly","jugular venous distention","lymphadenopathy"],"test":[],"treatment":[],"problem_indices_start":[12,33,64],"problem_indices_end":[27,58,75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rate of 91 , first degree av block , intervals .22 , .92 , .36 , with left ventricular hypertrophy .","problem":["first degree av block","left ventricular hypertrophy"],"test":["intervals","rate"],"treatment":[],"problem_indices_start":[13,70],"problem_indices_end":[34,98],"test_indices_start":[0,37],"test_indices_end":[4,46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"admitted to bay state medical center hospital in 2012-10-22 in congestive heart failure at that time .","problem":["congestive heart failure"],"test":[],"treatment":[],"problem_indices_start":[63],"problem_indices_end":[87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. right hip replacement","problem":[],"test":[],"treatment":["right hip replacement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[24]}
{"text":"moderate pulmonary hypertension , pa pressure 48\/24 , 1+ mitral regurgitation , severe aortic stenosis with an lvedp of 19 and an ejection fraction of 43% .","problem":["severe aortic stenosis","1+ mitral regurgitation","moderate pulmonary hypertension"],"test":["an ejection fraction","an lvedp","pa pressure"],"treatment":[],"problem_indices_start":[0,54,80],"problem_indices_end":[31,77,102],"test_indices_start":[34,108,127],"test_indices_end":[45,116,147],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"soft , nontender , nondistended , normal active bowel sounds , no hepatosplenomegaly .","problem":["hepatosplenomegaly","nondistended","nontender"],"test":[],"treatment":[],"problem_indices_start":[7,19,66],"problem_indices_end":[16,31,84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"include glucovance 5\/500 one tablet twice a day , univasc 7.5 mg once daily , lasix 20 mg every other day , and aspirin 325 mg once daily .","problem":[],"test":[],"treatment":["glucovance","aspirin","lasix","univasc"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[8,50,78,112],"treatment_indices_end":[18,57,83,119]}
{"text":"sodium 141 , potassium 4.3 , chloride 108 , co2 25 , bun 24 , creatinine 0.8 , glucose 140 .","problem":[],"test":["creatinine","glucose","sodium","bun","co2","chloride","potassium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,29,44,53,62,79],"test_indices_end":[6,22,37,47,56,72,86],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. aortic stenosis","problem":["aortic stenosis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was then referred to cardiothoracic surgery for aortic valve replacement .","problem":[],"test":[],"treatment":["aortic valve replacement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[52],"treatment_indices_end":[76]}
{"text":"at the time of transfer , the patient 's physical examination is as follows :","problem":[],"test":["the patient 's physical examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26],"test_indices_end":[61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient did well in the immediate postoperative period , however , her blood pressure remained somewhat labile .","problem":["somewhat labile"],"test":["her blood pressure"],"treatment":[],"problem_indices_start":[99],"problem_indices_end":[114],"test_indices_start":[71],"test_indices_end":[89],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"therapy .","problem":[],"test":[],"treatment":["therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"warm and well perfused , with no cyanosis , clubbing or edema , no varicosities .","problem":["edema","cyanosis","clubbing","varicosities"],"test":[],"treatment":[],"problem_indices_start":[33,44,56,67],"problem_indices_end":[41,52,61,79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"soft , nontender , nondistended , normal active bowel sounds .","problem":["nontender","nondistended"],"test":[],"treatment":[],"problem_indices_start":[7,19],"problem_indices_end":[16,31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white count 5.3 , hematocrit 43 , platelets 200 .","problem":[],"test":["white count","platelets","hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,18,34],"test_indices_end":[11,28,43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no carotid bruits were noted .","problem":["carotid bruits"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white count 4.1 , hematocrit 23 , platelets 144 .","problem":[],"test":["platelets","hematocrit","white count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,18,34],"test_indices_end":[11,28,43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"incision with staples , open to air , clean and dry .","problem":["incision"],"test":[],"treatment":["staples"],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[21]}
{"text":"sodium 138 , potassium 4.9 , chloride 102 , co2 25 , bun 24 , creatinine 0.9 , glucose 309 .","problem":[],"test":["sodium","co2","chloride","potassium","glucose","bun","creatinine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,29,44,53,62,79],"test_indices_end":[6,22,37,47,56,72,86],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"warm and well perfused , with no cyanosis , clubbing or edema .","problem":["clubbing","cyanosis","edema"],"test":[],"treatment":[],"problem_indices_start":[33,44,56],"problem_indices_end":[41,52,61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"scattered rhonchi with diminished breath sounds in the bases .","problem":["scattered rhonchi","diminished breath sounds in the bases"],"test":[],"treatment":[],"problem_indices_start":[0,23],"problem_indices_end":[17,60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she tolerated the operation well , and was transferred from the operating room to the cardiothoracic intensive care unit .","problem":[],"test":[],"treatment":["the operation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[27]}
{"text":"in summary , she had an aortic valve replacement with a #21 mosaic porcine valve .","problem":[],"test":[],"treatment":["a #21 mosaic porcine valve","an aortic valve replacement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21,54],"treatment_indices_end":[48,80]}
{"text":"therefore , she was continued on a neo-synephrine drip to maintain a systolic blood pressure greater than 110 .","problem":[],"test":["a systolic blood pressure"],"treatment":["a neo-synephrine drip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[67],"test_indices_end":[92],"treatment_indices_start":[33],"treatment_indices_end":[54]}
{"text":"regular rate and rhythm , s1 , s2 , with soft systolic ejection murmur .","problem":["soft systolic ejection murmur"],"test":[],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"laboratory data on 02-15 :","problem":[],"test":["laboratory data"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ranitidine 150 mg twice a day , enteric-coated aspirin 325 mg once daily , glucovance 5\/500 one tablet twice a day , metoprolol 25 mg twice a day , furosemide 20 mg once daily for 14 days , potassium chloride 20 meq once daily for 14 days , colace 100 mg twice a day , niferex 150 mg once daily , percocet 5\/325 one to two tablets every four hours as needed , ibuprofen 400 mg every six hours as needed .","problem":[],"test":[],"treatment":["colace","potassium chloride","niferex","ibuprofen","percocet","enteric-coated aspirin","ranitidine","metoprolol","glucovance","furosemide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,32,75,117,148,190,241,269,297,360],"treatment_indices_end":[10,54,85,127,158,208,247,276,305,369]}
{"text":"her chest tubes were discontinued and , at the end of the day , she was transferred from the cardiothoracic intensive care unit to the floor for continuing postoperative care and cardiac rehabilitation .","problem":[],"test":[],"treatment":["her chest tubes","cardiac rehabilitation","continuing postoperative care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,145,179],"treatment_indices_end":[15,174,201]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"significant for her father , who died at 50 years from myocarditis .","problem":["myocarditis"],"test":[],"treatment":[],"problem_indices_start":[55],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pulses :","problem":[],"test":["pulses"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"aortic valve replacement .","problem":[],"test":[],"treatment":["aortic valve replacement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"heart rate 108 and regular , blood pressure 145\/76 , respiratory rate 20 , height 5'2\" , weight 141 pounds .","problem":[],"test":["heart rate","respiratory rate","blood pressure","weight","height"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,29,53,75,89],"test_indices_end":[10,43,69,81,95],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest x-ray is pending at the time of physical .","problem":[],"test":["physical","chest x-ray"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,38],"test_indices_end":[11,46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. aortic stenosis status post aortic valve replacement with a #21 mosaic porcine valve","problem":["aortic stenosis"],"test":[],"treatment":["aortic valve replacement","a #21 mosaic porcine valve"],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31,61],"treatment_indices_end":[55,87]}
{"text":"electrocardiogram :","problem":[],"test":["electrocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was referred from an outside hospital with a chief complaint of increasing shortness of breath and tires easily with exertion .","problem":["tires easily","increasing shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[76,111],"problem_indices_end":[106,123],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition , she was slow to awaken after her anesthesia was reversed , and in several attempts to wean from the ventilator , she developed a respiratory acidosis .","problem":["a respiratory acidosis"],"test":[],"treatment":["her anesthesia","the ventilator"],"problem_indices_start":[141],"problem_indices_end":[163],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[43,110],"treatment_indices_end":[57,124]}
{"text":"healthy-appearing woman , in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"strength 5\/5 in upper and lower extremities .","problem":[],"test":["strength"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pupils equal , round and reactive to light , extraocular movements intact , anicteric , not injected .","problem":["anicteric","injected"],"test":[],"treatment":[],"problem_indices_start":[76,92],"problem_indices_end":[85,100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her neo-synephrine drip was weaned to off .","problem":[],"test":[],"treatment":["her neo-synephrine drip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[23]}
{"text":"she was again weaned from the ventilator , and successfully extubated .","problem":[],"test":[],"treatment":["the ventilator"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[40]}
{"text":"no lesions or rashes .","problem":["rashes","lesions"],"test":[],"treatment":[],"problem_indices_start":[3,14],"problem_indices_end":[10,20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she therefore remained on the ventilator throughout the day of postoperative day one .","problem":[],"test":[],"treatment":["the ventilator"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[40]}
{"text":"referred to memorial hospital ( worcester ) for cardiac catheterization to further evaluate her aortic stenosis .","problem":["her aortic stenosis"],"test":["cardiac catheterization"],"treatment":[],"problem_indices_start":[92],"problem_indices_end":[111],"test_indices_start":[48],"test_indices_end":[71],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac catheterization done on 01-07 showed an aortic valve area of .38 cm.sq. , with a mean gradient of 62 , and a peak gradient of 85 .","problem":[],"test":["cardiac catheterization","an aortic valve area","a mean gradient","a peak gradient"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,45,87,115],"test_indices_end":[23,65,102,130],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her respiratory condition remained stable and , on postoperative day four , she was deemed stable and ready to be transferred to rehabilitation for continuing postoperative care and physical","problem":[],"test":[],"treatment":["continuing postoperative care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[148],"treatment_indices_end":[177]}
{"text":"via echocardiogram , found to have aortic stenosis .","problem":["aortic stenosis"],"test":["echocardiogram"],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[50],"test_indices_start":[4],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"clear to auscultation bilaterally .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[9],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"regular rate and rhythm , s1 , s2 , with iii\/vi blowing murmur .","problem":["iii\/vi blowing murmur"],"test":[],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. diabetes mellitus type 2","problem":["diabetes mellitus type 2"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. right hip replacement","problem":[],"test":[],"treatment":["right hip replacement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[24]}
{"text":"2. diabetes mellitus type 2","problem":["diabetes mellitus type 2"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. noninsulin dependent diabetes mellitus","problem":["noninsulin dependent diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"temperature is 98.3 f. ; pulse is 76 ; blood pressure 113\/52 ; breathing 18 ; 98% on room air .","problem":[],"test":["breathing","temperature","pulse","blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,25,39,63],"test_indices_end":[11,30,53,72],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on admission include a white blood cell count of 5.6 , hematocrit of 32.5 , platelets of 202 .","problem":[],"test":["hematocrit","platelets","a white blood cell count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[21,55,76],"test_indices_end":[45,65,85],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was fully weaned from ventilatory support secondary to a persistent acidemia .","problem":["a persistent acidemia"],"test":[],"treatment":["ventilatory support"],"problem_indices_start":[67],"problem_indices_end":[88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[53]}
{"text":"the patient has no cyanosis , clubbing or edema in extremities .","problem":["cyanosis","edema in extremities","clubbing"],"test":[],"treatment":[],"problem_indices_start":[19,30,42],"problem_indices_end":[27,38,62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sodium of 140 , potassium of 3.5 , bun of 4 , creatinine of 0.6 , glucose of 137 .","problem":[],"test":["glucose","creatinine","sodium","bun","potassium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,35,46,66],"test_indices_end":[6,25,38,56,73],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had a recent admission earlier in the month and he was discharged on 2015-09-10 , after undergoing cardiac catheterization .","problem":[],"test":["cardiac catheterization"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[111],"test_indices_end":[134],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen is soft and nontender .","problem":["nontender"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac catheterization demonstrates no significant disease in the coronary arteries .","problem":["significant disease in the coronary arteries"],"test":["cardiac catheterization"],"treatment":[],"problem_indices_start":[40],"problem_indices_end":[84],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mitral valve repair .","problem":[],"test":[],"treatment":["mitral valve repair"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[19]}
{"text":"the patient was brought to the cardiothoracic intensive care unit in stable condition on minimal pressor support .","problem":[],"test":[],"treatment":["minimal pressor support"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[89],"treatment_indices_end":[112]}
{"text":"there is a persistent flow through an inferior branch of the left anterior descending to pa fistula and a persistent branch of the circumflex to pa branch fistula which anatomically were not suitable for coil embolization .","problem":["pa fistula","a persistent flow","the circumflex to pa branch fistula"],"test":[],"treatment":["coil embolization"],"problem_indices_start":[9,89,127],"problem_indices_end":[26,99,162],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[204],"treatment_indices_end":[221]}
{"text":"two branches of an left anterior descending to pa fistula which was successfully coiled .","problem":["an left anterior descending to pa fistula"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he tolerated this procedure well .","problem":[],"test":[],"treatment":["this procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[27]}
{"text":"3. the patient will call for any fevers or difficulties with the wound care , and will be instructed with an interpreter present .","problem":["any fevers","difficulties with the wound care"],"test":[],"treatment":[],"problem_indices_start":[29,43],"problem_indices_end":[39,75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was equally up to 700 cc. an hour and a renal consultation was obtained .","problem":[],"test":["a renal consultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[41],"test_indices_end":[61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. colace 100 mg p.o. twice a day .","problem":[],"test":[],"treatment":["colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"1. mitral regurgitation status post minimally invasive mitral valve repair .","problem":["mitral regurgitation"],"test":[],"treatment":["minimally invasive mitral valve repair"],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36],"treatment_indices_end":[74]}
{"text":"there is no cervical lymphadenopathy .","problem":["cervical lymphadenopathy"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mitral valve repair .","problem":[],"test":[],"treatment":["mitral valve repair"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[19]}
{"text":"he underwent a head ct scan to rule out intracranial pathology leading to diabetes insipidus .","problem":["diabetes insipidus","intracranial pathology"],"test":["a head ct scan"],"treatment":[],"problem_indices_start":[40,74],"problem_indices_end":[62,92],"test_indices_start":[13],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's serum and urine electrolytes indicated that this diuresis was appropriate .","problem":[],"test":["the patient 's serum","urine electrolytes"],"treatment":["this diuresis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,25],"test_indices_end":[20,43],"treatment_indices_start":[59],"treatment_indices_end":[72]}
{"text":"he was successfully weaned off this support .","problem":[],"test":[],"treatment":["this support"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31],"treatment_indices_end":[43]}
{"text":"the patient is a 52 year old czech speaking gentleman with a history of severe mitral regurgitation .","problem":["severe mitral regurgitation"],"test":[],"treatment":[],"problem_indices_start":[72],"problem_indices_end":[99],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had developed some hematuria which has resolved .","problem":["some hematuria"],"test":[],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was treated with sodium bicarbonate and a swan-ganz was placed to provide close hemodynamic monitoring .","problem":[],"test":["close hemodynamic monitoring"],"treatment":["a swan-ganz","sodium bicarbonate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[79],"test_indices_end":[107],"treatment_indices_start":[22,45],"treatment_indices_end":[40,56]}
{"text":"1. mitral valve regurgitation .","problem":["mitral valve regurgitation"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is missing many teeth .","problem":["missing many teeth"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was found to have stable hemodynamics with appropriate mixed venous saturations in the 70% range .","problem":[],"test":["venous saturations"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[73],"test_indices_end":[91],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition , the patient 's early postoperative course had a tremendous urine output .","problem":[],"test":["urine output"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[73],"test_indices_end":[85],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's urine output has decreased and his bun and creatinine remained normal .","problem":[],"test":["his bun","creatinine","the patient 's urine output"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,46,58],"test_indices_end":[27,53,68],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was then weaned off of ventilatory support and was successfully extubated .","problem":[],"test":[],"treatment":["ventilatory support"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[45]}
{"text":"3. nitroglycerin sublingual p.r.n.","problem":[],"test":[],"treatment":["nitroglycerin sublingual"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[27]}
{"text":"the patient did have a slight bit of confusion early in post-extubation course which cleared .","problem":["a slight bit of confusion"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was significant for demonstrating no flow-limited disease in the coronaries but several fistulae","problem":["flow-limited disease in the coronaries","several fistulae"],"test":[],"treatment":[],"problem_indices_start":[42,85],"problem_indices_end":[80,101],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he reports severe dyspnea on exertion .","problem":["severe dyspnea"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his lungs are clear to auscultation bilaterally .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[23],"test_indices_end":[35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"for the past several years , the patient has continued to have significant exercise intolerance which has limited his ability to work .","problem":["significant exercise intolerance"],"test":[],"treatment":[],"problem_indices_start":[63],"problem_indices_end":[95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. lopressor 75 mg p.o. twice a day .","problem":[],"test":[],"treatment":["lopressor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"the patient 's foley was discontinued .","problem":[],"test":[],"treatment":["the patient 's foley"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[20]}
{"text":"heart is regular rate and rhythm with a iii\/vi systolic ejection murmur .","problem":["a iii\/vi systolic ejection murmur"],"test":[],"treatment":[],"problem_indices_start":[38],"problem_indices_end":[71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. percocet one to two p.o. q. four hours p.r.n.","problem":[],"test":[],"treatment":["percocet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"several of these were coil embolized during this admission .","problem":[],"test":[],"treatment":["coil embolized"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[36]}
{"text":"1. atenolol 25 mg p.o. q. day .","problem":[],"test":[],"treatment":["atenolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"ejection fraction was 60% .","problem":[],"test":["ejection fraction"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest x-ray shows no infiltrate or pneumothorax .","problem":["infiltrate","pneumothorax"],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[21,35],"problem_indices_end":[31,47],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he tolerated this well , was sent home , and now returns for his mitral valve repair .","problem":[],"test":[],"treatment":["his mitral valve repair"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61],"treatment_indices_end":[84]}
{"text":"4. aspirin 325 mg p.o. q. day .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"2. enteric-coated aspirin 325 mg p.o. q. day .","problem":[],"test":[],"treatment":["enteric-coated aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[25]}
{"text":"2013-10-29 11:37 am blood wbc - 11.4 *# rbc - 3.09 *# hgb - 9.1 *# hct - 27.5 *# mcv - 89 mch - 29.5 mchc - 33.3 rdw - 14.6 plt ct - 180","problem":[],"test":["plt ct","blood","wbc","hgb","rbc","mch","hct","mchc","rdw","mcv"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,40,54,67,81,90,101,113,124],"test_indices_end":[25,29,43,57,70,84,93,105,116,130],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"arthritis","problem":["arthritis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you will need to follow up with your primary care physician \/ urologist prior to removal of your urinary catheter .","problem":[],"test":[],"treatment":["your urinary catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[92],"treatment_indices_end":[113]}
{"text":"6. glipizide 10 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["glipizide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"3. oxycodone - acetaminophen 5-325 mg tablet sig : 1-2 tablets po q4h ( every 4 hours ) as needed for pain for 30 doses .","problem":["pain"],"test":[],"treatment":["oxycodone","acetaminophen"],"problem_indices_start":[102],"problem_indices_end":[106],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,15],"treatment_indices_end":[12,28]}
{"text":"mr. andersen is a 71-year-old male with worsening anginal symptoms who underwent catheterization that showed severe three-vessel disease .","problem":["worsening anginal symptoms","severe three-vessel disease"],"test":["catheterization"],"treatment":[],"problem_indices_start":[40,109],"problem_indices_end":[66,136],"test_indices_start":[81],"test_indices_end":[96],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dm2 - dx 'd at the age of 48","problem":["dm2"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cv : rrr , no m\/r\/g","problem":["m\/r\/g"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2013-10-29 11:37 am blood pt - 16.2 * ptt - 29.0 inr(pt) - 1.7","problem":[],"test":["pt","inr(pt)","ptt","blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,38,49],"test_indices_end":[25,28,41,56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent : perrla , no carotid bruits","problem":["carotid bruits"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please call if you notice redness , swelling , or tenderness of your chest wound , or if it begins to drain pus .","problem":["your chest wound","pus","tenderness","swelling","redness"],"test":[],"treatment":[],"problem_indices_start":[26,36,50,64,108],"problem_indices_end":[33,44,60,80,111],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on post-op day #3 , the patient 's pacing wires were removed , and his lopressor was started .","problem":[],"test":[],"treatment":["the patient 's pacing wires","his lopressor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20,67],"treatment_indices_end":[47,80]}
{"text":"2. aspirin 81 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po daily ( daily ).","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"he was discharged home on post-op day #6 in stable condition with a foley catheter and leg bag .","problem":[],"test":[],"treatment":["leg bag","a foley catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[66,87],"treatment_indices_end":[82,94]}
{"text":"7. tamsulosin 0.4 mg capsule , sust. release 24 hr sig : one ( 1 ) capsule , sust . release 24 hr po hs ( at bedtime ).","problem":[],"test":[],"treatment":["tamsulosin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"wash incision with mild soap and water , then pat dry .","problem":["incision"],"test":[],"treatment":[],"problem_indices_start":[5],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"avandia 8 mg daily","problem":[],"test":[],"treatment":["avandia"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"2013-10-29 01:09 pm blood glucose - 172 * urean - 11 creat - 0.9 na - 142 cl - 111 * hco3 - 22","problem":[],"test":["blood","hco3","na","creat","urean","glucose","cl"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,42,53,65,74,85],"test_indices_end":[25,33,47,58,67,76,89],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2013-10-29 01:09 pm blood mg - 2.6","problem":[],"test":["mg","blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26],"test_indices_end":[25,28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2013-10-29 11:37 am blood plt ct - 180","problem":[],"test":["blood","plt ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26],"test_indices_end":[25,32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tonsillectomy around the age of 10","problem":[],"test":[],"treatment":["tonsillectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"father died of colon cancer .","problem":["colon cancer"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mother with pacemaker , alive at 91 years old .","problem":[],"test":[],"treatment":["pacemaker"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[21]}
{"text":"4. atorvastatin calcium 10 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["atorvastatin calcium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[23]}
{"text":"8. metoprolol tartrate 25 mg tablet sig : 0.5 tablet po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["metoprolol tartrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"10. pantoprazole sodium 40 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po q24h ( every 24 hours ).","problem":[],"test":[],"treatment":["pantoprazole sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[23]}
{"text":"5. rosiglitazone maleate 8 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["rosiglitazone maleate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[24]}
{"text":"the patient was taken to the operating room on 2013-10-29 for a cabg x5 .","problem":[],"test":[],"treatment":["a cabg"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[62],"treatment_indices_end":[68]}
{"text":"he is presenting for revascularization .","problem":[],"test":[],"treatment":["revascularization"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[38]}
{"text":"htn","problem":["htn"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient tolerated this procedure well .","problem":[],"test":[],"treatment":["this procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[36]}
{"text":"9. furosemide 20 mg tablet sig : one ( 1 ) tablet po every twelve ( 12 ) hours .","problem":[],"test":[],"treatment":["furosemide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"coronary artery disease","problem":["coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cabg x 5","problem":[],"test":[],"treatment":["cabg"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[4]}
{"text":"abd : soft , nt\/nd , nabs","problem":["nt\/nd"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on post-op day #4 , the patient failed the first of his void trials .","problem":[],"test":["his void trials"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[52],"test_indices_end":[67],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his central line and chest tubes were removed on post-op day #2 and was transferred to the floor in stable condition .","problem":[],"test":[],"treatment":["chest tubes","his central line"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,21],"treatment_indices_end":[16,32]}
{"text":"ext : cool , no varicosities , 1+ pedal pulses","problem":["varicosities"],"test":["pedal pulses"],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[28],"test_indices_start":[34],"test_indices_end":[46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"11. potassium chloride 10 meq capsule , sustained release sig : two ( 2 ) capsule , sustained release po q12h ( every 12 hours ).","problem":[],"test":[],"treatment":["potassium chloride"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[22]}
{"text":"patient recorded as having no known allergies to drugs","problem":["known allergies to drugs"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please return to the hospital or call dr. alvarado 's office if you experience chills or fever greater than 101 degrees f.","problem":["chills","fever greater than 101 degrees f."],"test":[],"treatment":[],"problem_indices_start":[79,89],"problem_indices_end":[85,122],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coronary artery disease requiring surgical intervention","problem":["coronary artery disease"],"test":[],"treatment":["surgical intervention"],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[55]}
{"text":"metformin 500 mg two tabs bid","problem":[],"test":[],"treatment":["metformin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"diovan 160 mg daily","problem":[],"test":[],"treatment":["diovan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"glipizide 10 mg bid","problem":[],"test":[],"treatment":["glipizide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"1. docusate sodium 100 mg capsule sig : one ( 1 ) capsule po bid ( 2 times a day ) as needed for constipation .","problem":["constipation"],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[97],"problem_indices_end":[109],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"awake and alert , nad","problem":["nad"],"test":[],"treatment":[],"problem_indices_start":[18],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"omeprazole 20 mg q pm","problem":[],"test":[],"treatment":["omeprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"4. anterior instrumentation l3-l4 .","problem":[],"test":[],"treatment":["anterior instrumentation l3-l4"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[33]}
{"text":"- mylanta 30 cc po q6 prn","problem":[],"test":[],"treatment":["mylanta"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[9]}
{"text":"5. autograft , bone morphogenic protein , and allograft .","problem":[],"test":[],"treatment":["bone morphogenic protein","allograft","autograft"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,15,46],"treatment_indices_end":[12,39,55]}
{"text":"- albuterol \/ atrovent nebs q4","problem":[],"test":[],"treatment":["atrovent","albuterol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2,14],"treatment_indices_end":[11,22]}
{"text":"the patient was continued on his iron supplements .","problem":[],"test":[],"treatment":["his iron supplements"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[49]}
{"text":"2. fusion at l3-l4 .","problem":[],"test":[],"treatment":["fusion at l3-l4"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"# anemia : his hct remained stable post-surgery .","problem":["anemia"],"test":["his hct"],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[8],"test_indices_start":[11],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. vertebral spacer at l3-l4 .","problem":[],"test":[],"treatment":["vertebral spacer at l3-l4"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[28]}
{"text":"1. partial vertebrectomy of l3 and l4 .","problem":[],"test":[],"treatment":["partial vertebrectomy of l3 and l4"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[37]}
{"text":"his dressings were changed by the nursing staff accordingly .","problem":[],"test":[],"treatment":["his dressings"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"penicillins","problem":[],"test":[],"treatment":["penicillins"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"wound care was consulted and made recommendations for ulcer care .","problem":[],"test":[],"treatment":["ulcer care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[54],"treatment_indices_end":[64]}
{"text":"transfer from newton-wellesley hospital hospital for epidural abscess","problem":["epidural abscess"],"test":[],"treatment":[],"problem_indices_start":[53],"problem_indices_end":[69],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"12. fluconazole 200 mg tablet sig : two ( 2 ) tablet po q24h ( every 24 hours ) for 7 days .","problem":[],"test":[],"treatment":["fluconazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[15]}
{"text":"6. acetaminophen 325 mg tablet sig : two ( 2 ) tablet po q6h ( every 6 hours ) as needed for fever or pain .","problem":["fever","pain"],"test":[],"treatment":["acetaminophen"],"problem_indices_start":[93,102],"problem_indices_end":[98,106],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"5. miconazole nitrate 2 % powder sig : one ( 1 ) appl topical tid ( 3 times a day ) as needed .","problem":[],"test":[],"treatment":["miconazole nitrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[21]}
{"text":"- metoprolol 50 mg po daily","problem":[],"test":[],"treatment":["metoprolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[12]}
{"text":"- metformin 500 mg po bid","problem":[],"test":[],"treatment":["metformin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[11]}
{"text":"- vancomycin 1.5 gm q 12 hours","problem":[],"test":[],"treatment":["vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[12]}
{"text":"- glipizide 5 mg po bid","problem":[],"test":[],"treatment":["glipizide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[11]}
{"text":"3. aluminum-magnesium hydroxide 225-200 mg \/ 5 ml suspension sig : 15-30 mls po qid ( 4 times a day ) as needed .","problem":[],"test":[],"treatment":["aluminum-magnesium hydroxide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[31]}
{"text":"- insulin sliding scale","problem":[],"test":[],"treatment":["insulin sliding scale"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[23]}
{"text":"2. ipratropium bromide 0.02 % solution sig : one ( 1 ) inhalation q6h ( every 6 hours ) as needed .","problem":[],"test":[],"treatment":["ipratropium bromide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"- pepcid 20 mg po daily","problem":[],"test":[],"treatment":["pepcid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[8]}
{"text":"4. glipizide 5 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["glipizide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"states he first developed back pain 5 weeks ago but was still able to ambulate with his cane .","problem":["back pain"],"test":[],"treatment":["his cane"],"problem_indices_start":[26],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[84],"treatment_indices_end":[92]}
{"text":"9. docusate sodium 100 mg capsule sig : one ( 1 ) capsule po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"10. senna 8.6 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ) as needed .","problem":[],"test":[],"treatment":["senna"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[9]}
{"text":"pt states he has been receiving chemotherapy up until 1 week ago .","problem":[],"test":[],"treatment":["chemotherapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32],"treatment_indices_end":[44]}
{"text":"8. cepacol 2 mg lozenge sig : one ( 1 ) lozenge mucous membrane prn ( as needed ).","problem":[],"test":[],"treatment":["cepacol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"pt has h\/o colon can to liver , s\/p resxn with serosal implants in 9\/03 .","problem":["serosal implants","colon can to liver"],"test":[],"treatment":["resxn"],"problem_indices_start":[11,47],"problem_indices_end":[29,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36],"treatment_indices_end":[41]}
{"text":"7. metoprolol tartrate 25 mg tablet sig : 1.5 tablets po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["metoprolol tartrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"20. insulin lispro ( human ) 100 unit \/ ml cartridge sig : one ( 1 ) subcutaneous four times a day : as directed by sliding scale-please see attached scale .","problem":[],"test":[],"treatment":["sliding scale-please","insulin lispro ( human )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4,116],"treatment_indices_end":[28,136]}
{"text":"73 yo m transferred from newton-wellesley hospital hospital for epidural abscess .","problem":["epidural abscess"],"test":[],"treatment":[],"problem_indices_start":[64],"problem_indices_end":[80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. echocardiogram","problem":[],"test":["echocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. incision and drainage","problem":[],"test":[],"treatment":["drainage","incision"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,16],"treatment_indices_end":[11,24]}
{"text":"16. vancomycin in dextrose 1 g \/ 200 ml piggyback sig : one ( 1 ) intravenous q 12h ( every 12 hours ): to finish on 2020-05-12 .","problem":[],"test":[],"treatment":["vancomycin in dextrose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[26]}
{"text":"14. bisacodyl 5 mg tablet , delayed release ( e.c. ) sig : two ( 2 ) tablet , delayed release ( e.c. ) po bid ( 2 times a day ) as needed .","problem":[],"test":[],"treatment":["bisacodyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"15. aspirin 81 mg tablet , chewable sig : one ( 1 ) tablet , chewable po daily ( daily ).","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[11]}
{"text":"6. debridement","problem":[],"test":[],"treatment":["debridement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"13. oxycodone 10 mg tablet sustained release 12 hr sig : one ( 1 ) tablet sustained release 12hr po q12h ( every 12 hours ).","problem":[],"test":[],"treatment":["oxycodone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"11. oxycodone 5 mg tablet sig : 1-2 tablets po every 4-6 hours as needed for pain for 14 days .","problem":["pain"],"test":[],"treatment":["oxycodone"],"problem_indices_start":[77],"problem_indices_end":[81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"initially on vanc and cipro on friday but then seen by id who reccommended no abx but a bone biopsy , blood cx .","problem":[],"test":["blood cx","a bone biopsy"],"treatment":["cipro","vanc","abx"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[86,102],"test_indices_end":[99,110],"treatment_indices_start":[13,22,78],"treatment_indices_end":[17,27,81]}
{"text":"- cad s\/p cabg x4 in ' 03 .","problem":["cad"],"test":[],"treatment":["cabg"],"problem_indices_start":[2],"problem_indices_end":[5],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10],"treatment_indices_end":[14]}
{"text":"19. insulin glargine 100 unit \/ ml solution sig : four ( 4 ) units subcutaneous at dinner time .","problem":[],"test":[],"treatment":["insulin glargine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[20]}
{"text":"- dm with neuropathy .","problem":["neuropathy","dm"],"test":[],"treatment":[],"problem_indices_start":[2,10],"problem_indices_end":[4,20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- worsening pain or weakness in your legs , loss of bowel or bladder function or any other concerning symptoms .","problem":["loss of bowel or bladder function","any other concerning symptoms","weakness in your legs","worsening pain"],"test":[],"treatment":[],"problem_indices_start":[2,20,44,81],"problem_indices_end":[16,41,77,110],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"primary diagnosis : epidural abscess","problem":["epidural abscess"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"18. heparin lock flush ( porcine ) 100 unit \/ ml syringe sig : two ( 2 ) ml intravenous daily ( daily ) as needed : 10 ml ns followed by 2 ml of 100 units \/ ml heparin ( 200 units heparin ) each lumen daily and prn .","problem":[],"test":[],"treatment":["heparin","ns","heparin","heparin lock flush ( porcine )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4,122,160,180],"treatment_indices_end":[34,124,167,187]}
{"text":"an mri was done and this showed a signal abno in l3 l4 ? disciitis vs osteo without a definitive epidural abscess .","problem":["a signal abno in l3 l4","disciitis","osteo","a definitive epidural abscess"],"test":["an mri"],"treatment":[],"problem_indices_start":[32,57,70,84],"problem_indices_end":[54,66,75,113],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- persistent r foot ulcer","problem":["persistent r foot ulcer"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- dm with neuropathy .","problem":["dm","neuropathy"],"test":[],"treatment":[],"problem_indices_start":[2,10],"problem_indices_end":[4,20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent : clear op , mm very dry .","problem":["mm very dry"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neck : supple , no lad , no jvd","problem":["jvd","lad"],"test":[],"treatment":[],"problem_indices_start":[19,28],"problem_indices_end":[22,31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- hypercholesterolemia","problem":["hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- cad s\/p cabg x4 in ' 03 .","problem":["cad"],"test":[],"treatment":["cabg"],"problem_indices_start":[2],"problem_indices_end":[5],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10],"treatment_indices_end":[14]}
{"text":"he states he gives her one of his pensions and she helps him with medicines etc .","problem":[],"test":[],"treatment":["medicines"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[66],"treatment_indices_end":[75]}
{"text":"- colon cancer with mets to liver s\/p resection 09-07 .","problem":["colon cancer","mets to liver"],"test":[],"treatment":["resection"],"problem_indices_start":[2,20],"problem_indices_end":[14,33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[47]}
{"text":"- hypercholesterolemia","problem":["hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- colon cancer with mets to liver s\/p resection 09-07 .","problem":["colon cancer","mets to liver"],"test":[],"treatment":["resection"],"problem_indices_start":[2,20],"problem_indices_end":[14,33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[47]}
{"text":"continue to take the antibiotics as directed .","problem":[],"test":[],"treatment":["the antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17],"treatment_indices_end":[32]}
{"text":"currently pt denies sensory deficits or weakness .","problem":["weakness","sensory deficits"],"test":[],"treatment":[],"problem_indices_start":[20,40],"problem_indices_end":[36,48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"states he is not able to walk because of severe pain .","problem":["severe pain"],"test":[],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"take the pain medication as directed and do not drive while taking this medication .","problem":[],"test":[],"treatment":["the pain medication","this medication"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[5,67],"treatment_indices_end":[24,82]}
{"text":"gen : in nad , but winces in pain with movements of his back .","problem":["nad","pain"],"test":[],"treatment":[],"problem_indices_start":[9,29],"problem_indices_end":[12,33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cxr also showed small pleural effusion and attempt was made to tap it , but pt did not tolerate the procedure and asked that it be deferred .","problem":["small pleural effusion"],"test":["cxr"],"treatment":["tap","the procedure"],"problem_indices_start":[16],"problem_indices_end":[38],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[63,96],"treatment_indices_end":[66,109]}
{"text":"- persistent r foot ulcer","problem":["persistent r foot ulcer"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no bowel or bladder incontinence .","problem":["bowel or bladder incontinence"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he did undergo a ct-guided aspiration \/ biopsy at the l3-4 disc space on 2020-03-11 and the pt was transferred to mediplex rehab hospital immediately following this .","problem":[],"test":["a ct-guided aspiration \/ biopsy at the l3-4 disc space"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[15],"test_indices_end":[69],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"stable , afebrile","problem":["afebrile"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you were diagnosed with an epidural abscess .","problem":["an epidural abscess"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"states pain is worst when he sits up or twists his back .","problem":["pain"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- epidural abscess","problem":["epidural abscess"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was subsequently restared on vancomycin for corynebacterium in blood cx from fri ; followup cx has been ngtd .","problem":["corynebacterium"],"test":["followup cx","blood cx"],"treatment":["vancomycin"],"problem_indices_start":[47],"problem_indices_end":[62],"test_indices_start":[66,86],"test_indices_end":[74,97],"treatment_indices_start":[32],"treatment_indices_end":[42]}
{"text":"- chest pain or shortness of breath","problem":["chest pain","shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[2,16],"problem_indices_end":[12,35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"17. pepcid 20 mg tablet sig : one ( 1 ) tablet po once a day .","problem":[],"test":[],"treatment":["pepcid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"- fever > 102","problem":["fever"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"well healed midline scar from chest down to pubis .","problem":["well healed midline scar"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ext : no edema .","problem":["edema"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no hsm .","problem":["hsm"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ii\/vi sem at lsb with radiation to apex .","problem":["ii\/vi sem at lsb","radiation to apex"],"test":[],"treatment":[],"problem_indices_start":[0,22],"problem_indices_end":[16,39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abd : pt very tense in abdomen ( states belly is fine , but he is weary of his back ).","problem":["very tense in abdomen"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"na : 135 , k 4.5 , cl 96 , co2 27 , bun 12 , cr 0.7 , glu 167 , ca 8.4 , vanco trough 13 , wbc 5.3 , hct 32.0 , plt 330 , inr 1.0 .","problem":[],"test":["na","k","vanco trough","inr","plt","hct","ca","glu","cl","co2","wbc","bun","cr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,11,19,27,36,45,54,64,73,91,101,112,122],"test_indices_end":[2,12,21,30,39,47,57,66,85,94,104,115,125],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1 + dp pulses bl","problem":[],"test":["dp pulses"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[4],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no erythema or swelling noted .","problem":["swelling","erythema"],"test":[],"treatment":[],"problem_indices_start":[3,15],"problem_indices_end":[11,23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dressing c\/d\/i over r le ulcer .","problem":["r le ulcer"],"test":[],"treatment":["dressing"],"problem_indices_start":[20],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"chest : port a cath in r chest , no erythema or tenderness .","problem":["tenderness","erythema"],"test":[],"treatment":["port a cath in r chest"],"problem_indices_start":[36,48],"problem_indices_end":[44,58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[8],"treatment_indices_end":[30]}
{"text":"back : + ttp of lumbar spine and paraspinal muscles , r > l .","problem":["ttp of lumbar spine and paraspinal muscles"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no culture data was sent .","problem":[],"test":["culture data"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lungs : + crackles at l base > r base .","problem":["crackles at l base"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cxr ( youville hospital 2020-03-09 ): persistent unchanged l mid and lower lung field airspace disease with moderate l pleural effusion .","problem":["moderate l pleural effusion","persistent unchanged l mid and lower lung field airspace disease"],"test":["cxr"],"treatment":[],"problem_indices_start":[38,108],"problem_indices_end":[102,135],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mri lumbar spine ( youville hospital 2020-03-10 ): l3-4 osteomyelitis , discitis , and epidural abscess .","problem":["epidural abscess","discitis","l3-4 osteomyelitis"],"test":["mri lumbar spine"],"treatment":[],"problem_indices_start":[51,72,87],"problem_indices_end":[69,80,103],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"# corynebacterium bacteremia : presumably corynebacterium in epidural abscess as well .","problem":["corynebacterium bacteremia","corynebacterium","epidural abscess"],"test":[],"treatment":[],"problem_indices_start":[2,42,61],"problem_indices_end":[28,57,77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"degenerative changes including multilevel central spinal stenosis .","problem":["degenerative changes","multilevel central spinal stenosis"],"test":[],"treatment":[],"problem_indices_start":[0,31],"problem_indices_end":[20,65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was continued on iv vancomycin throughout his course and had therapeutic troughs .","problem":[],"test":["troughs"],"treatment":["iv vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[76],"test_indices_end":[83],"treatment_indices_start":[20],"treatment_indices_end":[33]}
{"text":"impression on the anterior aspect of the lower spinal cord at t11-12 by disc bulge .","problem":["disc bulge","impression on the anterior aspect of the lower spinal cord at t11-12"],"test":[],"treatment":[],"problem_indices_start":[0,72],"problem_indices_end":[68,82],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"addendum : findings are c\/w paraspinous extension of infection anteriorly and laterally into the medial aspects of the psoas muscles bilaterally at the l3 and l4 levels .","problem":["paraspinous extension of infection"],"test":[],"treatment":[],"problem_indices_start":[28],"problem_indices_end":[62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"73 yo m transferred from youville hospital with h\/o colon cancer with known liver mets now with epidural abscess and corynebacterium bacteremia :","problem":["corynebacterium bacteremia","epidural abscess","colon cancer","known liver mets"],"test":[],"treatment":[],"problem_indices_start":[52,70,96,117],"problem_indices_end":[64,86,112,143],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"# pleural effusion : the patient was noted have an effusion on cxr .","problem":["an effusion","pleural effusion"],"test":["cxr"],"treatment":[],"problem_indices_start":[2,48],"problem_indices_end":[18,59],"test_indices_start":[63],"test_indices_end":[66],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"# epidural abscess : the patient was evaluated by orthopedic spine consult service and id .","problem":["epidural abscess"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had no blood cultures to grow corynebacterium while hospitalized .","problem":["corynebacterium"],"test":["blood cultures"],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[57],"test_indices_start":[19],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please see the operation notes for details about the surgeries .","problem":[],"test":[],"treatment":["the surgeries"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49],"treatment_indices_end":[62]}
{"text":"the patient was briefly admitted to the icu for low hematocrit and hyponatremia immediately following the surgery but was then transferred back to the floor in stable condition .","problem":["low hematocrit","hyponatremia"],"test":[],"treatment":["the surgery"],"problem_indices_start":[48,67],"problem_indices_end":[62,79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[102],"treatment_indices_end":[113]}
{"text":"the patient was started on diflucan .","problem":[],"test":[],"treatment":["diflucan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[35]}
{"text":"# candidemia : the patient was noted to have a positive blood culture from 03-12 .","problem":["candidemia"],"test":["blood culture"],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[12],"test_indices_start":[56],"test_indices_end":[69],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient will also wear a back brace at all times while out of bed .","problem":[],"test":[],"treatment":["a back brace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[39]}
{"text":"a repeat ct was done showing nodular thickening along the right major and minor fissure , concerning for intrapleural tumor implants .","problem":["intrapleural tumor implants","nodular thickening"],"test":["a repeat ct"],"treatment":[],"problem_indices_start":[29,105],"problem_indices_end":[47,132],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had a picc line placed and will continue a 8 week course of antibiotics .","problem":[],"test":[],"treatment":["a picc line","a 8 week course of antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16,53],"treatment_indices_end":[27,83]}
{"text":"the tap was negative for malignant cells .","problem":["malignant cells"],"test":["the tap"],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[40],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ip was consulted and did a thoracentesis .","problem":[],"test":["a thoracentesis"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[25],"test_indices_end":[40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ophthalmology was consulted and ruled out ocular spread .","problem":["ocular spread"],"test":[],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"outpatient course and pleurodesis if the pt becomes symptomatic 02-07 fluid accumulation .","problem":["symptomatic","fluid accumulation"],"test":[],"treatment":["pleurodesis"],"problem_indices_start":[52,70],"problem_indices_end":[63,88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[33]}
{"text":"the patient 's portocath was removed .","problem":[],"test":[],"treatment":["the patient 's portocath"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"- lovenox 40 mg sc q24 for dvt ppx","problem":[],"test":[],"treatment":["lovenox"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[9]}
{"text":"- iron sulfate 300 mg po tid","problem":[],"test":[],"treatment":["iron sulfate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[14]}
{"text":"the tip was culture negative .","problem":[],"test":["culture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- procrit 40,000 units sc q friday","problem":[],"test":[],"treatment":["procrit"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[9]}
{"text":"the patient will get a total of a two week course of diflucan .","problem":[],"test":[],"treatment":["a two week course of diflucan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32],"treatment_indices_end":[61]}
{"text":"1. albuterol sulfate 0.083 % solution sig : one ( 1 ) inhalation q4h ( every 4 hours ) as needed .","problem":[],"test":[],"treatment":["albuterol sulfate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[20]}
{"text":"- morphine 2-4 mg iv q3-4 prn","problem":[],"test":[],"treatment":["morphine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[10]}
{"text":"he was also seen by spine who repeated the mri and this showed l3-4 osteomyelitis and discitis and an epidural abscess , 5cm .","problem":["discitis","an epidural abscess","l3-4 osteomyelitis"],"test":["the mri"],"treatment":[],"problem_indices_start":[63,86,99],"problem_indices_end":[81,94,118],"test_indices_start":[39],"test_indices_end":[46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ip reviewed the films and recommended continue oncologic care according to","problem":[],"test":["the films"],"treatment":["oncologic care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12],"test_indices_end":[21],"treatment_indices_start":[47],"treatment_indices_end":[61]}
{"text":"# foot ulcer : diabetic ulcer s\/p surgery but never healed .","problem":["diabetic ulcer","foot ulcer"],"test":[],"treatment":["surgery"],"problem_indices_start":[2,15],"problem_indices_end":[12,29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[41]}
{"text":"she received a 7 day course of amoxicillin for which enterococcus was sensitive but klebsiella unknown .","problem":["enterococcus","klebsiella"],"test":[],"treatment":["amoxicillin"],"problem_indices_start":[53,84],"problem_indices_end":[65,94],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31],"treatment_indices_end":[42]}
{"text":"rifaximine 200 mg tid","problem":[],"test":[],"treatment":["rifaximine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"lactulose 30 cc qid titrated to 3-4 bm \/ day","problem":[],"test":[],"treatment":["lactulose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"pt previously diagnosed with hepatorenal and was started on midodrine , octreotide and albumin ; these were","problem":["hepatorenal"],"test":[],"treatment":["octreotide","midodrine","albumin"],"problem_indices_start":[29],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[60,72,87],"treatment_indices_end":[69,82,94]}
{"text":"the hospitalisation was also significant for mild dic for which she received cryoglobulins and uti (+ enterococcus and + klebsiella ).","problem":["klebsiella","enterococcus","uti","mild dic"],"test":[],"treatment":["cryoglobulins"],"problem_indices_start":[45,95,102,121],"problem_indices_end":[53,98,114,131],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[77],"treatment_indices_end":[90]}
{"text":"her creatinine continued to increase , likely due to her worsening liver failure .","problem":["her worsening liver failure"],"test":["her creatinine"],"treatment":[],"problem_indices_start":[53],"problem_indices_end":[80],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a\/p : 48 yo morbidly obese woman with hcv cirrhosis c\/b encephalopathy , esophageal varices and partial vein thrombosis ( but no hx of sbp ) presents with increasing abdominal girth likely secondary to ascites .","problem":["sbp","hcv cirrhosis","encephalopathy","esophageal varices","partial vein thrombosis","ascites","increasing abdominal girth"],"test":[],"treatment":[],"problem_indices_start":[38,56,73,96,135,155,202],"problem_indices_end":[51,70,91,119,138,181,209],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hcv cirrhosis c\/b esophageal varices , ascites , partial portal vein thrombosis","problem":["hcv cirrhosis","esophageal varices","ascites","partial portal vein thrombosis"],"test":[],"treatment":[],"problem_indices_start":[0,18,39,49],"problem_indices_end":[13,36,46,79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"protonix 40 mg po qd","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"admitted for diagnostic \/ therapeutic paracentesis and then transferred to the icu for hypotension , confusion and anemia .","problem":["confusion","hypotension","anemia"],"test":[],"treatment":["diagnostic \/ therapeutic paracentesis"],"problem_indices_start":[87,101,115],"problem_indices_end":[98,110,121],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[50]}
{"text":"syndrome ( cr 3.3 at its worst ) which resolved prior to her discharge .","problem":["syndrome"],"test":["cr"],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[11],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"also , due to worsening renal function , she was started on octreotide \/ midodrine \/ albumin for hepatorenal","problem":["worsening renal function"],"test":[],"treatment":["midodrine","albumin","octreotide"],"problem_indices_start":[14],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[60,73,85],"treatment_indices_end":[70,82,92]}
{"text":"2. moderate ascites .","problem":["moderate ascites"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"# liver cirrhosis : meld score of 34 on admission .","problem":["liver cirrhosis"],"test":["meld score"],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[17],"test_indices_start":[20],"test_indices_end":[30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"while her discharge summary maintains that she was continued on furosemide \/ spirinolactone \/ propranolol , the patient did not receive any scripts on discharge and as a result did not take these medications .","problem":[],"test":[],"treatment":["furosemide","propranolol","spirinolactone","these medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[64,77,94,190],"treatment_indices_end":[74,91,105,207]}
{"text":"urine lytes with na of 10 indicating either pre-renal or hepatorenal .","problem":["pre-renal","hepatorenal"],"test":["na","urine lytes"],"treatment":[],"problem_indices_start":[44,57],"problem_indices_end":[53,68],"test_indices_start":[0,17],"test_indices_end":[11,19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"fluid challenge with 36gm of albumin , one unit of prbcs and 2l of ns .","problem":[],"test":["fluid challenge"],"treatment":["ns","prbcs","albumin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[29,51,67],"treatment_indices_end":[36,56,69]}
{"text":"her mental status also had decreased from admission and her urine output was minimal , 225cc over the past 12 hours .","problem":["decreased","minimal"],"test":["her urine output"],"treatment":[],"problem_indices_start":[27,77],"problem_indices_end":[36,84],"test_indices_start":[56],"test_indices_end":[72],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"temp noted to be low at 94 and she was placed on bear hugger which improved temp to 96.7 .","problem":["low"],"test":["temp","temp"],"treatment":["bear hugger"],"problem_indices_start":[17],"problem_indices_end":[20],"test_indices_start":[0,76],"test_indices_end":[4,80],"treatment_indices_start":[49],"treatment_indices_end":[60]}
{"text":"will check creatinine this afternoon .","problem":[],"test":["creatinine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was recently hospitalised from 02-23 \/ 03-04 for abdominal discomfort at which time she underwent paracentesis that ruled out sbp and relieved her abdominal pain .","problem":["sbp","her abdominal pain","abdominal discomfort"],"test":[],"treatment":["paracentesis"],"problem_indices_start":[53,130,147],"problem_indices_end":[73,133,165],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[102],"treatment_indices_end":[114]}
{"text":"creatinine this am was 1.9 from 0.9 yesterday .","problem":[],"test":["creatinine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was placed on pressors to maintain a map > 55 .","problem":[],"test":["a map"],"treatment":["pressors"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[39],"test_indices_end":[44],"treatment_indices_start":[18],"treatment_indices_end":[26]}
{"text":"she received 2 units of plts and 1 unit of prbc s.","problem":[],"test":[],"treatment":["plts","prbc s."],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24,43],"treatment_indices_end":[28,50]}
{"text":"in the am , she was found to have a hct of 24 , down from 32 and plts 35 , down from 72 .","problem":[],"test":["a hct","plts"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[34,65],"test_indices_end":[39,69],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her bp was then noted to be decreased at 80\/40 which improved mildly to 90\/30 with 1.5l of ns .","problem":["decreased"],"test":["her bp"],"treatment":["ns"],"problem_indices_start":[28],"problem_indices_end":[37],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[91],"treatment_indices_end":[93]}
{"text":"once the decision was made to withdraw care , the pressors were discontinued .","problem":[],"test":[],"treatment":["the pressors"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[46],"treatment_indices_end":[58]}
{"text":"# anemia : hct dropped following the tap and there was concern for bleed into her abdomen .","problem":["bleed into her abdomen","hct dropped","anemia"],"test":[],"treatment":["the tap"],"problem_indices_start":[2,11,67],"problem_indices_end":[8,22,89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[33],"treatment_indices_end":[40]}
{"text":"she received 36gm of albumin following the tap .","problem":[],"test":[],"treatment":["albumin","the tap"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21,39],"treatment_indices_end":[28,46]}
{"text":"she received one unit of prbc s.","problem":[],"test":[],"treatment":["prbc s."],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25],"treatment_indices_end":[32]}
{"text":"she then had 6l of non-bloody ascitic fluid removed without complication .","problem":["complication","non-bloody ascitic fluid"],"test":[],"treatment":[],"problem_indices_start":[19,60],"problem_indices_end":[43,72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her bp on admission was 120\/70 and remained stable following the tap .","problem":[],"test":["her bp"],"treatment":["the tap"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[61],"treatment_indices_end":[68]}
{"text":"ct of the abdomen and pelvis showed no evidence of bleed .","problem":["bleed"],"test":["ct of the abdomen and pelvis"],"treatment":[],"problem_indices_start":[51],"problem_indices_end":[56],"test_indices_start":[0],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"over the next several hours , pt complained of abd pain but this resolved on its own without medication .","problem":["abd pain"],"test":[],"treatment":["medication"],"problem_indices_start":[47],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[93],"treatment_indices_end":[103]}
{"text":"her hematocrit remained stable at 24-26 following the acute drop.","problem":["the acute drop."],"test":["her hematocrit"],"treatment":[],"problem_indices_start":[50],"problem_indices_end":[65],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"# arf : creatinine has increased from 0.9 on admission to 1.9 on admission to icu .","problem":["arf"],"test":["creatinine"],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[5],"test_indices_start":[8],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she denied abd pain , fevers , chills .","problem":["abd pain","chills","fevers"],"test":[],"treatment":[],"problem_indices_start":[11,22,31],"problem_indices_end":[19,28,37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was admitted for a large volume paracentesis but her inr on admission was 3.8 .","problem":[],"test":["her inr"],"treatment":["a large volume paracentesis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[53],"test_indices_end":[60],"treatment_indices_start":[21],"treatment_indices_end":[48]}
{"text":"she received 4units of ffp which decreased her inr to 2.2 and then 2 more units during the tap .","problem":[],"test":["her inr"],"treatment":["ffp","the tap"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[43],"test_indices_end":[50],"treatment_indices_start":[23,87],"treatment_indices_end":[26,94]}
{"text":"# recurrent ascites : on the medical floor , pt had a large volume paracentesis ( 6 liters ) followed by replacement with albumin .","problem":["recurrent ascites"],"test":[],"treatment":["replacement with albumin","a large volume paracentesis"],"problem_indices_start":[2],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[52,105],"treatment_indices_end":[79,129]}
{"text":"she also described sob , nausea , worsening lower ext edema .","problem":["worsening lower ext edema","sob","nausea"],"test":[],"treatment":[],"problem_indices_start":[19,25,34],"problem_indices_end":[22,31,59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"# hypotension : pt became hypotensive following the large volume paracentesis despite replacement with albumin .","problem":["hypotensive","hypotension"],"test":[],"treatment":["the large volume paracentesis","replacement with albumin"],"problem_indices_start":[2,26],"problem_indices_end":[13,37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48,86],"treatment_indices_end":[77,110]}
{"text":"this was thought to be 04-09 the large volume tap verses sepsis though she had no other evidence of sepsis .","problem":["sepsis","sepsis"],"test":[],"treatment":["the large volume tap"],"problem_indices_start":[57,100],"problem_indices_end":[63,106],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[49]}
{"text":"47 female with h\/o hcv cirrhosis compocated by encephalopathy , ascites , and h\/o portal vein thrombosis ( right anterior portal vein ) and portalcaval shunt ( reversed flow in main portal vein ) presents from liver clinic with increasing abdominal girth .","problem":["portal vein thrombosis","encephalopathy","hcv cirrhosis","ascites","increasing abdominal girth"],"test":[],"treatment":["portalcaval shunt"],"problem_indices_start":[19,47,64,82,228],"problem_indices_end":[32,61,71,104,254],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[140],"treatment_indices_end":[157]}
{"text":"2015-03-26 10:10 am blood pt - 23.0 * ptt - 63.2 * inr(pt) - 3.8","problem":[],"test":["blood","inr(pt)","ptt","pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,38,51],"test_indices_end":[25,28,41,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-03-26 10:10 am blood glucose - 76 urean - 17 creat - 0.8 na - 129 * k - 3.9 cl - 101 hco3 - 19 * angap - 13","problem":[],"test":["creat","urean","glucose","blood","na","k","hco3","angap","cl"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,39,50,62,73,81,90,102],"test_indices_end":[25,33,44,55,64,74,83,94,107],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-03-26 10:10 am blood alt - 33 ast - 65 * alkphos - 70 totbili - 30.3 * dirbili - 20.8 * indbili - 9.5","problem":[],"test":["blood","alt","dirbili","ast","indbili","totbili","alkphos"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,35,46,59,76,93],"test_indices_end":[25,29,38,53,66,83,100],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-03-26 10:10 am blood neuts - 68.3 bands - 0 lymphs - 19.8 monos - 10.6 eos - 1.1 baso - 0.2","problem":[],"test":["blood","baso","eos","monos","lymphs","bands","neuts"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,39,49,63,76,86],"test_indices_end":[25,31,44,55,68,79,90],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-03-26 10:10 am blood wbc - 8.1 rbc - 3.69 * hgb - 11.0 * hct - 32.4 * mcv - 88 mch - 29.8 mchc - 33.9 rdw - 26.0 * plt ct - 72 *#","problem":[],"test":["blood","mcv","wbc","rbc","mchc","rdw","plt ct","hgb","hct","mch"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,36,49,62,75,84,95,107,120],"test_indices_end":[25,29,39,52,65,78,87,99,110,126],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"paracentesis","problem":[],"test":[],"treatment":["paracentesis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"2015-03-26 10:10 am blood hypochr - 1 + anisocy - 2 + poiklo - 2 + macrocy - 2 + microcy - normal polychr - normal ovalocy - occasional target - occasional schisto - occasional tear dr clark","problem":[],"test":["target","blood","microcy","macrocy","ovalocy","polychr","poiklo","anisocy","hypochr","schisto"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,40,54,67,81,98,115,136,156],"test_indices_end":[25,33,47,60,74,88,105,122,142,163],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4u ffp","problem":[],"test":[],"treatment":["4u ffp"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"3. cholelithiasis without evidence of acute cholecystitis .","problem":["acute cholecystitis","cholelithiasis"],"test":[],"treatment":[],"problem_indices_start":[3,38],"problem_indices_end":[17,57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"increasing abdominal girth","problem":["increasing abdominal girth"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"decision was made by the family and the medical team to withdraw care .","problem":[],"test":[],"treatment":["care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[65],"treatment_indices_end":[69]}
{"text":"1. small cirrhotic liver with what appears to be a portocaval shunt .","problem":["small cirrhotic liver"],"test":[],"treatment":["a portocaval shunt"],"problem_indices_start":[3],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49],"treatment_indices_end":[67]}
{"text":"morphine \/ histamine h2 inhibitors \/ heparin agents","problem":[],"test":[],"treatment":["heparin agents","morphine","histamine h2 inhibitors"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,11,37],"treatment_indices_end":[8,34,51]}
{"text":"2015-03-26 10:10 am blood ammonia - 39","problem":[],"test":["ammonia","blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26],"test_indices_end":[25,33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no thrush .","problem":["thrush"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-03-26 10:10 am blood albumin - 3.1 *","problem":[],"test":["blood","albumin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26],"test_indices_end":[25,33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after it was explained that the pt 's prognosis was very poor given that she was not a transplant candidate , the","problem":["the pt 's prognosis"],"test":[],"treatment":["a transplant"],"problem_indices_start":[28],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[85],"treatment_indices_end":[97]}
{"text":"cardiac : rrr , no murmurs","problem":["murmurs"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen : obese , soft , mildly distended dull to percussion throughout , no tenderness , liver non-palpable due to large volume of ascited","problem":["mildly distended","obese","large volume of ascited","tenderness","liver non-palpable","dull"],"test":["percussion"],"treatment":[],"problem_indices_start":[10,25,42,77,90,116],"problem_indices_end":[15,41,46,87,108,139],"test_indices_start":[50],"test_indices_end":[60],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"morbid obesity","problem":["morbid obesity"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she also underwent us that revealed patent portal and hepatic vessels .","problem":[],"test":["us"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"expired","problem":["expired"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt became more encephalopathic during her hospital course .","problem":["more encephalopathic"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extremities : 05-09 + pretibial edema extending above knee r > l , no asterixis .","problem":["pretibial edema","asterixis"],"test":[],"treatment":[],"problem_indices_start":[22,70],"problem_indices_end":[37,79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no palmar erythema","problem":["palmar erythema"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was not a transplant candidate due to her obesity .","problem":["her obesity"],"test":[],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had no evidence of sbp .","problem":["sbp"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. no hydronephrosis .","problem":["hydronephrosis"],"test":[],"treatment":[],"problem_indices_start":[6],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. borderline splenomegaly .","problem":["borderline splenomegaly"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sickle cell trait","problem":["sickle cell trait"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"physical exam : t 95 , bp 120\/70 , hr 82 , rr 20 , 96% ra wt 301.6 lb","problem":[],"test":["hr","t","rr","bp","wt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16,23,35,43,58],"test_indices_end":[17,25,37,45,60],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"recent cholecystitis 08-10","problem":["cholecystitis"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"h\/o gastritis","problem":["gastritis"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent : + scleral icterus .","problem":["scleral icterus"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she began enteral feeds on day of life #2 advancing to mother 's breastmilk 30 with promod at 150 cc \/ kg \/ day .","problem":[],"test":[],"treatment":["enteral feeds","promod"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10,84],"treatment_indices_end":[23,90]}
{"text":"6. immunizations recommended -","problem":[],"test":[],"treatment":["immunizations"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"lungs : breath sounds clear and equal bilaterally , no retractions .","problem":["retractions"],"test":["breath sounds"],"treatment":[],"problem_indices_start":[55],"problem_indices_end":[66],"test_indices_start":[8],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. tuberculosis , mother was treated in 2001 according to chart with subsequent negative chest x-ray , and","problem":["tuberculosis"],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[89],"test_indices_end":[100],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"synagis respiratory syncytial virus prophylaxis should be considered from october through april for infants who meet","problem":[],"test":[],"treatment":["synagis respiratory syncytial virus prophylaxis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[47]}
{"text":"heart : regular rate and rhythm , no murmur , normal s1 and s2 , pulses 2 +.","problem":["murmur"],"test":["pulses"],"treatment":[],"problem_indices_start":[37],"problem_indices_end":[43],"test_indices_start":[65],"test_indices_end":[71],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was initially started on d10 \/ w at 80 cc \/ kg \/ day .","problem":[],"test":[],"treatment":["d10 \/ w"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37],"treatment_indices_end":[44]}
{"text":"the patient had a weight of 1400 gm , length 41.5 cm and head circumference of 29.25 cm .","problem":[],"test":["head circumference","a weight","length"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16,38,57],"test_indices_end":[24,44,75],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"thickening consistent with trisomy 21 in the b co-twin .","problem":["trisomy 21","thickening"],"test":[],"treatment":[],"problem_indices_start":[0,27],"problem_indices_end":[10,37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. with chronic lung disease .","problem":["chronic lung disease"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. cardiovascular - the patient has been cardiovascularly stable without murmur .","problem":["murmur"],"test":[],"treatment":[],"problem_indices_start":[73],"problem_indices_end":[79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after some debate , we concluded that vetrano was not at unusually high risk from rsv , but that her sister might be .","problem":["rsv"],"test":[],"treatment":[],"problem_indices_start":[82],"problem_indices_end":[85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"baby received parenteral nutrition and lipids for four days .","problem":[],"test":[],"treatment":["lipids","parenteral nutrition"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14,39],"treatment_indices_end":[34,45]}
{"text":"abdomen : soft , nondistended .","problem":["nondistended"],"test":[],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the pregnancy was complicated by twin gestation and by polyhydramnios with apparent duodenal atresia and nuchal","problem":["duodenal atresia","polyhydramnios","twin gestation"],"test":[],"treatment":[],"problem_indices_start":[33,55,84],"problem_indices_end":[47,69,100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vetrano probably does not need synagis at least until her sibling is discharged from the hospital .","problem":[],"test":[],"treatment":["synagis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31],"treatment_indices_end":[38]}
{"text":"without hepatosplenomegaly , without masses .","problem":["masses","hepatosplenomegaly"],"test":[],"treatment":[],"problem_indices_start":[8,37],"problem_indices_end":[26,43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"influenza immunization should be considered annually in the fall for preterm infants with chronic lung disease once they","problem":["chronic lung disease"],"test":[],"treatment":["influenza immunization"],"problem_indices_start":[90],"problem_indices_end":[110],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[22]}
{"text":"the baby received no blood products .","problem":[],"test":[],"treatment":["blood products"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[35]}
{"text":"2. medications - poly-vi-james 1 cc p.o. q. day ; iron or fer-in-james 0.2 cc p.o. q. day to give 2 mg \/ kg \/ day","problem":[],"test":[],"treatment":["fer-in-james","medications","iron","poly-vi-james"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,17,50,58],"treatment_indices_end":[14,30,54,70]}
{"text":"group b streptococcus status unknown .","problem":[],"test":["group b streptococcus status"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no fever , no fetal tachycardia , rupture of membranes at delivery .","problem":["fetal tachycardia","fever","rupture of membranes"],"test":[],"treatment":[],"problem_indices_start":[3,14,34],"problem_indices_end":[8,31,54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sepsis risk factors :","problem":["sepsis risk factors"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"anterior fontanelle , soft and flat , palate intact , nondysmorphic features .","problem":["nondysmorphic features"],"test":[],"treatment":[],"problem_indices_start":[54],"problem_indices_end":[76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rebound bilirubin 6.4 .","problem":[],"test":["rebound bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. car seat screening - passed .","problem":[],"test":["car seat screening"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. gastrointestinal , genitourinary - peak bilirubin 8.5 , phototherapy times 24 hours .","problem":[],"test":["peak bilirubin"],"treatment":["phototherapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[38],"test_indices_end":[52],"treatment_indices_start":[59],"treatment_indices_end":[71]}
{"text":"4. state newborn screening - last on 2009-01-07 , all within normal range .","problem":[],"test":["state newborn screening"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. immunizations received - hepatitis b vaccine given 2009-01-22 .","problem":[],"test":[],"treatment":["immunizations","hepatitis b vaccine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,28],"treatment_indices_end":[16,47]}
{"text":"initial complete blood count with white blood cell count 14 , hemoglobin 21.6 , hematocrit 62.9 , 65 neutrophils , no bands , 28 lymphocytes .","problem":[],"test":["initial complete blood count","white blood cell count","hematocrit","hemoglobin","lymphocytes","neutrophils","bands"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,34,62,80,101,118,129],"test_indices_end":[28,56,72,90,112,123,140],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"well-appearing female without distress on admission to the newborn intensive care unit .","problem":["distress"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. hematology - most recent hematocrit was 42.8 on 50-05-25 .","problem":[],"test":["hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[28],"test_indices_end":[38],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. feeds - breastfeeding ad lib , supplementing with enfamil 24 or breastmilk 24 cal \/ oz made with 1 tsp of enfamil powder per 100 cc of breastmilk .","problem":[],"test":[],"treatment":["enfamil","enfamil powder"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[53,109],"treatment_indices_end":[60,123]}
{"text":"maternal hypertension was noted in the doctor 's office and mom was referred to nonreassuring fetal tracing , necessitating an urgent cesarean section .","problem":["maternal hypertension"],"test":["nonreassuring fetal tracing"],"treatment":["an urgent cesarean section"],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[80],"test_indices_end":[107],"treatment_indices_start":[124],"treatment_indices_end":[150]}
{"text":"6. infectious disease - no sepsis risk factors .","problem":["sepsis risk factors"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"apgars were 8 at one minute and 8 at five minutes .","problem":[],"test":["apgars"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"twin #1 cried spontaneously at birth , was bulb suctioned and received blow-by oxygen .","problem":[],"test":[],"treatment":["blow-by oxygen","bulb suctioned"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[43,71],"treatment_indices_end":[57,85]}
{"text":"a follow up examination is recommended in six to eight months .","problem":[],"test":["a follow up examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. fluids , electrolytes and nutrition - birthweight was 1400 gm , 25th percentile .","problem":[],"test":["birthweight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[41],"test_indices_end":[52],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"twin #1 was noted to be in a breech presentation .","problem":["a breech presentation"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"baby is presently tolerating mother 's breastmilk with enfamil powder to make 24 cal \/ oz at 130 cc \/ kg \/ day .","problem":[],"test":[],"treatment":["enfamil powder"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[55],"treatment_indices_end":[69]}
{"text":"breath sounds , clear and equal , without retractions , respiratory rate 30 s to 60 s.","problem":["retractions"],"test":["breath sounds","respiratory rate"],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[53],"test_indices_start":[0,56],"test_indices_end":[13,72],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"amniocentesis was not performed .","problem":[],"test":["amniocentesis"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. sensory - audiology , hearing screening was performed with automated auditory brain stem responses .","problem":[],"test":["hearing screening"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[25],"test_indices_end":[42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on day of life #1 , caffeine was started .","problem":[],"test":[],"treatment":["caffeine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[28]}
{"text":"reach six months of age , before this age the family and other caregivers should be considered for immunization against","problem":[],"test":[],"treatment":["immunization"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[99],"treatment_indices_end":[111]}
{"text":"blood cultures negative .","problem":[],"test":["blood cultures"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"positive suck , positive grasp .","problem":[],"test":["suck","grasp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[9,25],"test_indices_end":[13,30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. respiratory - gerardo was initially placed in nasal cannula oxygen to maintain oxygen saturation greater than 94 .","problem":[],"test":["oxygen saturation"],"treatment":["nasal cannula oxygen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[82],"test_indices_end":[99],"treatment_indices_start":[49],"treatment_indices_end":[69]}
{"text":"influenza to protect the infant .","problem":["influenza"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"baby passed hearing test on 2009-01-21 .","problem":[],"test":["hearing test"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"maternal blood type 0-positive , dat negative , negative , rpr nonreactive .","problem":[],"test":["maternal blood type","dat","rpr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,33,59],"test_indices_end":[19,36,62],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no hypoglycemia issues noted .","problem":["hypoglycemia issues"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. prematurity , former 32 4\/7 weeks , twin #1","problem":["prematurity"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. infertility .","problem":["infertility"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"caffeine was discontinued on day of life #19 .","problem":[],"test":[],"treatment":["caffeine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"2. rule out sepsis","problem":["sepsis"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was also to obtain a second opinion regarding the question of possible surgical management .","problem":[],"test":[],"treatment":["surgical management"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[75],"treatment_indices_end":[94]}
{"text":"her abdomen was notable for voluntary guarding but no involuntary guarding or rebound , mild right lower quadrant tenderness greater than left lower quadrant , nondistended .","problem":["involuntary guarding","nondistended","mild right lower quadrant tenderness","rebound","voluntary guarding"],"test":[],"treatment":[],"problem_indices_start":[28,54,78,88,160],"problem_indices_end":[46,74,85,124,172],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was continued on her antibiotics , and was afebrile until hospital day number five , when she had a temperature spike to 102.3 .","problem":["a temperature spike","afebrile"],"test":[],"treatment":["her antibiotics"],"problem_indices_start":[47,102],"problem_indices_end":[55,121],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[36]}
{"text":"this is a 49-year-old gravida iii , para ii , status post uterine artery embolization on 2009-01-07 due to uterine fibroids , with continued abdominal pain and ct scan revealing fluid and gas in the endometrial cavity .","problem":["continued abdominal pain","fluid and gas in the endometrial cavity","uterine fibroids"],"test":["ct scan"],"treatment":["status post uterine artery embolization"],"problem_indices_start":[107,131,178],"problem_indices_end":[123,155,217],"test_indices_start":[160],"test_indices_end":[167],"treatment_indices_start":[46],"treatment_indices_end":[85]}
{"text":"temperature 100.4 , pulse 108 , respirations 20 , blood pressure 110\/70 , oxygen saturation 100% on room air .","problem":[],"test":["pulse","temperature","oxygen saturation","respirations","blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,20,32,50,74],"test_indices_end":[11,25,44,64,91],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient requested an outside second opinion , as she was reluctant to undergo hysterectomy at this time .","problem":[],"test":[],"treatment":["hysterectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[82],"treatment_indices_end":[94]}
{"text":"her sedimentation rate was elevated at 110 .","problem":["elevated"],"test":["her sedimentation rate"],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[35],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has had continuing vaginal discharge , and was diagnosed with bacterial vaginosis one day prior to admission , and was given a prescription for flagyl .","problem":["continuing vaginal discharge","bacterial vaginosis"],"test":[],"treatment":["flagyl"],"problem_indices_start":[12,66],"problem_indices_end":[40,85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[148],"treatment_indices_end":[154]}
{"text":"the patient was to have a repeat ct scan in one week .","problem":[],"test":["a repeat ct scan"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24],"test_indices_end":[40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"possible drainage of the abscess vs. hysterectomy .","problem":["the abscess"],"test":[],"treatment":["hysterectomy","drainage"],"problem_indices_start":[21],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9,37],"treatment_indices_end":[17,49]}
{"text":"she also complained of some loose stools on the day of admission , no nausea or vomiting .","problem":["vomiting","nausea","some loose stools"],"test":[],"treatment":[],"problem_indices_start":[23,70,80],"problem_indices_end":[40,76,88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"discussion was had at this time with the patient regarding whether or not this represented an infected abscess vs. post-surgical change .","problem":["post-surgical change","an infected abscess"],"test":[],"treatment":[],"problem_indices_start":[91,115],"problem_indices_end":[110,135],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was discharged to home on hospital day number eight , on oral antibiotics .","problem":[],"test":[],"treatment":["oral antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61],"treatment_indices_end":[77]}
{"text":"the patient was admitted and was initially started on intravenous ampicillin , gentamicin and clindamycin .","problem":[],"test":[],"treatment":["intravenous ampicillin","gentamicin","clindamycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[54,79,94],"treatment_indices_end":[76,89,105]}
{"text":"she went to her primary care physician 's office on the day of admission complaining of abdominal pain , which she stated was constant but intermittently sharper at times .","problem":["abdominal pain"],"test":[],"treatment":[],"problem_indices_start":[88],"problem_indices_end":[102],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"history of herpes simplex virus , last outbreak in 2000 .","problem":["herpes simplex virus"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her temperature was 100.4 in the office , and she had no chills .","problem":["chills"],"test":["her temperature"],"treatment":[],"problem_indices_start":[57],"problem_indices_end":[63],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on hospital day number three , her blood cultures came back positive in the anaerobic culture for gram-positive cocci in pairs and clusters .","problem":["gram-positive cocci in pairs and clusters","positive"],"test":["her blood cultures","the anaerobic culture"],"treatment":[],"problem_indices_start":[60,98],"problem_indices_end":[68,139],"test_indices_start":[31,72],"test_indices_end":[49,93],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dilatation and curettage x 1 for sab .","problem":["sab"],"test":[],"treatment":["dilatation and curettage"],"problem_indices_start":[33],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"at this time , an infectious disease consult was obtained , and the recommendation was to discontinue the ampicillin , gentamicin and clindamycin , and start her on intravenous unasyn .","problem":[],"test":[],"treatment":["the ampicillin","gentamicin","clindamycin","intravenous unasyn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[102,119,134,165],"treatment_indices_end":[116,129,145,183]}
{"text":"her electrolytes were within normal limits .","problem":[],"test":["her electrolytes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"some spotting on the day prior to admission , but not a normal period .","problem":["some spotting"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cesarean section x 2 , dilatation and curettage x 1 , neck fusion after motor vehicle accident , shoulder surgery after motor vehicle accident .","problem":[],"test":[],"treatment":["shoulder surgery","cesarean section","neck fusion","dilatation and curettage"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,23,54,97],"treatment_indices_end":[16,47,65,113]}
{"text":"her white blood cell count was 12.8 , with a normal differential .","problem":[],"test":["her white blood cell count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her initial white blood cell count was 11.3 , with a normal differential .","problem":[],"test":["her initial white blood cell count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cesarean section x 2 , spontaneous abortion x 1 .","problem":["spontaneous abortion"],"test":[],"treatment":["cesarean section"],"problem_indices_start":[23],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"repeat blood cultures were sent .","problem":[],"test":["repeat blood cultures"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she noted increasing abdominal pain two days prior to admission , which became more severe on the day prior to admission .","problem":["increasing abdominal pain"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was sent for a ct scan of her abdomen , which revealed fluid and question of gas in the endometrial cavity , and she was sent to pinewood , norfolk for treatment and admission .","problem":["fluid","gas in the endometrial cavity"],"test":["a ct scan of her abdomen"],"treatment":["treatment","admission"],"problem_indices_start":[59,81],"problem_indices_end":[64,110],"test_indices_start":[17],"test_indices_end":[41],"treatment_indices_start":[156,170],"treatment_indices_end":[165,179]}
{"text":"fibroid uterus status post embolization on 2009-01-07 .","problem":["fibroid uterus"],"test":[],"treatment":["embolization"],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[39]}
{"text":"further identification revealed staphylococcus coag-negative , which was sensitive to gentamicin and clindamycin .","problem":["staphylococcus coag-negative"],"test":["further identification"],"treatment":["clindamycin","gentamicin"],"problem_indices_start":[32],"problem_indices_end":[60],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[86,101],"treatment_indices_end":[96,112]}
{"text":"lupron x three months prior to embolization .","problem":[],"test":[],"treatment":["lupron","embolization"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,31],"treatment_indices_end":[6,43]}
{"text":"she was maintained on intravenous antibiotics .","problem":[],"test":[],"treatment":["intravenous antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[45]}
{"text":"her uterus and adnexa were difficult to assess secondary to voluntary tensing of her abdomen .","problem":["voluntary tensing of her abdomen"],"test":[],"treatment":[],"problem_indices_start":[60],"problem_indices_end":[92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"flagyl .","problem":[],"test":[],"treatment":["flagyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"she underwent a pelvic ultrasound and an abdomen and pelvis ct , which revealed continued air in the endometrial cavity vs. in the fundal fibroid .","problem":["continued air in the endometrial cavity","the fundal fibroid"],"test":["an abdomen and pelvis ct","a pelvic ultrasound"],"treatment":[],"problem_indices_start":[80,127],"problem_indices_end":[119,145],"test_indices_start":[14,38],"test_indices_end":[33,62],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her pelvic examination was notable for some brownish discharge .","problem":["some brownish discharge"],"test":["her pelvic examination"],"treatment":[],"problem_indices_start":[39],"problem_indices_end":[62],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is a 49-year-old gravida iii , para ii , who was sent from her primary care physician 's office secondary to lower abdominal pain .","problem":["lower abdominal pain"],"test":[],"treatment":[],"problem_indices_start":[121],"problem_indices_end":[141],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is status post uterine artery embolization on 2009-01-07 secondary to fibroids .","problem":["fibroids"],"test":[],"treatment":["uterine artery embolization"],"problem_indices_start":[82],"problem_indices_end":[90],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[54]}
{"text":"no history of abnormal pap smears .","problem":["abnormal pap smears"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in general , she was in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please give patient medications as prescribed and read warning labels carefully .","problem":[],"test":[],"treatment":["medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[31]}
{"text":"if signs and symptoms of infection , such as fevers \/ chills , purulent discharge from wound \/ incision site , increased redness , increased pain , please call or go to the emergency room .","problem":["increased redness","infection","fevers","chills","increased pain","purulent discharge from wound \/ incision site","signs and symptoms"],"test":[],"treatment":[],"problem_indices_start":[3,25,45,54,63,111,131],"problem_indices_end":[21,34,51,60,108,128,145],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"stage 2 of the surgery will be done in 3 weeks .","problem":[],"test":[],"treatment":["the surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[11],"treatment_indices_end":[22]}
{"text":"trazodone \/ ambien \/ sinequan","problem":[],"test":[],"treatment":["trazodone","ambien","sinequan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,12,21],"treatment_indices_end":[9,18,29]}
{"text":"7. atorvastatin 10 mg tablet sig : one ( 1 ) tablet po hs ( at bedtime ).","problem":[],"test":[],"treatment":["atorvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"6. divalproex sodium oral","problem":[],"test":[],"treatment":["divalproex sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[20]}
{"text":"please clean incision site with normal saline or clean water three times a day and place antibiotic ointment ( given ) on top of wound .","problem":["wound","incision site"],"test":[],"treatment":["antibiotic ointment","normal saline"],"problem_indices_start":[13,129],"problem_indices_end":[26,134],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32,89],"treatment_indices_end":[45,108]}
{"text":"1. paroxetine hcl 10 mg tablet sig : one ( 1 ) tablet po am ().","problem":[],"test":[],"treatment":["paroxetine hcl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[17]}
{"text":"8. oxybutynin chloride 5 mg tablet sig : one ( 1 ) tablet po qpm ( once a day ( in the evening )).","problem":[],"test":[],"treatment":["oxybutynin chloride"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"10. bacitracin-polymyxin-neosp hc ointment sig : one ( 1 ) topical three times a day .","problem":[],"test":[],"treatment":["bacitracin-polymyxin-neosp hc ointment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[42]}
{"text":"most importantly , the patient must be watch one-on-one so that she does not pick at her wound .","problem":["her wound"],"test":[],"treatment":[],"problem_indices_start":[85],"problem_indices_end":[94],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right nose \/ ala reconstruction using right cheek advancement and forehead local flap","problem":[],"test":[],"treatment":["right cheek advancement","forehead local flap","right nose \/ ala reconstruction"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,38,66],"treatment_indices_end":[31,61,85]}
{"text":"extremities : no edema , cyanosis , full range of motion","problem":["cyanosis","edema"],"test":[],"treatment":[],"problem_indices_start":[17,25],"problem_indices_end":[22,33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gen : no acute distress , able to communicate and follow orders","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she went to surgery the next morning and tolerated the surgery well .","problem":[],"test":[],"treatment":["the surgery","surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12,51],"treatment_indices_end":[19,62]}
{"text":"bipolar disorder","problem":["bipolar disorder"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"acquired defect from basal cell carcinoma resection","problem":["acquired defect"],"test":[],"treatment":["basal cell carcinoma resection"],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[51]}
{"text":"on presentation , pt was afebrile with normal vital signs","problem":["afebrile"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mental retardation","problem":["mental retardation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lungs : clear to asculation","problem":[],"test":["asculation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ms. marshall is a 64-year old , mentally retarded , female who presented with an aquired defect of the right nasal ala and medial cheek region after basal cell carcinoma was resected by dermatology .","problem":["an aquired defect of the right nasal ala and medial cheek region","basal cell carcinoma","mentally retarded"],"test":[],"treatment":[],"problem_indices_start":[32,78,149],"problem_indices_end":[49,142,169],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , she was slow to awake from anesthesia , and was admitted to the cmed ccu observation .","problem":[],"test":["observation"],"treatment":["anesthesia"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[83],"test_indices_end":[94],"treatment_indices_start":[37],"treatment_indices_end":[47]}
{"text":"upon admission , the patient was pre-op 'd and made npo \/ ivf .","problem":[],"test":[],"treatment":["npo","ivf"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[52,58],"treatment_indices_end":[55,61]}
{"text":"abdomen : soft , non-tender , non-distended","problem":["non-tender","non-distended"],"test":[],"treatment":[],"problem_indices_start":[17,30],"problem_indices_end":[27,43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"diabetes","problem":["diabetes"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head and neck : 5 cm circular full thickness defect at the junction of the right ala and cheek","problem":["5 cm circular full thickness defect"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. divalproex sodium 500 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po qam ( once a day ( in the morning )).","problem":[],"test":[],"treatment":["divalproex sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[20]}
{"text":"2. multivitamin capsule sig : one ( 1 ) cap po qam ( once a day ( in the morning )).","problem":[],"test":[],"treatment":["multivitamin capsule"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[23]}
{"text":"stage two of her surgery will be done in 3 weeks .","problem":[],"test":[],"treatment":["her surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[24]}
{"text":"aquired deformity of the right ala \/ nose and medial cheek from basal cell carcinoma resection","problem":["aquired deformity of the right ala \/ nose and medial cheek"],"test":[],"treatment":["basal cell carcinoma resection"],"problem_indices_start":[0],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[64],"treatment_indices_end":[94]}
{"text":"9. hydrocodone-acetaminophen 5-500 mg tablet sig : 1-2 tablets po q4h ( every 4 hours ).","problem":[],"test":[],"treatment":["hydrocodone-acetaminophen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[28]}
{"text":"she will be discharged today back to her nursing home in good condition , on pain meds , antibiotics , and with anticipated 1:1 watch .","problem":[],"test":[],"treatment":["pain meds","antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[77,89],"treatment_indices_end":[86,100]}
{"text":"4. docusate sodium 100 mg capsule sig : one ( 1 ) capsule po bid ( 2 times a day ) as needed : constipation .","problem":["constipation"],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[95],"problem_indices_end":[107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"her wound has remaind dry and closed , without evidence of infection or breakdown .","problem":["her wound","infection","breakdown"],"test":[],"treatment":[],"problem_indices_start":[0,59,72],"problem_indices_end":[9,68,81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was transfered to the floor post-op day 2 where she had been afebrile with normal vitals , making good urine , and tolerating a regular diet .","problem":["afebrile"],"test":[],"treatment":[],"problem_indices_start":[65],"problem_indices_end":[73],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. triamcinolone acetonide 0.1 % cream sig : one ( 1 ) appl topical bid ( 2 times a day ).","problem":[],"test":[],"treatment":["triamcinolone acetonide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[26]}
{"text":"95 yo f with mmp who sustained a mechanical fall down stairs resulting in a hip and arm fracture .","problem":["mmp","a hip and arm fracture","a mechanical fall"],"test":[],"treatment":[],"problem_indices_start":[13,31,74],"problem_indices_end":[16,48,96],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct of the abdomen without iv contrast : there are bilateral pleural effusions , right greater the left ; there is compressive atelectasis at the left lung base .","problem":["bilateral pleural effusions","compressive atelectasis at the left lung base"],"test":["ct of the abdomen without iv contrast"],"treatment":[],"problem_indices_start":[50,114],"problem_indices_end":[77,159],"test_indices_start":[0],"test_indices_end":[37],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neither iv nor oral contrast were used .","problem":[],"test":["iv nor oral contrast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[8],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"technique : a multidetector scanner was used to obtain contiguous axial images from the lung bases to the pubic symphysis .","problem":[],"test":["contiguous axial images"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[55],"test_indices_end":[78],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lipid \/ cholesterol triglyc hdl chol\/hd ldlcalc","problem":[],"test":["chol\/hd","hdl","ldlcalc","triglyc","cholesterol","lipid"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,8,20,28,32,40],"test_indices_end":[5,19,27,31,39,47],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"indication : 94-year-old woman with mental status changes , now with abdominal pain and hypertension .","problem":["abdominal pain","hypertension","mental status changes"],"test":[],"treatment":[],"problem_indices_start":[36,69,88],"problem_indices_end":[57,83,100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"contraindications for iv contrast : renal failure","problem":["renal failure"],"test":["iv contrast"],"treatment":[],"problem_indices_start":[36],"problem_indices_end":[49],"test_indices_start":[22],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7) gi : ms. pimental is an unfortunate 95 year old woman , status post a recent fall necessitating right orif of the hip and right wrist fracture orif , who was in the hospital for this event , when it was noted that she had abdominal pain , distention and coffee ground emesis with worsening mental status and renal failure .","problem":["right wrist fracture","worsening mental status","abdominal pain","distention","renal failure","coffee ground emesis","a recent fall"],"test":[],"treatment":["orif","right orif of the hip"],"problem_indices_start":[71,125,225,242,257,283,311],"problem_indices_end":[84,145,239,252,277,306,324],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[99,146],"treatment_indices_end":[120,150]}
{"text":"ct of the pelvis without iv contrast : as previously noted , there is a small amount of free fluid surrounding the right colon , tracking along the mesentery and into the pelvis .","problem":["a small amount of free fluid"],"test":["ct of the pelvis without iv contrast"],"treatment":[],"problem_indices_start":[70],"problem_indices_end":[98],"test_indices_start":[0],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the remainder of the bowel loops are fluid filled , and nondilated .","problem":["nondilated"],"test":[],"treatment":[],"problem_indices_start":[56],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a catheter is seen entering the left inguinal region and coursing along the iliac vessels , terminating in the left pelvis .","problem":[],"test":[],"treatment":["a catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"osseous structures are remarkable for degenerative changes of the spine , and a fracture of the proximal right humerus , with orthopedic hardware causing beam hardening artifact .","problem":["a fracture of the proximal right humerus","beam hardening artifact","degenerative changes of the spine"],"test":[],"treatment":["orthopedic hardware"],"problem_indices_start":[38,78,154],"problem_indices_end":[71,118,177],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[126],"treatment_indices_end":[145]}
{"text":"ext - 2 + edema to knees , warm 2 + pulses , pain in r arm and r hip","problem":["edema to knees","pain in r arm and r hip"],"test":["pulses"],"treatment":[],"problem_indices_start":[10,45],"problem_indices_end":[24,68],"test_indices_start":[36],"test_indices_end":[42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. bilateral pleural effusions , right greater than left , with left-sided compressive atelectasis .","problem":["bilateral pleural effusions","left-sided compressive atelectasis"],"test":[],"treatment":[],"problem_indices_start":[3,64],"problem_indices_end":[30,98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2013-05-18 06:00 pm glucose - 188 * urea n - 48 * creat - 1.3 * sodium - 138 potassium - 4.0 chloride - 106 total co2 - 21 * anion gap - 15","problem":[],"test":["anion gap","creat","urea n","glucose","sodium","chloride","total co2","potassium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,36,50,64,77,93,108,125],"test_indices_end":[27,42,55,70,86,101,117,134],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10. history of lower gastrointestinal bleed in 2009-06-05 .","problem":["lower gastrointestinal bleed"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"92 year old woman with ms changes , abd pain hypotension and bloody lavage on lovenox+asa","problem":["ms changes","bloody lavage","abd pain","hypotension"],"test":[],"treatment":["lovenox+asa"],"problem_indices_start":[23,36,45,61],"problem_indices_end":[33,44,56,74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[78],"treatment_indices_end":[89]}
{"text":"11. spinal stenosis","problem":["spinal stenosis"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2013-05-18 06:00 pm pt - 13.3 ptt - 26.4 inr(pt) - 1.2 ekg - nsr 64 , 1st deg block , lad , new twi inf\/lat leads , new st depressions v4-6","problem":["lad","1st deg block","new twi inf\/lat leads","new st depressions v4-6"],"test":["inr(pt)","pt","ptt","ekg"],"treatment":[],"problem_indices_start":[70,86,92,116],"problem_indices_end":[83,89,113,139],"test_indices_start":[20,30,41,55],"test_indices_end":[22,33,48,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient denies cp , sob , light headedness , or dizziness prior to of after the fall .","problem":["sob","cp","light headedness","the fall","dizziness"],"test":[],"treatment":[],"problem_indices_start":[15,20,26,48,76],"problem_indices_end":[17,23,42,57,84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chemistry totprot albumin globuln calcium phos mg uricacd iron cholest","problem":[],"test":["calcium","cholest","albumin","uricacd","mg","globuln","totprot","iron","phos","chemistry"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,18,26,34,42,47,50,58,63],"test_indices_end":[9,17,25,33,41,46,49,57,62,70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a small amount of nondependent free air is seen in the anterior aspect of the abdomen .","problem":["a small amount of nondependent free air"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2013-05-19 09:20 am 1603 - 5419 ldl(calc) invalid if trig > 400 or non-fasting sample lab use only greenhd","problem":[],"test":["ldl(calc)","trig"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[32,53],"test_indices_end":[41,57],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a dual chamber pacemaker is seen with leads terminating in the right atrium and right ventricle .","problem":[],"test":[],"treatment":["a dual chamber pacemaker"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"nasogastric tube is seen coiling in the stomach , with its tip at the pylorus .","problem":[],"test":[],"treatment":["nasogastric tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"hemogloblin fractions ( cooximetry ) hgb calchct o2 sat cohgb methgb","problem":[],"test":["methgb","calchct","hgb","o2 sat","cooximetry","hemogloblin fractions","cohgb"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,24,37,41,49,56,62],"test_indices_end":[21,34,40,48,55,61,68],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood gases type temp rates tidal v peep fio2 o2 flow po2 pco2 ph calhco3 base xs aado2 req o2 intubat vent","problem":[],"test":["type","o2","fio2","flow","pco2","calhco3","po2","ph","peep","tidal v","rates","temp","blood gases","aado2","base xs"],"treatment":["intubat","vent","req o2"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,12,17,22,28,36,41,46,49,54,58,63,66,74,82],"test_indices_end":[11,16,21,27,35,40,45,48,53,57,62,65,73,81,87],"treatment_indices_start":[88,95,103],"treatment_indices_end":[94,102,107]}
{"text":"there are coronary vascular calcifications .","problem":["coronary vascular calcifications"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the mid-distal lad was underfilled initially but was without obstructive disease .","problem":["underfilled","obstructive disease"],"test":[],"treatment":[],"problem_indices_start":[23,61],"problem_indices_end":[34,80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"calcium freeca","problem":[],"test":["freeca","calcium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,8],"test_indices_end":[7,14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct abdomen w\/o contrast 2013-05-23 5:46 pm","problem":[],"test":["ct abdomen w\/o contrast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"multiorgan failure","problem":["multiorgan failure"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tylenol","problem":[],"test":[],"treatment":["tylenol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"imdur 60 mg qdau","problem":[],"test":[],"treatment":["imdur"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"1. exploratory laparotomy with drainage of intra-abdominal abscess and peritonitis with gross soilage with bile and gastric contents .","problem":["intra-abdominal abscess","gross soilage with bile and gastric contents","peritonitis"],"test":["exploratory laparotomy"],"treatment":["drainage"],"problem_indices_start":[43,71,88],"problem_indices_end":[66,82,132],"test_indices_start":[3],"test_indices_end":[25],"treatment_indices_start":[31],"treatment_indices_end":[39]}
{"text":"2. examination under anesthesia with placement of splint , right elbow .","problem":[],"test":["examination under anesthesia"],"treatment":["placement of splint , right elbow"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[31],"treatment_indices_start":[37],"treatment_indices_end":[70]}
{"text":"duodenal perforation","problem":["duodenal perforation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lasix alt 40 mg and 20 mg qday","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"continue to deteriorate spiking fevers with ventilatory support on pressors to hold the bp. with no improvement in mental staus was made cmo 5\/20\/5 .","problem":["spiking fevers"],"test":["the bp."],"treatment":["pressors","ventilatory support"],"problem_indices_start":[24],"problem_indices_end":[38],"test_indices_start":[84],"test_indices_end":[91],"treatment_indices_start":[44,67],"treatment_indices_end":[63,75]}
{"text":"glipizide 5 mg qday","problem":[],"test":[],"treatment":["glipizide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"asa 325 mg qday","problem":[],"test":[],"treatment":["asa"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[3]}
{"text":"levothyrox 50 mcg qday","problem":[],"test":[],"treatment":["levothyrox"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"blood gas","problem":[],"test":["blood gas"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nicholas seizures , no loc , no head or neck trauma .","problem":["loc","head or neck trauma","nicholas seizures"],"test":[],"treatment":[],"problem_indices_start":[0,23,32],"problem_indices_end":[17,26,51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. placement of a right femoral arterial line .","problem":[],"test":[],"treatment":["a right femoral arterial line"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[45]}
{"text":"90 yo f with mmp ( see below ) who sustained a mechanical fall down stairs resulting in a hip and arm fracture .","problem":["a hip and arm fracture","mmp","a mechanical fall"],"test":[],"treatment":[],"problem_indices_start":[13,45,88],"problem_indices_end":[16,62,110],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. anemia , transfusion dependent every three months .","problem":["transfusion dependent","anemia"],"test":[],"treatment":[],"problem_indices_start":[3,12],"problem_indices_end":[9,33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"enzymes & bilirubin alt ast ld(ldh) ck(cpk) alkphos amylase totbili dirbili","problem":[],"test":["ast","alt","ld(ldh)","ck(cpk)","totbili","amylase","dirbili","alkphos","enzymes","bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,20,24,28,36,44,52,60,68],"test_indices_end":[7,19,23,27,35,43,51,59,67,75],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. tube gastrostomy .","problem":[],"test":[],"treatment":["tube gastrostomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[19]}
{"text":"2. exposure and wide drainage of perforated posterior duodenal ulcer with internal and external drainage .","problem":["perforated posterior duodenal ulcer"],"test":[],"treatment":["wide drainage","internal and external drainage","exposure"],"problem_indices_start":[33],"problem_indices_end":[68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,16,74],"treatment_indices_end":[11,29,104]}
{"text":"3. feeding jejunostomy .","problem":[],"test":[],"treatment":["feeding jejunostomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"renal & glucose glucose urean creat na k cl hco3 angap","problem":[],"test":["glucose","k","creat","hco3","cl","angap","urean","na"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16,24,30,36,39,41,44,49],"test_indices_end":[23,29,35,38,40,43,48,54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. chronic renal insufficiency with a b\/l creatinine of 1.4 .","problem":["chronic renal insufficiency"],"test":["a b\/l creatinine"],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[30],"test_indices_start":[36],"test_indices_end":[52],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. history of syncope and first degree a-v heart block with beta blocker therapy .","problem":["first degree a-v heart block","syncope"],"test":[],"treatment":["beta blocker therapy"],"problem_indices_start":[14,26],"problem_indices_end":[21,54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[60],"treatment_indices_end":[80]}
{"text":"12. pacemaker - ddd dual chamber rate response pacemaker 2011-08-22 for symptomatic bradycardia","problem":["symptomatic bradycardia"],"test":[],"treatment":["pacemaker","ddd dual chamber rate response pacemaker"],"problem_indices_start":[72],"problem_indices_end":[95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4,16],"treatment_indices_end":[13,56]}
{"text":"ct scan was obtained and this revealed free air and massive ascites .","problem":["free air","massive ascites"],"test":["ct scan"],"treatment":[],"problem_indices_start":[39,52],"problem_indices_end":[47,67],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"t 96.0 bp 177\/61 p 70 r 18 o2 97 on ra","problem":[],"test":["t","r","bp","p","o2"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,7,17,22,27],"test_indices_end":[1,9,18,23,29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2) cv - patient has cad and chf with a low hct and major trauma .","problem":["a low hct","major trauma","cad","chf"],"test":[],"treatment":[],"problem_indices_start":[20,28,37,51],"problem_indices_end":[23,31,46,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"basic coagulation ( pt , ptt , plt , inr ) pt ptt plt smr plt ct inr(pt) lplt","problem":[],"test":["pt","plt","ptt","inr(pt)","pt","ptt","lplt","plt smr","plt ct","inr","basic coagulation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,20,25,31,37,43,46,50,58,65,73],"test_indices_end":[17,22,28,34,40,45,49,57,64,72,77],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gen - somnolent , confused","problem":["somnolent","confused"],"test":[],"treatment":[],"problem_indices_start":[6,18],"problem_indices_end":[15,26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3) anemia - patient transfusion dependant with a baseline of 28 .","problem":["anemia","transfusion dependant"],"test":[],"treatment":[],"problem_indices_start":[3,20],"problem_indices_end":[9,41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"whole blood , miscellaneous chemistry glucose lactate na k cl calhco3","problem":[],"test":["lactate","k","cl","na","glucose","calhco3","miscellaneous chemistry"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[14,38,46,54,57,59,62],"test_indices_end":[37,45,53,56,58,61,69],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5) dm - glipizide , iss","problem":["dm"],"test":[],"treatment":["iss","glipizide"],"problem_indices_start":[3],"problem_indices_end":[5],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[8,20],"treatment_indices_end":[17,23]}
{"text":"4) gerd - ppi","problem":["gerd"],"test":[],"treatment":["ppi"],"problem_indices_start":[3],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10],"treatment_indices_end":[13]}
{"text":"6) pmr - cont prednisone","problem":["pmr"],"test":[],"treatment":["prednisone"],"problem_indices_start":[3],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[24]}
{"text":"2. exposure and wide drainage of perforated posterior duodenal ulcer with internal and external drainage .","problem":["perforated posterior duodenal ulcer"],"test":[],"treatment":["wide drainage","internal and external drainage","exposure"],"problem_indices_start":[33],"problem_indices_end":[68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,16,74],"treatment_indices_end":[11,29,104]}
{"text":"hip fracture","problem":["hip fracture"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient recorded as having no known allergies to drugs","problem":["known allergies to drugs"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. feeding jejunostomy .","problem":[],"test":[],"treatment":["feeding jejunostomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"4. tube gastrostomy .","problem":[],"test":[],"treatment":["tube gastrostomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[19]}
{"text":"5. polymyalgia rheumatica .","problem":["polymyalgia rheumatica"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct of head and neck neg for fx , bleed , and dislocation .","problem":["bleed","fx","dislocation"],"test":["ct of head and neck"],"treatment":[],"problem_indices_start":[28,33,45],"problem_indices_end":[30,38,56],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. closed reduction of right hip with open placement of dynamic hip screw , right hip .","problem":[],"test":[],"treatment":["open placement of dynamic hip screw , right hip","closed reduction of right hip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,38],"treatment_indices_end":[32,85]}
{"text":"presented to taunton and found to have r humerus and r hip fx .","problem":["r humerus and r hip fx"],"test":[],"treatment":[],"problem_indices_start":[39],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"red cell morphology hypochr anisocy poiklo macrocy microcy polychr","problem":[],"test":["polychr","anisocy","poiklo","hypochr","microcy","macrocy","red cell morphology"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,20,28,36,43,51,59],"test_indices_end":[19,27,35,42,50,58,66],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt underwent surgery on 05-23","problem":[],"test":[],"treatment":["surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[20]}
{"text":"1. coronary artery disease status post non-st-elevation myocardial infarction in 2009-05-05 , status post cardiac catheterization with left anterior descending artery stent placement in 05\/2001 .","problem":["coronary artery disease","non-st-elevation myocardial infarction"],"test":["cardiac catheterization"],"treatment":["left anterior descending artery stent placement"],"problem_indices_start":[3,39],"problem_indices_end":[26,77],"test_indices_start":[106],"test_indices_end":[129],"treatment_indices_start":[135],"treatment_indices_end":[182]}
{"text":"complete blood count wbc rbc hgb hct mcv mch mchc rdw plt ct","problem":[],"test":["mch","rbc","complete blood count","hgb","plt ct","rdw","hct","wbc","mchc","mcv"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,21,25,29,33,37,41,45,50,54],"test_indices_end":[20,24,28,32,36,40,44,49,53,60],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. exploratory laparotomy with drainage of intra-abdominal abscess and peritonitis with gross soilage with bile and gastric contents .","problem":["intra-abdominal abscess","peritonitis","gross soilage with bile and gastric contents"],"test":["exploratory laparotomy"],"treatment":["drainage"],"problem_indices_start":[43,71,88],"problem_indices_end":[66,82,132],"test_indices_start":[3],"test_indices_end":[25],"treatment_indices_start":[31],"treatment_indices_end":[39]}
{"text":"2. chf with an ejection fraction of 40-45% 02-09","problem":["chf"],"test":["an ejection fraction"],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[6],"test_indices_start":[12],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"differential neuts bands lymphs monos eos baso atyps metas","problem":[],"test":["metas","baso","lymphs","monos","neuts","bands","atyps","eos","differential"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,19,25,32,38,42,47,53],"test_indices_end":[12,18,24,31,37,41,46,52,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hct 28 b\/l","problem":[],"test":["hct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. successful ptca and stenting of the proximal lad with overlapping 2.25 x 13 mm and 2.25 x 18 mm hepacoat stents with no residual stenosis or dissection and normal flow ( see ptca comments ).","problem":["dissection","residual stenosis"],"test":[],"treatment":["successful ptca","stenting of the proximal lad","overlapping 2.25 x 13 mm and 2.25 x 18 mm hepacoat stents","ptca"],"problem_indices_start":[123,144],"problem_indices_end":[140,154],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,23,57,177],"treatment_indices_end":[18,51,114,181]}
{"text":"new inferior and inferolateral wall motion abnormalities with more severe mitral regurgitation present .","problem":["more severe mitral regurgitation","new inferior and inferolateral wall motion abnormalities"],"test":[],"treatment":[],"problem_indices_start":[0,62],"problem_indices_end":[56,94],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"resting regional wall motion abnormalities include inferolateral , inferior and mid septal hypokinesis .","problem":["inferolateral , inferior and mid septal hypokinesis","resting regional wall motion abnormalities"],"test":[],"treatment":[],"problem_indices_start":[0,51],"problem_indices_end":[42,102],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. coronary angiography demonstrated single vessel disease in a right dominant system .","problem":["single vessel disease in a right dominant system"],"test":["coronary angiography"],"treatment":[],"problem_indices_start":[37],"problem_indices_end":[85],"test_indices_start":[3],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the left atrium is elongated .","problem":["elongated"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cath 2001","problem":[],"test":["cath"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2013-05-18 06:00 pm plt smr - normal plt count - 216","problem":[],"test":["plt count","plt smr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,37],"test_indices_end":[27,46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2013-05-18 06:00 pm hypochrom - 1 + anisocyt - normal poikilocy - normal macrocyt - normal microcyt - normal polychrom - normal","problem":[],"test":["polychrom","microcyt","poikilocy","hypochrom","anisocyt","macrocyt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,36,54,73,91,109],"test_indices_end":[29,44,63,81,99,118],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2013-05-18 06:00 pm neuts - 87.9 * bands - 0 lymphs - 6.3 * monos - 5.7 eos - 0.1 basos - 0","problem":[],"test":["eos","bands","monos","neuts","lymphs","basos"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,35,45,60,72,82],"test_indices_end":[25,40,51,65,75,87],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2013-05-18 06:00 pm wbc - 14.9 *# rbc - 2.91 * hgb - 8.5 * hct - 24.7 * mcv - 85 mch - 29.3 mchc - 34.5 rdw - 14.6","problem":[],"test":["wbc","mchc","mcv","rdw","hgb","rbc","hct","mch"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,34,47,59,72,81,92,104],"test_indices_end":[23,37,50,62,75,84,96,107],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. one vessel coronary artery disease .","problem":["one vessel coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. the mitral valve leaflets are mildly thickened .","problem":["mildly thickened"],"test":[],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2013-05-18 06:00 pm ck(cpk) - 32","problem":[],"test":["ck(cpk)"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2013-05-18 06:00 pm ck-mb - notdone","problem":[],"test":["ck-mb"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. hypothyroidism .","problem":["hypothyroidism"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. the aortic valve leaflets ( 3 ) are mildly thickened .","problem":["mildly thickened"],"test":[],"treatment":[],"problem_indices_start":[39],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"toprol xl 25 mg qday","problem":[],"test":[],"treatment":["toprol xl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"famotidine 20 mg qday","problem":[],"test":[],"treatment":["famotidine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"fe so4 325 mg qday","problem":[],"test":[],"treatment":["fe so4"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"3. diabetes type 2 .","problem":["diabetes type 2"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. moderately elevated right and left sided filling pressures .","problem":["moderately elevated right and left sided filling pressures"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2013-05-24 04:31 am art 36.4 16 \/ 662-15484 * 7.26 * 16 * -10","problem":[],"test":["art"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2013-05-24 07:58 am art 102 36 7.26 * 17 * -9","problem":[],"test":["art"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. successful stenting of the proximal lad .","problem":[],"test":[],"treatment":["successful stenting of the proximal lad"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[42]}
{"text":"the dominant rca was a large vessel with no significant disease .","problem":["significant disease"],"test":[],"treatment":[],"problem_indices_start":[44],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. left ventriculography was not performed due to the presence of moderate renal insufficiency ( creatinine 1.6 ).","problem":["moderate renal insufficiency"],"test":["creatinine","left ventriculography"],"treatment":[],"problem_indices_start":[66],"problem_indices_end":[94],"test_indices_start":[3,97],"test_indices_end":[24,107],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"moderate pulmonary hypertension was present with a pa of 52\/28 .","problem":["moderate pulmonary hypertension"],"test":["a pa"],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[31],"test_indices_start":[49],"test_indices_end":[53],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the cardiac index was preserved at 3.0 l \/ min \/ m2 .","problem":[],"test":["the cardiac index"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the lad had serial 90% lesions proximally , involving the origin of the first diagonal , which was occluded and filled via left to left collaterals .","problem":["occluded","serial 90% lesions proximally"],"test":[],"treatment":[],"problem_indices_start":[12,99],"problem_indices_end":[41,107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the non-dominant circumflex system had no hemodynamically significant stenoses .","problem":["hemodynamically significant stenoses"],"test":[],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. resting hemodynamics revealed elevated right and left sided filling pressures with a mean ra pressure of 12 mm hg and a mean wedge pressure 24 mm hg .","problem":["elevated right and left sided filling pressures"],"test":["a mean ra pressure","resting hemodynamics","a mean wedge pressure"],"treatment":[],"problem_indices_start":[33],"problem_indices_end":[80],"test_indices_start":[3,86,121],"test_indices_end":[23,104,142],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"fall was witnessed by daughter .","problem":["fall"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[4],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. the left atrium is moderately dilated .","problem":["moderately dilated"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"echo 02-09","problem":[],"test":["echo"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. the left ventricular wall thicknesses are normal .","problem":[],"test":["the left ventricular wall thicknesses"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is mild regional left ventricular systolic dysfunction .","problem":["mild regional left ventricular systolic dysfunction"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the left ventricular cavity size is normal .","problem":[],"test":["the left ventricular cavity size"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"overall left ventricular systolic function is mildly depressed .","problem":["mildly depressed"],"test":["left ventricular systolic function"],"treatment":[],"problem_indices_start":[46],"problem_indices_end":[62],"test_indices_start":[8],"test_indices_end":[42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she fell on her r side and had a great deal of pain in her r arm and hip .","problem":["pain in her r arm and hip"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"multiple trauma","problem":["multiple trauma"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. right ventricular chamber size is normal .","problem":[],"test":["right ventricular chamber size"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1 ctropnt > 0.10 ng\/ml suggests acute mi","problem":["acute mi"],"test":["ctropnt"],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[40],"test_indices_start":[2],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"other enzymes & bilirubins lipase","problem":[],"test":["lipase","other enzymes","bilirubins"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,27],"test_indices_end":[13,26,33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"compared with the findings of the prior study ( tape reviewed ) of 2009-06-05 , the lv function has improved with an improvementt in function of the apex , septal and anterior walls .","problem":[],"test":["the lv function","the prior study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[30,80],"test_indices_end":[45,95],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right ventricular systolic function is normal .","problem":[],"test":["right ventricular systolic function"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cpk isoenzymes ck-mb mb indx ctropnt","problem":[],"test":["ctropnt","ck-mb","cpk","isoenzymes","mb indx"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,4,15,21,29],"test_indices_end":[3,14,20,28,36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"prednisone 5 mg qday","problem":[],"test":[],"treatment":["prednisone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"chemistry","problem":[],"test":["chemistry"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lisinopril 5 mg qday","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"1. a small amount of free air and free fluid in the pelvis and abdomen , mostly along the right pericolic gutter and surrounding the ascending colon , concerning for perforation .","problem":["perforation","free air and free fluid in the pelvis and abdomen"],"test":[],"treatment":[],"problem_indices_start":[21,166],"problem_indices_end":[70,177],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"other bowel loops are unremarkable on this limited study .","problem":[],"test":["this limited study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[38],"test_indices_end":[56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. right proximal humeral fracture status post fixation .","problem":["right proximal humeral fracture"],"test":[],"treatment":["fixation"],"problem_indices_start":[3],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47],"treatment_indices_end":[55]}
{"text":"- transfuse 2 units today , with lasix","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[33],"treatment_indices_end":[38]}
{"text":"the study and the report were reviewed by the staff radiologist .","problem":[],"test":["the study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a small amount of free air is seen in the nondependent portion of the pelvis .","problem":["a small amount of free air"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"assist \/ con1 intubated","problem":[],"test":[],"treatment":["intubated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[23]}
{"text":"she also has new changes on ekg .","problem":["new changes on ekg"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vascular calcifications are seen in the abdominal aorta and iliac arteries .","problem":["vascular calcifications"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cor - rrr , no m\/r\/g","problem":["m\/r\/g"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. there is no pericardial effusion .","problem":["pericardial effusion"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"subcutaneous edema is noted in the lower abdomen and pelvis .","problem":["subcutaneous edema"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on pressor to hold mean 60 .","problem":[],"test":[],"treatment":["pressor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"patient has injuries to her shoulder and hip .","problem":["injuries to her shoulder and hip"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a nasogastric tube is seen coiling in the stomach .","problem":[],"test":[],"treatment":["a nasogastric tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[18]}
{"text":"1) s\/p fall - unlikely to be mechanical in nature .","problem":["fall"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"allowing for the limitations of this noncontrast study , the liver , pancreas , adrenals , stomach are unremarkable .","problem":[],"test":["this noncontrast study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[32],"test_indices_end":[54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a 1.8 cm exophytic renal cyst is seen on the left .","problem":["a 1.8 cm exophytic renal cyst"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a similar lesion is seen on the right , measuring 2.2 cm .","problem":["a similar lesion"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the aorta is normal in caliber , with vascular calcifications .","problem":["vascular calcifications"],"test":[],"treatment":[],"problem_indices_start":[38],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a small amount of free fluid is seen tracking around the liver , right pericolic gutter , along the mesentery and surrounding the right colon , which is collapsed .","problem":["a small amount of free fluid"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no aortic regurgitation present .","problem":["aortic regurgitation"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct abdomen w\/o contrast ; ct pelvis w\/o contrast","problem":[],"test":["ct pelvis w\/o contrast","ct abdomen w\/o contrast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,26],"test_indices_end":[23,48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abd - s\/nt\/nd +bs","problem":["s\/nt\/nd"],"test":[],"treatment":[],"problem_indices_start":[6],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"expired","problem":["expired"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. there is moderate pulmonary artery systolic hypertension .","problem":["moderate pulmonary artery systolic hypertension"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"reason : please eval for perf \/ ischemic bowel","problem":["perf \/ ischemic bowel"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"moderate ( 2 +) mitral regurgitation is seen .","problem":["moderate ( 2 +) mitral regurgitation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please eval for perf \/ ischemic bowel","problem":["perf \/ ischemic bowel"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sodium 139 , potassium 3.8 , chloride 101 , bicarb 26 , bun 9 , creatinine 0.7 , glucose 141 , albumin 4.1 , calcium 8.9 , ldh 665 , ast 44 , alt of 57 , amylase 41 , ck 32 .","problem":[],"test":["albumin","calcium","potassium","chloride","bun","sodium","ldh","amylase","ast","ck","alt","bicarb","glucose","creatinine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,29,44,56,64,81,95,109,123,133,142,154,167],"test_indices_end":[6,22,37,50,59,74,88,102,116,126,136,145,161,169],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. prempro as the patient was formerly taking .","problem":[],"test":[],"treatment":["prempro"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"1. levaquin 500 mg one po q day times seven days .","problem":[],"test":[],"treatment":["levaquin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"the patient was given a prescription for ten pills .","problem":[],"test":[],"treatment":["a prescription for ten pills"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[50]}
{"text":"she was to continue on a brat diet over the weekend and two days after discharge she could advance to a low fat no dairy diet .","problem":[],"test":[],"treatment":["a low fat no dairy diet","a brat diet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23,102],"treatment_indices_end":[34,125]}
{"text":"the patient is a 59 year-old female status post endoscopic retrograde cholangiopancreatography on the day of admission , which had been done to evaluate for possible bile leak after cholecystectomy was performed four days ago .","problem":["bile leak"],"test":["endoscopic retrograde cholangiopancreatography"],"treatment":["cholecystectomy"],"problem_indices_start":[166],"problem_indices_end":[175],"test_indices_start":[48],"test_indices_end":[94],"treatment_indices_start":[182],"treatment_indices_end":[197]}
{"text":"placement for a bile leak from the duct of luschka .","problem":["a bile leak from the duct of luschka"],"test":[],"treatment":["placement"],"problem_indices_start":[14],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"electrocardiogram showed normal sinus rhythm at 73 beats per minute .","problem":[],"test":["electrocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. hypokalemia .","problem":["hypokalemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was to make an appointment with dr. nicholson within one to two months after discharge for removal of the stent .","problem":[],"test":[],"treatment":["removal of the stent"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[103],"treatment_indices_end":[123]}
{"text":"5. bile leak .","problem":["bile leak"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her liver function tests and amylase and lipase were followed closely .","problem":[],"test":["amylase","her liver function tests","lipase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,29,41],"test_indices_end":[24,36,47],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"therefore she was made npo and given aggressive intravenous hydration .","problem":[],"test":[],"treatment":["npo","aggressive intravenous hydration"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23,37],"treatment_indices_end":[26,69]}
{"text":"her bicarb began to drop and she developed an anion gap acidosis .","problem":["an anion gap acidosis"],"test":["her bicarb"],"treatment":[],"problem_indices_start":[43],"problem_indices_end":[64],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was in her usual state of health until four days prior to admission when she had a cholecystectomy .","problem":[],"test":[],"treatment":["a cholecystectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[93],"treatment_indices_end":[110]}
{"text":"on the day of discharge the patient was tolerating a brat diet without significant abdominal","problem":[],"test":[],"treatment":["a brat diet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[51],"treatment_indices_end":[62]}
{"text":"pain .","problem":["pain"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[4],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her postop course was uneventful until one day prior to admission when she developed abdominal pain .","problem":["abdominal pain"],"test":[],"treatment":[],"problem_indices_start":[85],"problem_indices_end":[99],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. protonix 40 mg po q day .","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"on the day of admission she returned to the outside hospital emergency room where an abdominal ct was performed , which showed \" thickened stomach and free air .\"","problem":["free air","thickened stomach"],"test":["an abdominal ct"],"treatment":[],"problem_indices_start":[129,151],"problem_indices_end":[146,159],"test_indices_start":[82],"test_indices_end":[97],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was aggressively hydrated given that she was npo .","problem":[],"test":[],"treatment":["npo","aggressively hydrated"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16,57],"treatment_indices_end":[37,60]}
{"text":"3. percocet one to two tablets po q 4 to 6 hours prn .","problem":[],"test":[],"treatment":["percocet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"there were post laparoscopic incisions without erythema with steri-strips in place .","problem":["post laparoscopic incisions","erythema"],"test":[],"treatment":["steri-strips"],"problem_indices_start":[11,47],"problem_indices_end":[38,55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61],"treatment_indices_end":[73]}
{"text":"she was followed closely with serial abdominal examinations .","problem":[],"test":["serial abdominal examinations"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[30],"test_indices_end":[59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was started on ampicillin , gentamycin and flagyl .","problem":[],"test":[],"treatment":["ampicillin","gentamycin","flagyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19,32,47],"treatment_indices_end":[29,42,53]}
{"text":"there were no rashes .","problem":["rashes"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was admitted originally for airway monitoring status post endoscopic retrograde","problem":[],"test":["airway monitoring"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[40],"test_indices_end":[57],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"white blood cell count 9.0 , hematocrit 39.3 , platelets 296 , neutrophil count 82 , lymphocytes 14 , 4 monocytes , troponin was less then 0.3 .","problem":[],"test":["lymphocytes","monocytes","troponin","neutrophil count","hematocrit","platelets","white blood cell count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,29,47,63,85,104,116],"test_indices_end":[22,39,56,79,96,113,124],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cholangiopancreatography with adverse reaction to fentanyl and tongue injury .","problem":["adverse reaction","tongue injury"],"test":["cholangiopancreatography"],"treatment":["fentanyl"],"problem_indices_start":[30,63],"problem_indices_end":[46,76],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[50],"treatment_indices_end":[58]}
{"text":"there was no rebound or guarding .","problem":["guarding","rebound"],"test":[],"treatment":[],"problem_indices_start":[13,24],"problem_indices_end":[20,32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdominal ct showed inflammation in the right upper quadrant , small fluid in the circumferential thickening of the distal stomach .","problem":["small fluid in the circumferential thickening of the distal stomach","inflammation in the right upper quadrant"],"test":["abdominal ct"],"treatment":[],"problem_indices_start":[20,63],"problem_indices_end":[60,130],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , her white blood cell count was never really elevated and she did not have a bandemia .","problem":["really elevated","a bandemia"],"test":["her white blood cell count"],"treatment":[],"problem_indices_start":[47,84],"problem_indices_end":[62,94],"test_indices_start":[10],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was a tiny amount of free air .","problem":["free air"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her amylase and lipase on the day following the endoscopic retrograde cholangiopancreatography","problem":[],"test":["the endoscopic retrograde cholangiopancreatography","her amylase","lipase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,44],"test_indices_end":[11,22,94],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"amylase was 2304 with lipase being 7116 .","problem":[],"test":["amylase","lipase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,22],"test_indices_end":[7,28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen was soft , nontender , nondistended .","problem":["nondistended","nontender"],"test":[],"treatment":[],"problem_indices_start":[19,31],"problem_indices_end":[28,43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. anemia .","problem":["anemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an abdominal ct was obtained , which showed only mild pancreatitis .","problem":["mild pancreatitis"],"test":["an abdominal ct"],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[66],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. post endoscopic retrograde cholangiopancreatography pancreatitis .","problem":["post endoscopic retrograde cholangiopancreatography pancreatitis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there were no intra-abdominal fluid collections , which required any drainage .","problem":["intra-abdominal fluid collections"],"test":[],"treatment":["any drainage"],"problem_indices_start":[14],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[65],"treatment_indices_end":[77]}
{"text":"on the third hospital day the patient 's pain was improving and the rebound was decreasing .","problem":["the rebound","the patient 's pain"],"test":[],"treatment":[],"problem_indices_start":[26,64],"problem_indices_end":[45,75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. trazodone at bedtime .","problem":[],"test":[],"treatment":["trazodone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"the patient received ampicillin , gentamycin and flagyl empirically as well as narcan to reverse fentanyl .","problem":[],"test":[],"treatment":["fentanyl","flagyl","narcan","gentamycin","ampicillin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21,34,49,79,97],"treatment_indices_end":[31,44,55,85,105]}
{"text":"after her endoscopic retrograde cholangiopancreatography the patient developed \" jaw clenching , biting tongue , rigidity and cold \/ chills .\"","problem":["rigidity","cold \/ chills","biting tongue","jaw clenching"],"test":["her endoscopic retrograde cholangiopancreatography"],"treatment":[],"problem_indices_start":[81,97,113,126],"problem_indices_end":[94,110,121,139],"test_indices_start":[6],"test_indices_end":[56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"were elevated .","problem":["elevated"],"test":[],"treatment":[],"problem_indices_start":[5],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in general , the patient was groggy status post anesthesia , shivering , but awake .","problem":["shivering","groggy"],"test":[],"treatment":["anesthesia"],"problem_indices_start":[29,61],"problem_indices_end":[35,70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48],"treatment_indices_end":[58]}
{"text":"no murmurs , rubs or gallops .","problem":["rubs","murmurs","gallops"],"test":[],"treatment":[],"problem_indices_start":[3,13,21],"problem_indices_end":[10,17,28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had no further rebound .","problem":["further rebound"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was most likely secondary to ketoacidosis as she had no dextrose in her intravenous fluids .","problem":["ketoacidosis"],"test":[],"treatment":["dextrose","her intravenous fluids"],"problem_indices_start":[34],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61,73],"treatment_indices_end":[69,95]}
{"text":"sating 98% on 3 liters .","problem":[],"test":["sating"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she required periodic repletion of her potassium .","problem":[],"test":[],"treatment":["periodic repletion of her potassium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[48]}
{"text":"blood pressure 162\/76 .","problem":[],"test":["blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had no temperature spikes in greater then 24 hours at the time of discharge .","problem":["temperature spikes"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's hematocrit was 34.8 at the time of admission .","problem":[],"test":["the patient 's hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. anion gap acidosis .","problem":["anion gap acidosis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it decreased to 30 in the setting of aggressive hydration .","problem":[],"test":[],"treatment":["aggressive hydration"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37],"treatment_indices_end":[57]}
{"text":"no known drug allergies at the time of admission , however , it is assumed that her rigidity and jaw clenching was secondary to fentanyl .","problem":["her rigidity","jaw clenching","known drug allergies"],"test":[],"treatment":["fentanyl"],"problem_indices_start":[3,80,97],"problem_indices_end":[23,92,110],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[128],"treatment_indices_end":[136]}
{"text":"her enzymes continued to trend down .","problem":[],"test":["her enzymes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was added on the evening prior to discharge and on the day of discharge her anion gap acidosis had resolved .","problem":["her anion gap acidosis"],"test":[],"treatment":[],"problem_indices_start":[77],"problem_indices_end":[99],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vital signs temperature 100.6 .","problem":[],"test":["temperature","vital signs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,12],"test_indices_end":[11,23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was continued on ampicillin , gentamycin and flagyl , which had been started at the time of transfer to the cmed ccu .","problem":[],"test":[],"treatment":["flagyl","gentamycin","ampicillin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29,42,57],"treatment_indices_end":[39,52,63]}
{"text":"3. urinary frequency secondary to interstitial cystitis .","problem":["urinary frequency","interstitial cystitis"],"test":[],"treatment":[],"problem_indices_start":[3,34],"problem_indices_end":[20,55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. prempro .","problem":[],"test":[],"treatment":["prempro"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"she received clear liquids in the evening and tolerated these well .","problem":[],"test":[],"treatment":["clear liquids"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[26]}
{"text":"4. mitral valve prolapse .","problem":["mitral valve prolapse"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the extremities were without edema .","problem":["edema"],"test":[],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"respiratory rate 18 .","problem":[],"test":["respiratory rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on the day of transfer to the general medical floor the patient had received clear liquids .","problem":[],"test":[],"treatment":["clear liquids"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[77],"treatment_indices_end":[90]}
{"text":"1. hiatal hernia .","problem":["hiatal hernia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"because of the tongue injury and tachycardia as well as possible infection given her fevers or chills the gi service transferred the patient to the cmed ccu for close observation .","problem":["chills","tachycardia","infection","her fevers","the tongue injury"],"test":[],"treatment":[],"problem_indices_start":[11,33,65,81,95],"problem_indices_end":[28,44,74,91,101],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had waxing and waning fevers .","problem":["waxing and waning fevers"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. tubal ligation many years ago .","problem":[],"test":[],"treatment":["tubal ligation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[17]}
{"text":"on the second hospital day on the general medical floor the patient had marked rebound to palpation of her abdomen .","problem":["marked rebound"],"test":["palpation of her abdomen"],"treatment":[],"problem_indices_start":[72],"problem_indices_end":[86],"test_indices_start":[90],"test_indices_end":[114],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. cmed ccu drops .","problem":[],"test":[],"treatment":["cmed ccu drops"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[17]}
{"text":"heart rate 105 .","problem":[],"test":["heart rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her amylase and lipase were trending down , however .","problem":[],"test":["lipase","her amylase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16],"test_indices_end":[11,22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. status post cholecystectomy four days prior to admission .","problem":[],"test":[],"treatment":["cholecystectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[30]}
{"text":"there was a question of a small ulcer .","problem":["a small ulcer"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there were no st or t wave changes .","problem":["st or t wave changes"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dorsalis pedis pulses were intact bilaterally .","problem":[],"test":["dorsalis pedis pulses"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in summary the patient is a 59 year-old female who was admitted to quincy medical center for an endoscopic retrograde cholangiopancreatography for possible stent placement for a bile leak secondary to cholecystectomy performed four days prior to admission .","problem":["a bile leak"],"test":["an endoscopic retrograde cholangiopancreatography"],"treatment":["stent placement","cholecystectomy"],"problem_indices_start":[176],"problem_indices_end":[187],"test_indices_start":[93],"test_indices_end":[142],"treatment_indices_start":[156,201],"treatment_indices_end":[171,216]}
{"text":"a stent was placed successfully .","problem":[],"test":[],"treatment":["a stent"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"she had a successful endoscopic retrograde cholangiopancreatography , which showed a bile leak at the duct of luschka .","problem":["a bile leak at the duct of luschka"],"test":["a successful endoscopic retrograde cholangiopancreatography"],"treatment":[],"problem_indices_start":[83],"problem_indices_end":[117],"test_indices_start":[8],"test_indices_end":[67],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent showed tongue with laceration on the right edge .","problem":["laceration on the right edge"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she then suffered rigidity with jaw clenching and tongue biting secondary to fentanyl administration and was transferred to the cmed ccu for close observation .","problem":["tongue biting","jaw clenching","rigidity"],"test":[],"treatment":["fentanyl"],"problem_indices_start":[18,32,50],"problem_indices_end":[26,45,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[77],"treatment_indices_end":[85]}
{"text":"lungs were clear to auscultation bilaterally .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was sent to new england sinai hospital & rehab center for an endoscopic retrograde cholangiopancreatography and possible stent placement .","problem":[],"test":["an endoscopic retrograde cholangiopancreatography"],"treatment":["stent placement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[62],"test_indices_end":[111],"treatment_indices_start":[125],"treatment_indices_end":[140]}
{"text":"as stated the patient was status post endoscopic retrograde cholangiopancreatography with stent","problem":[],"test":["endoscopic retrograde cholangiopancreatography"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[38],"test_indices_end":[84],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. hepatic candidiasis .","problem":["hepatic candidiasis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. burkitt's lymphoma .","problem":["burkitt's lymphoma"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient went for a repeat mri which showed no change in the previously noted enumerable hepatic cyst in her liver .","problem":["the previously noted enumerable hepatic cyst in her liver"],"test":["a repeat mri"],"treatment":[],"problem_indices_start":[60],"problem_indices_end":[117],"test_indices_start":[21],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she is also started on marinol 2.5 mg p.o. b.i.d. and encouraged p.o. intake .","problem":[],"test":[],"treatment":["marinol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[30]}
{"text":"the patient was continued on tpn over the past couple days .","problem":[],"test":[],"treatment":["tpn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[32]}
{"text":"1. liver lesions :","problem":["liver lesions"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. colace 100 mg p.o. b.i.d.","problem":[],"test":[],"treatment":["colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"a hepatology consult was obtained who felt that the most likely etiology of these cysts were from hepatic candidiasis , although one could not rule out lymphoma involving from burkitt's .","problem":["lymphoma","hepatic candidiasis","these cysts","burkitt's"],"test":[],"treatment":[],"problem_indices_start":[76,98,152,176],"problem_indices_end":[87,117,160,185],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. atarax 25 mg iv \/ p.o. q. 4-6 h. prn for itching .","problem":["itching"],"test":[],"treatment":["atarax"],"problem_indices_start":[44],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"this regimen , that being ambisome , was recommended by the infectious disease physicians , who felt that ambisome was a better drug of choice as compared to fluconazole .","problem":[],"test":[],"treatment":["ambisome","fluconazole","ambisome"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,106,158],"treatment_indices_end":[34,114,169]}
{"text":"6. nystatin 06-18 ml swish and swallow q.6. prn .","problem":[],"test":[],"treatment":["nystatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"7. peridex 15 ml swish and swallow prn .","problem":[],"test":[],"treatment":["peridex"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"5. protonix 40 mg p.o. \/ iv q.d.","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"1. ambisome 300 mg iv q.d.","problem":[],"test":[],"treatment":["ambisome"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"her white count remained elevated despite discontinuing her g-csf .","problem":["elevated"],"test":["her white count"],"treatment":["her g-csf"],"problem_indices_start":[25],"problem_indices_end":[33],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[56],"treatment_indices_end":[65]}
{"text":"3. on the morning of 12-01 , the patient had some transient episodes of hypotension with sbp s in the 70 s.","problem":["hypotension"],"test":["sbp s"],"treatment":[],"problem_indices_start":[72],"problem_indices_end":[83],"test_indices_start":[89],"test_indices_end":[94],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's platelets , white count , and hematocrit have all been stable .","problem":[],"test":["white count","hematocrit","the patient 's platelets"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,27,45],"test_indices_end":[24,38,55],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her captopril was discontinued , and she was given two iv fluid boluses with appropriate response .","problem":[],"test":[],"treatment":["two iv fluid boluses","her captopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,51],"treatment_indices_end":[13,71]}
{"text":"however , the patient is not febrile and her white count should be continued to be watched .","problem":["febrile"],"test":["her white count"],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[36],"test_indices_start":[41],"test_indices_end":[56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. marinol 2.5 mg p.o. b.i.d. before breakfast and dinner .","problem":[],"test":[],"treatment":["marinol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"again , this was a 47-year-old female admitted with berkitt's lymphoma .","problem":["berkitt's lymphoma"],"test":[],"treatment":[],"problem_indices_start":[52],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her blood pressures and all of her vital signs are stable .","problem":[],"test":["her vital signs","her blood pressures"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,31],"test_indices_end":[19,46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she will be discharged on ambisome 300 mg iv q.d. for treatment of her hepatic candidiasis .","problem":["her hepatic candidiasis"],"test":[],"treatment":["ambisome"],"problem_indices_start":[67],"problem_indices_end":[90],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[34]}
{"text":"guarded , but stable .","problem":["guarded"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mr. eugene is a 67 year old male with a remote history of chronic pancreatitis due to alcohol abuse 30 years ago , who is transferred now from rehab hospital of the cape & islands hospital for an ercp and work-up for a cystic lesion at the head of his pancreas on ct scan shown at the outside hospital .","problem":["a cystic lesion","chronic pancreatitis"],"test":["an ercp","work-up","ct scan"],"treatment":[],"problem_indices_start":[58,217],"problem_indices_end":[78,232],"test_indices_start":[193,205,264],"test_indices_end":[200,212,271],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. prilosec 20 mg p.o. q. day .","problem":[],"test":[],"treatment":["prilosec"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"that evening , the patient again developed abdominal pain \" like his pancreatitis \" with nausea and vomiting , for which he was admitted to the rehab hospital of the cape & islands hospital .","problem":["abdominal pain","his pancreatitis","nausea","vomiting"],"test":[],"treatment":[],"problem_indices_start":[43,65,89,100],"problem_indices_end":[57,81,95,108],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. nph 10 units subcutaneously every morning and 8 units subcutaneously every evening .","problem":[],"test":[],"treatment":["nph"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[6]}
{"text":"during this admission , two ct scans had shown a question of an enlargement of the head of his pancreas","problem":["an enlargement of the head of his pancreas"],"test":["two ct scans"],"treatment":[],"problem_indices_start":[61],"problem_indices_end":[103],"test_indices_start":[24],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdominal examination revealed an abdomen that is nondistended , nontender .","problem":["nondistended","nontender"],"test":["abdominal examination"],"treatment":[],"problem_indices_start":[50,65],"problem_indices_end":[62,74],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. flomax 0.4 mg p.o. q. day .","problem":[],"test":[],"treatment":["flomax"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"pulmonary examination revealed lungs clear to auscultation bilaterally .","problem":[],"test":["pulmonary examination","auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,46],"test_indices_end":[21,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. augmentin 500 mg p.o. three times a day times ten days .","problem":[],"test":[],"treatment":["augmentin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"there was no rebound ; no munos sign .","problem":["rebound","munos sign"],"test":[],"treatment":[],"problem_indices_start":[13,26],"problem_indices_end":[20,36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. prilosec 30 mg p.o. q. day .","problem":[],"test":[],"treatment":["prilosec"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"2. right rotator cuff injury .","problem":["right rotator cuff injury"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is allergic to ciprofloxacin , morphine sulfate and droperidol .","problem":["allergic"],"test":[],"treatment":["morphine sulfate","ciprofloxacin","droperidol"],"problem_indices_start":[15],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,43,64],"treatment_indices_end":[40,59,74]}
{"text":"it appears from the discharge summary that the patient was placed on unasyn 3 grams intravenously every six hours after his ercp .","problem":[],"test":["his ercp"],"treatment":["unasyn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[120],"test_indices_end":[128],"treatment_indices_start":[69],"treatment_indices_end":[75]}
{"text":"3. gastroesophageal reflux disease with esophageal dilatation for stricture .","problem":["gastroesophageal reflux disease","stricture"],"test":[],"treatment":["esophageal dilatation"],"problem_indices_start":[3,66],"problem_indices_end":[34,75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40],"treatment_indices_end":[61]}
{"text":"the patient subsequently underwent a ct scan angiogram with pancreas protocol to assess the pseudocyst versus enlarged pancreas head .","problem":["pseudocyst","enlarged pancreas head"],"test":["a ct scan angiogram","pancreas protocol"],"treatment":[],"problem_indices_start":[92,110],"problem_indices_end":[102,132],"test_indices_start":[35,60],"test_indices_end":[54,77],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. type 2 diabetes mellitus .","problem":["type 2 diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"infectious disease department as well as cardiology had recommended a formal 14 - day course of intravenous antibiotics to treat a documented alpha streptococcal septicemia from outside hospital blood cultures .","problem":["a documented alpha streptococcal septicemia"],"test":["blood cultures"],"treatment":["intravenous antibiotics"],"problem_indices_start":[129],"problem_indices_end":[172],"test_indices_start":[195],"test_indices_end":[209],"treatment_indices_start":[96],"treatment_indices_end":[119]}
{"text":"he had three days of antibiotics remaining at the time of discharge .","problem":[],"test":[],"treatment":["antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[32]}
{"text":"4. humalog and regular insulin subcutaneously .","problem":[],"test":[],"treatment":["humalog","regular insulin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,15],"treatment_indices_end":[10,30]}
{"text":"2. alpha streptococcus septicemia .","problem":["alpha streptococcus septicemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. pancreatitis status post endoscopic retrogram cholangiopancreatography and sphincterotomy .","problem":["pancreatitis"],"test":["endoscopic retrogram cholangiopancreatography"],"treatment":["sphincterotomy"],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[28],"test_indices_end":[73],"treatment_indices_start":[78],"treatment_indices_end":[92]}
{"text":"4. regular insulin 15 units q. a.m. and 14 units q. p.m.","problem":[],"test":[],"treatment":["regular insulin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"1. unasyn 3 grams intravenous every six hours .","problem":[],"test":[],"treatment":["unasyn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"1. prilosec 20 mg p.o. q. day .","problem":[],"test":[],"treatment":["prilosec"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"the patient was alert , awake and oriented , pleasant , and in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[66],"problem_indices_end":[80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. flomax 4 mg p.o. q. day .","problem":[],"test":[],"treatment":["flomax"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"on admission showed a temperature of 97.1 f. ; heart rate of 65 ; blood pressure of 146\/74 ; respiratory rate of 20 ; oxygen saturation 98% on three liters and 95% on room air .","problem":[],"test":["oxygen saturation","a temperature","heart rate","blood pressure","respiratory rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,47,66,93,118],"test_indices_end":[33,57,80,109,135],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his liver span was 8 cm .","problem":[],"test":["his liver span"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was to return to the hospital with any signs of shaking chills or fever .","problem":["fever","shaking","chills"],"test":[],"treatment":[],"problem_indices_start":[51,59,69],"problem_indices_end":[58,65,74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. humalog 75\/25 , subcutaneously .","problem":[],"test":[],"treatment":["humalog"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"cardiovascular system revealed normal s1 and s2 , no murmurs or gallops and regular rate and rhythm .","problem":["murmurs","gallops"],"test":[],"treatment":[],"problem_indices_start":[53,64],"problem_indices_end":[60,71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. tylenol .","problem":[],"test":[],"treatment":["tylenol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"he had no icterus .","problem":["icterus"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. flomax 0.4 mg p.o. q. day .","problem":[],"test":[],"treatment":["flomax"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"extremities reveal no edema , no swelling .","problem":["swelling","edema"],"test":[],"treatment":[],"problem_indices_start":[22,33],"problem_indices_end":[27,41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was sensitive to clindamycin , erythromycin , penicillin s and vancomycin .","problem":[],"test":[],"treatment":["vancomycin","penicillin s","erythromycin","clindamycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,36,51,68],"treatment_indices_end":[33,48,63,78]}
{"text":"there was no formal strength test done .","problem":[],"test":["formal strength test"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"liver function tests revealed an alt of 31 , ast of 36 , alkaline phosphatase of 509 .","problem":[],"test":["ast","liver function tests","an alt","alkaline phosphatase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,30,45,57],"test_indices_end":[20,36,48,77],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's blood cultures at outside hospital grew out streptococcus sanguis-gordonii on 01-18 .","problem":["streptococcus sanguis-gordonii"],"test":["the patient 's blood cultures"],"treatment":[],"problem_indices_start":[59],"problem_indices_end":[89],"test_indices_start":[0],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"total bilirubin was 0.8 .","problem":[],"test":["total bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was therefore transferred to saints medical center for endoscopic retrogram cholangiopancreatography .","problem":[],"test":["endoscopic retrogram cholangiopancreatography"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[58],"test_indices_end":[103],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chemistry on admission showed a sodium of 141 , potassium of 4.3 , chloride of 107 , bicarbonate of 25 , bun of 4 , creatinine of 0.6 and a sugar of 177 .","problem":[],"test":["a sugar","bicarbonate","chloride","potassium","a sodium","creatinine","bun"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[30,48,67,85,105,116,138],"test_indices_end":[38,57,75,96,108,126,145],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had an attempted ercp on 01-18 , which was unsuccessful due to a long nipple like papilla .","problem":["a long nipple like papilla"],"test":["an attempted ercp"],"treatment":[],"problem_indices_start":[75],"problem_indices_end":[101],"test_indices_start":[16],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient presented initially to rehab hospital of the cape & islands hospital at the end of december for abdominal pain , and was found to have pancreatitis .","problem":["abdominal pain","pancreatitis"],"test":[],"treatment":[],"problem_indices_start":[108,147],"problem_indices_end":[122,159],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an ultrasound showed normal gallbladder with no wall thickening but a dilated common bile duct of 8 mm measured on ct scan .","problem":["a dilated common bile duct","wall thickening"],"test":["ct scan","an ultrasound"],"treatment":[],"problem_indices_start":[48,68],"problem_indices_end":[63,94],"test_indices_start":[0,115],"test_indices_end":[13,122],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he received an mrcp which was negative for evidence of stones .","problem":["stones"],"test":["an mrcp"],"treatment":[],"problem_indices_start":[55],"problem_indices_end":[61],"test_indices_start":[12],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neurologic examination revealed an alert and oriented individual .","problem":[],"test":["neurologic examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient lives with his disabled wife who has a psychiatric condition .","problem":["a psychiatric condition"],"test":[],"treatment":[],"problem_indices_start":[49],"problem_indices_end":[72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"during his admission to rehab hospital of the cape & islands hospital , the patient had dropped his hematocrit to the 30 s with recorded melena .","problem":["recorded melena"],"test":["his hematocrit"],"treatment":[],"problem_indices_start":[128],"problem_indices_end":[143],"test_indices_start":[96],"test_indices_end":[110],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a chest x-ray was unremarkable .","problem":[],"test":["a chest x-ray"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his electrocardiogram showed a normal sinus rhythm .","problem":[],"test":["his electrocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a hida scan showed no flow , question of pancreatitis versus common bile duct obstruction .","problem":["pancreatitis","no flow","common bile duct obstruction"],"test":["a hida scan"],"treatment":[],"problem_indices_start":[19,41,61],"problem_indices_end":[26,53,89],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his complete blood count showed 11% bandemia with a total white count of 10 .","problem":["11% bandemia"],"test":["a total white count","his complete blood count"],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[44],"test_indices_start":[0,50],"test_indices_end":[24,69],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urinalysis revealed trace glucose , no ketones , no red cells , no white cells and less than one epithelial cells .","problem":["white cells","trace glucose","ketones","red cells"],"test":["urinalysis"],"treatment":[],"problem_indices_start":[20,39,52,67],"problem_indices_end":[33,46,61,78],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient underwent a percutaneous sphincterotomy extended to a full sphincterectomy .","problem":[],"test":[],"treatment":["a percutaneous sphincterotomy","a full sphincterectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,64],"treatment_indices_end":[51,86]}
{"text":"he also had successful extraction of stone fragments .","problem":["stone fragments"],"test":[],"treatment":["successful extraction"],"problem_indices_start":[37],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[33]}
{"text":"the patient tolerated this procedure well and had no complications .","problem":["complications"],"test":[],"treatment":["this procedure"],"problem_indices_start":[53],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[36]}
{"text":"the results of this study indicated that this structure at the head of his pancreas is most likely a forming pseudocyst ; however , the suspicion of malignancy is still possible and the patient underwent an ultrasound guided biopsy of this mass on 2011-01-20 .","problem":["malignancy","this mass","a forming pseudocyst"],"test":["an ultrasound guided biopsy","this study"],"treatment":[],"problem_indices_start":[99,149,235],"problem_indices_end":[119,159,244],"test_indices_start":[15,204],"test_indices_end":[25,231],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"studies revealed a hematocrit of 32.6 , white count of 6.0 .","problem":[],"test":["a hematocrit","white count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17,40],"test_indices_end":[29,51],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his platelet count was 267 .","problem":[],"test":["his platelet count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his alkaline phosphatase and all the other abnormal liver function tests were resolving .","problem":["all the other abnormal liver function tests"],"test":["his alkaline phosphatase"],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[72],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his mcv was 88 , red cell distribution was 13.4 .","problem":[],"test":["his mcv","red cell distribution"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,17],"test_indices_end":[7,38],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had no pain and did not require any pain medications .","problem":["pain"],"test":[],"treatment":["any pain medications"],"problem_indices_start":[10],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[35],"treatment_indices_end":[55]}
{"text":"he was also found to have dilated pancreatic ducts with calcifications consistent with chronic pancreatitis .","problem":["chronic pancreatitis","dilated pancreatic ducts","calcifications"],"test":[],"treatment":[],"problem_indices_start":[26,56,87],"problem_indices_end":[50,70,107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cytology was obtained .","problem":[],"test":["cytology"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was tolerating food very well and was afebrile throughout admission .","problem":["afebrile"],"test":[],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"prior to this result , the patient had already been on ampicillin , sulbactam and gentamycin .","problem":[],"test":[],"treatment":["sulbactam","ampicillin","gentamycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[55,68,82],"treatment_indices_end":[65,77,92]}
{"text":"6. status post tonsillectomy as a child .","problem":[],"test":[],"treatment":["tonsillectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[28]}
{"text":"the cytology for this biopsy is still pending .","problem":[],"test":["this biopsy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17],"test_indices_end":[28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head , eyes , ears , nose and throat examination revealed mucous membranes that were moist .","problem":[],"test":["head , eyes , ears , nose and throat examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient recovered well status post these two procedures .","problem":[],"test":["these two procedures"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[39],"test_indices_end":[59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. regular insulin sliding scale .","problem":[],"test":[],"treatment":["regular insulin sliding scale"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[32]}
{"text":"on this examination , the patient was found to have mild biliary stricture most likely secondary to chronic pancreatitis .","problem":["mild biliary stricture","chronic pancreatitis"],"test":["this examination"],"treatment":[],"problem_indices_start":[52,100],"problem_indices_end":[74,120],"test_indices_start":[3],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his blood cultures were drawn and pending .","problem":[],"test":["his blood cultures"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was taken down to the endoscopic retrogram cholangiopancreatogram upon admission .","problem":[],"test":["the endoscopic retrogram cholangiopancreatogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[30],"test_indices_end":[77],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"albumin was 2.6 .","problem":[],"test":["albumin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"versus early pseudocyst .","problem":["early pseudocyst"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was focal mitral valve prolapse noted without pathologic mitral regurgitation .","problem":["focal mitral valve prolapse","pathologic mitral regurgitation"],"test":[],"treatment":[],"problem_indices_start":[10,52],"problem_indices_end":[37,83],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient , on admission , was placed on ampicillin , gentamycin and flagyl .","problem":[],"test":[],"treatment":["gentamycin","flagyl","ampicillin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[43,56,71],"treatment_indices_end":[53,66,77]}
{"text":"with repeated blood cultures that were negative , the patient was reduced to single mckenzie of intravenous ampicillin .","problem":[],"test":["repeated blood cultures"],"treatment":["intravenous ampicillin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[5],"test_indices_end":[28],"treatment_indices_start":[96],"treatment_indices_end":[118]}
{"text":"a complex plaque was found in the aortic arch in the descending thoracic aorta , although this plaque is non-mobile .","problem":["a complex plaque","this plaque"],"test":[],"treatment":[],"problem_indices_start":[0,90],"problem_indices_end":[16,101],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was thought to have normal dental hygiene and low suspicion for a source of his alpha septicemia from his mouth .","problem":["his alpha septicemia from his mouth"],"test":[],"treatment":[],"problem_indices_start":[88],"problem_indices_end":[123],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there were no other abnormalities noted on this study .","problem":["other abnormalities"],"test":["this study"],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[33],"test_indices_start":[43],"test_indices_end":[53],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was noted to have trace aortic regurgitation .","problem":["trace aortic regurgitation"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a panorex x-ray of his two teeth were obtained and a dental consultation was done .","problem":[],"test":["a panorex x-ray","a dental consultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,51],"test_indices_end":[15,72],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had no complications and no subsequently pancreatitis .","problem":["complications","subsequently pancreatitis"],"test":[],"treatment":[],"problem_indices_start":[10,31],"problem_indices_end":[23,56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was discussed with the patient to send him out on augmentin 500 mg three times a day for ten more days .","problem":[],"test":[],"treatment":["augmentin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[53],"treatment_indices_end":[62]}
{"text":"for this documented septicemia , this patient went for a endocarditis work-up .","problem":["this documented septicemia"],"test":["a endocarditis work-up"],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[30],"test_indices_start":[55],"test_indices_end":[77],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's insurance company , however , would not pay for home antibiotics .","problem":[],"test":[],"treatment":["home antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[63],"treatment_indices_end":[79]}
{"text":"after much discussion with the patient , the patient was informed of the risks of not finishing a 14 day course of intravenous antibiotics and chose to go home .","problem":[],"test":[],"treatment":["intravenous antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[115],"treatment_indices_end":[138]}
{"text":"he was to follow-up with his primary care physician within two to three days for repeat laboratory studies and blood cultures .","problem":[],"test":["repeat laboratory studies","blood cultures"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[81,111],"test_indices_end":[106,125],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient appeared to have been covered by ampicillin , gentamycin and then unasyn in the outside hospital .","problem":[],"test":[],"treatment":["gentamycin","ampicillin","unasyn"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[45,58,78],"treatment_indices_end":[55,68,84]}
{"text":"4. recent pancreatitis ; prior history for recurrent pancreatitis 30 years ago from alcohol .","problem":["recurrent pancreatitis","recent pancreatitis"],"test":[],"treatment":[],"problem_indices_start":[3,43],"problem_indices_end":[22,65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"upon obtaining more information from rehab hospital of the cape & islands hospital , it appears that the patient had two out of four bottles growing out streptococcus sanguis in the outside hospital .","problem":["streptococcus sanguis"],"test":[],"treatment":[],"problem_indices_start":[153],"problem_indices_end":[174],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had a transthoracic echocardiogram which revealed no vegetations .","problem":["vegetations"],"test":["a transthoracic echocardiogram"],"treatment":[],"problem_indices_start":[56],"problem_indices_end":[67],"test_indices_start":[7],"test_indices_end":[37],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. history of streptococcemia in the year 2008 ; source was unclear but presumed to be urinary .","problem":["streptococcemia"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"transfer from rehab hospital of the cape & islands hospital for an endoscopic retrogram cholangiopancreatography .","problem":[],"test":["an endoscopic retrogram cholangiopancreatography"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[64],"test_indices_end":[112],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on this echocardiogram , he was found to have mildly dilated left atrium , mild symmetric left ventricular hypertrophy , and a normal ejection fraction of greater than 55% .","problem":["mildly dilated left atrium","mild symmetric left ventricular hypertrophy"],"test":["this echocardiogram"],"treatment":[],"problem_indices_start":[46,75],"problem_indices_end":[72,118],"test_indices_start":[3],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on an office visit on 01-14 , the patient was found to have significantly elevated alkaline phosphatase .","problem":["significantly elevated alkaline phosphatase"],"test":[],"treatment":[],"problem_indices_start":[60],"problem_indices_end":[103],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"with regards to the patient 's documented strep septicemia in the outside hospital , the infectious disease team was formally consulted .","problem":["the patient 's documented strep septicemia"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on this echocardiogram , he was again noted to not have any evidence for valvular vegetations .","problem":["valvular vegetations"],"test":["this echocardiogram"],"treatment":[],"problem_indices_start":[73],"problem_indices_end":[93],"test_indices_start":[3],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient then underwent a transesophageal echocardiogram on 01-24 .","problem":[],"test":["a transesophageal echocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[27],"test_indices_end":[59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient became hypotensive into the 70 s without any symptoms .","problem":["hypotensive","any symptoms"],"test":[],"treatment":[],"problem_indices_start":[19,53],"problem_indices_end":[30,65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hypotension - on the night of 10-16 , the patient was diuresed with 20 mg of intravenous lasix .","problem":["hypotension"],"test":[],"treatment":["intravenous lasix"],"problem_indices_start":[0],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[77],"treatment_indices_end":[94]}
{"text":"red blood cells with a good response up to 30 .","problem":[],"test":[],"treatment":["red blood cells"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"she continues on her prednisone taper for her asthma and this is day # 14 of antibiotics .","problem":["her asthma"],"test":[],"treatment":["antibiotics","her prednisone taper"],"problem_indices_start":[42],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17,77],"treatment_indices_end":[37,88]}
{"text":"respiratory distress - on 10-12 , the patient was transferred to medicine intensive care unit secondary to respiratory distress .","problem":["respiratory distress","respiratory distress"],"test":[],"treatment":[],"problem_indices_start":[0,107],"problem_indices_end":[20,127],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the medicine intensive care unit , the patient was initially placed on high-flow 60% oxygen face mask and they diuresed approximately 5 liters off into the intravenous lasix .","problem":[],"test":[],"treatment":["high-flow 60% oxygen face mask","the intravenous lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[74,155],"treatment_indices_end":[104,176]}
{"text":"anemia - the patient 's hematocrit dropped in the intensive care unit to the mid 20s and she received one unit of packed","problem":["anemia"],"test":["the patient 's hematocrit"],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[6],"test_indices_start":[9],"test_indices_end":[34],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no further episodes of hypotension were noted .","problem":["hypotension"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given 250 cc of normal saline and her blood pressure responded coming back up to the high 90 s.","problem":[],"test":["her blood pressure"],"treatment":["normal saline"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[50],"test_indices_end":[68],"treatment_indices_start":[32],"treatment_indices_end":[45]}
{"text":"since then the patient 's oxygenation has been improving and today , 10-17 , she is requiring .5 liters of keep her saturations above 94 .","problem":[],"test":["her saturations"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[112],"test_indices_end":[127],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient continues to be diuresed with approximately 20 mg of lasix a day and she has had good urine output .","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[65],"treatment_indices_end":[70]}
{"text":"recent chest x-ray shows resolving right lower lobe pneumonia .","problem":["resolving right lower lobe pneumonia"],"test":["recent chest x-ray"],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[61],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her oxygen saturations were greater than 94% at the time .","problem":[],"test":["her oxygen saturations"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. clonidine 0.2 mg tablet sig : one ( 1 ) tablet po tid ( 3 times a day ).","problem":[],"test":[],"treatment":["clonidine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"carduac enzymes mildly elevated , felt 02-08 demand ischemia in setting of hypertensive urgency , ck and mb trended mcewen at time of admission to medical floor .","problem":["demand ischemia","hypertensive urgency","carduac enzymes mildly elevated"],"test":["mb","ck"],"treatment":[],"problem_indices_start":[0,45,75],"problem_indices_end":[31,60,95],"test_indices_start":[98,105],"test_indices_end":[100,107],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"plan is for surveillance cultures to be drawn at dialysis .","problem":[],"test":["surveillance cultures"],"treatment":["dialysis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12],"test_indices_end":[33],"treatment_indices_start":[49],"treatment_indices_end":[57]}
{"text":"upon presentation it was unclear when last time was that patient took meds , but hypertension likely d\/t inability to take meds in setting of n\/v .","problem":["hypertension","n\/v","inability to take meds"],"test":[],"treatment":["meds"],"problem_indices_start":[81,105,142],"problem_indices_end":[93,127,145],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[70],"treatment_indices_end":[74]}
{"text":"general : sleepy , arouses to voice but limited participation with physical exam","problem":["sleepy"],"test":["physical exam"],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[16],"test_indices_start":[67],"test_indices_end":[80],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt will compelete a 2 week course of vancomycin at hemodialysis , which has been arranged by renal service .","problem":[],"test":[],"treatment":["hemodialysis","vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37,51],"treatment_indices_end":[47,63]}
{"text":"6. clonidine 0.3 mg \/ 24 hr patch weekly sig : one ( 1 ) patch weekly transdermal q wed ( every wednesday ).","problem":[],"test":[],"treatment":["clonidine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"pt with surveillance cultures and port tip cultures showing ngtd on 01-24 , he will have futher surveillance cultures drawn at hemodialysis and followed by his nephrologist .","problem":[],"test":["port tip cultures","futher surveillance cultures","surveillance cultures"],"treatment":["hemodialysis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[8,34,89],"test_indices_end":[29,51,117],"treatment_indices_start":[127],"treatment_indices_end":[139]}
{"text":"his father recently died of esrd and diabetes .","problem":["esrd","diabetes"],"test":[],"treatment":[],"problem_indices_start":[28,37],"problem_indices_end":[32,45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if you have recurrent fevers , chills , naseau , vomitting , chest pain , shortness of breath , or other worrisome symptoms , please contact your primary care physician or the emergency department .","problem":["other worrisome symptoms","naseau","shortness of breath","vomitting","recurrent fevers","chills","chest pain"],"test":[],"treatment":[],"problem_indices_start":[12,31,40,49,61,74,99],"problem_indices_end":[28,37,46,58,71,93,123],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt discharged home on 01-24 with instructions to complete 2 week course of vancomycin at hemodialysis for his port line infection .","problem":["his port line infection"],"test":[],"treatment":["hemodialysis","vancomycin"],"problem_indices_start":[106],"problem_indices_end":[129],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[75,89],"treatment_indices_end":[85,101]}
{"text":"# hypertensive urgency :","problem":["hypertensive urgency"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt admitted to medical floor in hemodynamically stable condition without specific complaints .","problem":["specific complaints"],"test":[],"treatment":[],"problem_indices_start":[73],"problem_indices_end":[92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you were started on a 2 week course of vancomycin to be given at hemodialysis for your line infection .","problem":["your line infection"],"test":[],"treatment":["vancomycin","hemodialysis"],"problem_indices_start":[82],"problem_indices_end":[101],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39,65],"treatment_indices_end":[49,77]}
{"text":"if negative , pt is scheduled for presumptively replacement of port on 2019-02-11 with interventional radiology ( dr. arevalo ).","problem":[],"test":[],"treatment":["interventional radiology","presumptively replacement of port"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34,87],"treatment_indices_end":[67,111]}
{"text":"6. hx of foot ulcer","problem":["foot ulcer"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no signs of infection presently , and tolerating dialysis without difficulty .","problem":["difficulty","infection"],"test":[],"treatment":["dialysis"],"problem_indices_start":[12,66],"problem_indices_end":[21,76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49],"treatment_indices_end":[57]}
{"text":"skin : no rashes","problem":["rashes"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you will have your port replaced after 2 weeks of antibiotics if your blood cultures remain negative .","problem":[],"test":["your blood cultures"],"treatment":["antibiotics","your port"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[65],"test_indices_end":[84],"treatment_indices_start":[14,50],"treatment_indices_end":[23,61]}
{"text":"he has two sisters , one with diabetes , and six brothers , one with diabetes .","problem":["diabetes","diabetes"],"test":[],"treatment":[],"problem_indices_start":[30,69],"problem_indices_end":[38,77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent : perrl , left pupil smaller than right , pt will not participate in eomi , sclera anicteric , mm dry , no op lesions","problem":["anicteric","left pupil smaller than right","mm dry","op lesions"],"test":[],"treatment":[],"problem_indices_start":[16,89,101,113],"problem_indices_end":[45,98,107,123],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt with two episodes of hypoglycemia ( fsbs 22 and 27 ), etiology unclear , pt followed by strickland , who recommend no changes to current insulin regimen .","problem":["hypoglycemia"],"test":["fsbs"],"treatment":["current insulin regimen"],"problem_indices_start":[24],"problem_indices_end":[36],"test_indices_start":[39],"test_indices_end":[43],"treatment_indices_start":[132],"treatment_indices_end":[155]}
{"text":"an appointment was made with interventional radiology on 2019-02-11 to replace his port , under the assumption that his surveillance cultures from dialysis remain negative .","problem":[],"test":["his surveillance cultures"],"treatment":["dialysis","his port"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[116],"test_indices_end":[141],"treatment_indices_start":[79,147],"treatment_indices_end":[87,155]}
{"text":"# dmi : pt on sliding scale as inpatient and taking nph 2 units bid at home .","problem":["dmi"],"test":[],"treatment":["sliding scale","nph"],"problem_indices_start":[2],"problem_indices_end":[5],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14,52],"treatment_indices_end":[27,55]}
{"text":"upon transfer to the cmed ccu the patient appears somewhat uncomfortable , reporting nausea and abdominal pain , but when questioned he was unable \/ unwilling to participate in hpi or exam d\/t sleepiness .","problem":["somewhat uncomfortable","nausea","abdominal pain","sleepiness"],"test":["exam"],"treatment":[],"problem_indices_start":[50,85,96,193],"problem_indices_end":[72,91,110,203],"test_indices_start":[184],"test_indices_end":[188],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. dilaudid 4 mg tablet sig : one ( 1 ) tablet po q3-4hr prn .","problem":[],"test":[],"treatment":["dilaudid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"vitals : 97.4 , 164\/90 , 102 , 10 , 97% 4l","problem":[],"test":["vitals"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"# esrd : etiology likely 02-08 dm and htn , pt tolerating hd well , and underwent dialysis without difficulty on 01-24 .","problem":["dm","esrd","htn","difficulty"],"test":[],"treatment":["dialysis","hd"],"problem_indices_start":[2,31,38,99],"problem_indices_end":[6,33,41,109],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[58,82],"treatment_indices_end":[60,90]}
{"text":"cardiac and infectious sources of hypotension were considered , but cardiac enzymes were not changed from prior studies and he had no localizing signs of infection ; blood cultures were sent and a ultrasound of the l arm avf ordered to rule out abscess at the site .","problem":["abscess at the site","localizing signs of infection","hypotension"],"test":["blood cultures","cardiac enzymes","a ultrasound"],"treatment":["the l arm avf"],"problem_indices_start":[34,134,245],"problem_indices_end":[45,163,264],"test_indices_start":[68,166,195],"test_indices_end":[83,180,207],"treatment_indices_start":[211],"treatment_indices_end":[224]}
{"text":"etiology felt most likely demand ischemia in setting of original hypertensive urgency with persistent elevation of trop 02-08 esrd .","problem":["esrd","demand ischemia","original hypertensive urgency","persistent elevation of trop"],"test":[],"treatment":[],"problem_indices_start":[26,56,91,126],"problem_indices_end":[41,85,119,130],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt continued on home regimen of calcium acetate 667 mg , 3 capsules tid .","problem":[],"test":[],"treatment":["calcium acetate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32],"treatment_indices_end":[47]}
{"text":"labetalol was stopped and he received a 500 cc fluid bolus and his blood pressure rose to sbp 90 s.","problem":[],"test":["his blood pressure","sbp"],"treatment":["a 500 cc fluid bolus","labetalol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[63,90],"test_indices_end":[81,93],"treatment_indices_start":[0,38],"treatment_indices_end":[9,58]}
{"text":"pt was subtherapeuticon inr on admission , thus treated with heparin gtt .","problem":["subtherapeuticon inr"],"test":[],"treatment":["heparin gtt"],"problem_indices_start":[7],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61],"treatment_indices_end":[72]}
{"text":"he eloped prior to formal discharge when his fs was found to be critically high - recommended to patient that he stay for repeat , but left ama without signing any forms .","problem":["critically high"],"test":["his fs"],"treatment":[],"problem_indices_start":[64],"problem_indices_end":[79],"test_indices_start":[41],"test_indices_end":[47],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he will have levels drawn at dialysis and be dosed with vancomycin as appropriate .","problem":[],"test":["levels"],"treatment":["dialysis","vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13],"test_indices_end":[19],"treatment_indices_start":[29,56],"treatment_indices_end":[37,66]}
{"text":"also had labile blood sugars with repeated episodes of hypoglycemia , and strickland recommended sugars in the range of 150-200 .","problem":["hypoglycemia","labile blood sugars"],"test":["sugars"],"treatment":[],"problem_indices_start":[9,55],"problem_indices_end":[28,67],"test_indices_start":[97],"test_indices_end":[103],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition pt will be given vancomycin at dialysis x 2 week course ( last day 2019-02-05 ) given his port line infection .","problem":["his port line infection"],"test":[],"treatment":["vancomycin"],"problem_indices_start":[98],"problem_indices_end":[121],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[39]}
{"text":"he denied cp , sob , ha , vision changes , neck stiffness , dysuria , or other symptoms .","problem":["other symptoms","sob","cp","ha","neck stiffness","dysuria","vision changes"],"test":[],"treatment":[],"problem_indices_start":[10,15,21,26,43,60,73],"problem_indices_end":[12,18,23,40,57,67,87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ext : no c\/c\/e , left arm with fistula with good thrill","problem":["left arm with fistula","c\/c\/e"],"test":[],"treatment":[],"problem_indices_start":[9,17],"problem_indices_end":[14,38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"# av fistula : pt with h\/o numerous clots in av fistula .","problem":["numerous clots"],"test":[],"treatment":["av fistula","av fistula"],"problem_indices_start":[27],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2,45],"treatment_indices_end":[12,55]}
{"text":"pt discharged with instructions to continue coumadin 1.5 mg po q daily with goal inr 02-09 .","problem":[],"test":["goal inr"],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[76],"test_indices_end":[84],"treatment_indices_start":[44],"treatment_indices_end":[52]}
{"text":"pt was continued on aspirin , metoprolol , nifedipine .","problem":[],"test":[],"treatment":["aspirin","metoprolol","nifedipine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20,30,43],"treatment_indices_end":[27,40,53]}
{"text":"pt will be discharged home with plan to continue current dialysis schedule ( tue \/ th \/ sat ).","problem":[],"test":[],"treatment":["current dialysis schedule"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49],"treatment_indices_end":[74]}
{"text":"coumadin held on 01-22 for port removal , and restarted on 01-24 .","problem":[],"test":[],"treatment":["coumadin","port removal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,27],"treatment_indices_end":[8,39]}
{"text":"in the cmed ccu he became hypotensive to sbp 80 s.","problem":["hypotensive"],"test":["sbp"],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[37],"test_indices_start":[41],"test_indices_end":[44],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"calcium acetate 1340 mg tid with meals","problem":[],"test":[],"treatment":["calcium acetate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"troponins rose at admission , however ck and mb trending mcewen wat time of admission to medical service .","problem":[],"test":["troponins","ck","mb"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,38,45],"test_indices_end":[9,40,47],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"port was felt most likely source , and pt has had at least 2 sets of + blood cultures since it was placed .","problem":["+ blood cultures"],"test":[],"treatment":["port"],"problem_indices_start":[69],"problem_indices_end":[85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[4]}
{"text":"metoprolol tartrate 75 mg po tid","problem":[],"test":[],"treatment":["metoprolol tartrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[19]}
{"text":"anzemet 12.5 iv prn","problem":[],"test":[],"treatment":["anzemet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"# n\/v\/ abdominal pain : pt with multiple admissions with similar complaints , etiology 02-08 gastroparesis , improves considerably with ativan , dilaudid , reglan , pt was tolerating po meds \/ diet at time of admission to medical service and was restarted on oral reglan .","problem":["abdominal pain","gastroparesis","similar complaints","n\/v\/"],"test":[],"treatment":["reglan","po meds","oral reglan","dilaudid","ativan"],"problem_indices_start":[2,7,57,93],"problem_indices_end":[6,21,75,106],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[136,145,156,183,259],"treatment_indices_end":[142,153,162,190,270]}
{"text":"metoclopramide 10 mg po q6","problem":[],"test":[],"treatment":["metoclopramide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[14]}
{"text":"history is difficult to obtain from patient d\/t somnolence and lack of desire to participate in interview , but per frank note he was diaphoretic and ' writing in pain ', vomiting clear substance .","problem":["pain","diaphoretic","somnolence","lack of desire"],"test":[],"treatment":[],"problem_indices_start":[48,63,134,163],"problem_indices_end":[58,77,145,167],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"insulin nph 2 units subcutaneous twice a day .","problem":[],"test":[],"treatment":["insulin nph"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"he was restarted on his home regimen of antihypertensives without difficulty ( metoprolol 75 tid , clonidine patch and oral , nifedipine 30 sr q daily ).","problem":[],"test":[],"treatment":["antihypertensives","clonidine patch and oral","nifedipine","metoprolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40,79,99,126],"treatment_indices_end":[57,89,123,136]}
{"text":"this is a 37 y\/o male patient with pmh type i dm , htn , gastroparesis , esrd on hd ( last in 12\/26 per patient ) who presents to cmed ccu with hypertensive urgency unable from the larry .","problem":["esrd","gastroparesis","type i dm","htn","hypertensive urgency"],"test":[],"treatment":["hd"],"problem_indices_start":[39,51,57,73,144],"problem_indices_end":[48,54,70,77,164],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[81],"treatment_indices_end":[83]}
{"text":"clonidine 0.3 mg \/ 24 hr patch weekly transdermal qthur","problem":[],"test":[],"treatment":["clonidine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"his sbp s ranged 140 s- 170 s .","problem":[],"test":["his sbp s"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"# cad - pt denied cp \/ sob throughout hospitalization .","problem":["sob","cp","cad"],"test":[],"treatment":[],"problem_indices_start":[2,18,23],"problem_indices_end":[5,20,26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"clonidine 0.2 mg po tid","problem":[],"test":[],"treatment":["clonidine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"prochlorperazine 10 mg q 6 h","problem":[],"test":[],"treatment":["prochlorperazine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"prochlorperazine 10 mg iv q6h prn","problem":[],"test":[],"treatment":["prochlorperazine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"nausea and vomiting","problem":["vomiting","nausea"],"test":[],"treatment":[],"problem_indices_start":[0,11],"problem_indices_end":[6,19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"will discharge pt with instructions to continue nph 2 units bid as frederick tracey recs .","problem":[],"test":[],"treatment":["nph"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48],"treatment_indices_end":[51]}
{"text":"pt 's hypertensive urgency was resolved upon admission to the medical floor .","problem":["pt 's hypertensive urgency"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ativan 1 mg po q6h prn","problem":[],"test":[],"treatment":["ativan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"dilaudid 4mg po q3-4h prn","problem":[],"test":[],"treatment":["dilaudid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"no evidence of active end organ damage .","problem":["active end organ damage"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"protonix 40 qd","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"01-23 picc placement .","problem":[],"test":[],"treatment":["picc placement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6],"treatment_indices_end":[20]}
{"text":"pt was treated with labetalol gtt in cmed ccu which was weaned off on 01-20 .","problem":[],"test":[],"treatment":["labetalol gtt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[33]}
{"text":"also contribution of autonomic dysfunction .","problem":["autonomic dysfunction"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. metoclopramide 10 mg tablet sig : one ( 1 ) tablet po q6h ( every 6 hours ).","problem":[],"test":[],"treatment":["metoclopramide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[17]}
{"text":"2. metoprolol tartrate 25 mg tablet sig : three ( 3 ) tablet po tid ( 3 times a day ).","problem":[],"test":[],"treatment":["metoprolol tartrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"coumadin 1.5 mg po qhs","problem":[],"test":[],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"abd : soft , nd , nontender , + bs , no guarding , no rebound , multiple well healed scars","problem":["multiple well healed scars","nd","nontender","guarding","rebound"],"test":[],"treatment":[],"problem_indices_start":[13,18,40,54,64],"problem_indices_end":[15,27,48,61,90],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nifedipine 30 sr mg po qd","problem":[],"test":[],"treatment":["nifedipine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"bisacodyl prn","problem":[],"test":[],"treatment":["bisacodyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"he was given ativan a total of 4 mg of ativan , 6 mg of dilaudid , labetolol 20 mg iv x 1 and hydralazine 10 mg iv x 1 without good response ( 200\/99 ).","problem":[],"test":[],"treatment":["dilaudid","ativan","ativan","hydralazine","labetolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,39,56,67,94],"treatment_indices_end":[19,45,64,76,105]}
{"text":"01-24 picc removal .","problem":[],"test":[],"treatment":["picc removal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6],"treatment_indices_end":[18]}
{"text":"tte was obtained which was not concerning for endocarditis .","problem":["endocarditis"],"test":["tte"],"treatment":[],"problem_indices_start":[46],"problem_indices_end":[58],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt without stigmata of sbe .","problem":["stigmata of sbe"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"01-23 port line removal .","problem":[],"test":[],"treatment":["port line removal"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6],"treatment_indices_end":[23]}
{"text":"he recieved 2l ns and was started on labetolol gtt and bp decreased to 161\/79 .","problem":[],"test":["bp"],"treatment":["labetolol gtt","2l ns"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[55],"test_indices_end":[57],"treatment_indices_start":[12,37],"treatment_indices_end":[17,50]}
{"text":"id consult obtained which recommended removal of port , which was taken out on 01-23 .","problem":[],"test":[],"treatment":["removal of port"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[53]}
{"text":"7. h\/o clot in av graft x2 ( march and 2018-07-07 )","problem":["clot"],"test":[],"treatment":["av graft"],"problem_indices_start":[7],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[23]}
{"text":"a picc was breifly placed , however removed as it is unclear if pt can reliably flush this .","problem":[],"test":[],"treatment":["a picc"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"at that time bp was attributed to abdominal pain and inability to take po meds d\/t nausea \/ vomiting .","problem":["nausea","abdominal pain","vomiting"],"test":["bp"],"treatment":[],"problem_indices_start":[34,83,92],"problem_indices_end":[48,89,100],"test_indices_start":[13],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tranferred to cmed ccu for further management while on labetolol gtt .","problem":[],"test":[],"treatment":["labetolol gtt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[55],"treatment_indices_end":[68]}
{"text":"patient recorded as having no known allergies to drugs","problem":["known allergies"],"test":[],"treatment":["drugs"],"problem_indices_start":[30],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49],"treatment_indices_end":[54]}
{"text":"# bacteremia :","problem":["bacteremia"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt with 2\/4 bottles coag neg staph on 01-19 and again on 01-20 .","problem":["coag neg staph"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient early this morning to the ruthie with his usual nausea , vomiting , abdominal pain and was found to be hypertensive to 256\/110 , hr 102 , t 99.2 , rr 22 , 92% ra .","problem":["hypertensive","abdominal pain","vomiting","his usual nausea"],"test":["rr","t","hr"],"treatment":[],"problem_indices_start":[50,69,80,115],"problem_indices_end":[66,77,94,127],"test_indices_start":[141,150,159],"test_indices_end":[143,151,161],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his blood sugar at 10 pm was low at 22 and he was disoriented , which resolved with two glasses of juice ; he did not receive his standing dose of nph that evening .","problem":["disoriented"],"test":["his blood sugar"],"treatment":["nph"],"problem_indices_start":[50],"problem_indices_end":[61],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[147],"treatment_indices_end":[150]}
{"text":"he was to be called out to the medical floor on 2019-01-20 but became somnolent after receiving pain and anti-nausea meds , so he stayed in the icu for closer monitoring of respiratory status , which spontaneously improved .","problem":["somnolent"],"test":[],"treatment":["pain and anti-nausea meds"],"problem_indices_start":[70],"problem_indices_end":[79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[96],"treatment_indices_end":[121]}
{"text":"blood cultures returned positive with gpc in pairs and clusters , so a tte and surveillance cultures were ordered and vancomycin was started .","problem":["gpc in pairs and clusters"],"test":["surveillance cultures","blood cultures","a tte"],"treatment":["vancomycin"],"problem_indices_start":[38],"problem_indices_end":[63],"test_indices_start":[0,69,79],"test_indices_end":[14,74,100],"treatment_indices_start":[118],"treatment_indices_end":[128]}
{"text":"over night , his blood pressure trended up to 130 s systolic .","problem":[],"test":["his blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13],"test_indices_end":[31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"port will be replaced on 2019-02-11 per ir ( dr. welsh placed last port , then removed it on 01-23 ), ordered placed in omr .","problem":[],"test":[],"treatment":["port","port"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,67],"treatment_indices_end":[4,71]}
{"text":"please follow-up with your dialysis physician regarding replacing your port .","problem":[],"test":[],"treatment":["your port"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[66],"treatment_indices_end":[75]}
{"text":"he was restarted on his home blood pressure regimen .","problem":[],"test":[],"treatment":["his home blood pressure regimen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[51]}
{"text":"he received a partial hd session , limited by hypotension .","problem":["hypotension"],"test":[],"treatment":["a partial hd session"],"problem_indices_start":[46],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[32]}
{"text":"3. severe autonomic dysfunction with multiple hospitalizations for hypertensive emergency , gastroparesis , and orthostatic hypotension .","problem":["gastroparesis","hypertensive emergency","orthostatic hypotension","severe autonomic dysfunction"],"test":[],"treatment":[],"problem_indices_start":[3,67,92,112],"problem_indices_end":[31,89,105,135],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"diabetic gastropathy causing inability to toleral oral antihypertensive medication prompting repeated donald presentation for hypertensive urgency .","problem":["diabetic gastropathy","hypertensive urgency","inability to toleral oral antihypertensive medication"],"test":[],"treatment":[],"problem_indices_start":[0,29,126],"problem_indices_end":[20,82,146],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. dm type i","problem":["dm type"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please continue to take all of your medications as prescribed .","problem":[],"test":[],"treatment":["your medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31],"treatment_indices_end":[47]}
{"text":"5. cad with 1-vessel disease ( 50% stenosis d1 in 2014-06-07 ), normal stress","problem":["1-vessel disease","cad","50% stenosis d1"],"test":[],"treatment":[],"problem_indices_start":[3,12,31],"problem_indices_end":[6,28,46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bacteremia 02-08 port line infection","problem":["bacteremia","port line infection"],"test":[],"treatment":[],"problem_indices_start":[0,17],"problem_indices_end":[10,36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"diabetic gastropathy","problem":["diabetic gastropathy"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hypertensive urgency","problem":["hypertensive urgency"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. esrd on hemodialysis started 2017-01-07 on tu , th , sat","problem":["esrd"],"test":[],"treatment":["hemodialysis"],"problem_indices_start":[3],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[11],"treatment_indices_end":[23]}
{"text":"13. aspirin 81 mg tablet sig : one ( 1 ) tablet po once a day .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[11]}
{"text":"14. humalog 100 unit \/ ml solution sig : use as directed subcutaneous four times a day : please use attached sliding scale .","problem":[],"test":[],"treatment":["humalog","sliding scale"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4,109],"treatment_indices_end":[11,122]}
{"text":"15. insulin nph human recomb 100 unit \/ ml suspension sig : 2 units subcutaneous twice a day .","problem":[],"test":[],"treatment":["insulin nph human recomb"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[28]}
{"text":"neck : supple , no jvd","problem":["jvd"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cv : rrr , nl s1 , s2 , 2\/6 systolic murmur at lusb","problem":["2\/6 systolic murmur at lusb"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"11. bisacodyl 5 mg tablet sig : one ( 1 ) tablet po once a day as needed for constipation .","problem":["constipation"],"test":[],"treatment":["bisacodyl"],"problem_indices_start":[77],"problem_indices_end":[89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[13]}
{"text":"12. vancomycin in dextrose 1 g \/ 200 ml piggyback sig : one ( 1 ) intravenous qhd ( each hemodialysis ): 2 week course to be given at dialysis , last day 2019-02-05 .","problem":[],"test":[],"treatment":["vancomycin in dextrose","hemodialysis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4,89],"treatment_indices_end":[26,101]}
{"text":"chest : hd line in place without erythema","problem":["erythema"],"test":[],"treatment":["hd line"],"problem_indices_start":[33],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[8],"treatment_indices_end":[15]}
{"text":"his mother is in her 50 s and has hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. nifedipine 30 mg tablet sustained release sig : one ( 1 ) tablet sustained release po daily ( daily ).","problem":[],"test":[],"treatment":["nifedipine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"10. pantoprazole 40 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po q24h ( every 24 hours ).","problem":[],"test":[],"treatment":["pantoprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[16]}
{"text":"3. calcium acetate 667 mg capsule sig : three ( 3 ) capsule po tid w\/ meals ( 3 times a day with meals ).","problem":[],"test":[],"treatment":["calcium acetate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"4. ativan 1 mg tablet sig : one ( 1 ) tablet po q6h prn .","problem":[],"test":[],"treatment":["ativan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"4. history of esophageal erosion , mw tear","problem":["esophageal erosion","mw tear"],"test":[],"treatment":[],"problem_indices_start":[14,35],"problem_indices_end":[32,42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. warfarin 1 mg tablet sig : 1.5 tablets po daily ( daily ).","problem":[],"test":[],"treatment":["warfarin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"the patient overall continued to improve , but remained physically decompensated and the patient was transferred to waltham\/weston hospital rehabilitation hospital for intensive physical therapy .","problem":["physically decompensated"],"test":[],"treatment":["intensive physical therapy"],"problem_indices_start":[56],"problem_indices_end":[80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[168],"treatment_indices_end":[194]}
{"text":"with regard to the patient 's chronic obstructive pulmonary disease , the patient 's respiratory status improved throughout the remainder of her hospital course .","problem":["the patient 's chronic obstructive pulmonary disease"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was treated with wound care using eucerin cream and also patient was treated with lidocaine jelly for pain control .","problem":[],"test":[],"treatment":["eucerin cream","lidocaine jelly","pain control","wound care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,39,87,107],"treatment_indices_end":[32,52,102,119]}
{"text":"the patient had no shortness of breath or cough on discharge .","problem":["cough","shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[19,42],"problem_indices_end":[38,47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"discharge medications are the same with the addition of viscous lidocaine jelly to be applied to buttock prn and viscous lidocaine swish and swallow tid prn before meals .","problem":[],"test":[],"treatment":["viscous lidocaine jelly","discharge medications","viscous lidocaine swish and swallow"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,56,113],"treatment_indices_end":[21,79,148]}
{"text":"the patient was oxygenating well on her home o2 dose of 2 liters per minute .","problem":[],"test":[],"treatment":["her home o2 dose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36],"treatment_indices_end":[52]}
{"text":"the patient had stage 1 sacral decubitus on her buttocks .","problem":["stage 1 sacral decubitus on her buttocks"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was seen by the wound care nurse and the decubitus ulcer was felt to be mild , but was causing the patient a lot of discomfort and the wound care nurse ivy rose lidocaine jelly .","problem":["the decubitus ulcer","discomfort"],"test":[],"treatment":["lidocaine jelly"],"problem_indices_start":[49,128],"problem_indices_end":[68,138],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[173],"treatment_indices_end":[188]}
{"text":"showed normal sinus rhythm at 107 beats per minute with left axis deviation and poor r-wave progression .","problem":["poor r-wave progression","left axis deviation"],"test":[],"treatment":[],"problem_indices_start":[56,80],"problem_indices_end":[75,103],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , no acute changes were apparent .","problem":["acute changes"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"denies fever or chills .","problem":["fever","chills"],"test":[],"treatment":[],"problem_indices_start":[7,16],"problem_indices_end":[12,22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was believed that a troponin on admission in addition to the wall motion abnormalities she underwent a non-q wave myocardial infarction prior to resulted in her current cardiac failure .","problem":["her current cardiac failure","the wall motion abnormalities","a non-q wave myocardial infarction"],"test":["a troponin"],"treatment":[],"problem_indices_start":[60,104,160],"problem_indices_end":[89,138,187],"test_indices_start":[21],"test_indices_end":[31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she also noted increased dyspnea on exertion .","problem":["increased dyspnea"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bowel sounds positive , soft , non-tender , non-distended .","problem":["non-distended","non-tender"],"test":["bowel sounds"],"treatment":[],"problem_indices_start":[31,44],"problem_indices_end":[41,57],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. isosorbide mononitrate 30 q. day .","problem":[],"test":[],"treatment":["isosorbide mononitrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[25]}
{"text":"electrocardiogram :","problem":[],"test":["electrocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest x-ray showed patient was in congestive heart failure .","problem":["congestive heart failure"],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[58],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1+ lower extremity edema .","problem":["1+ lower extremity edema"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is an 86-year-old female with a past medical history of diabetes and hypertension who presented to the emergency department with a two day history of shortness of breath and easy fatigability .","problem":["easy fatigability","shortness of breath","diabetes","hypertension"],"test":[],"treatment":[],"problem_indices_start":[61,74,155,179],"problem_indices_end":[69,86,174,196],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a cardiac catheterization was deferred until the renal issue could be resolved .","problem":["the renal issue"],"test":["a cardiac catheterization"],"treatment":[],"problem_indices_start":[45],"problem_indices_end":[60],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"included normal cbc , bun 47 , creatinine 2.4 up from baseline of about 1.5 .","problem":[],"test":["bun","creatinine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22,31],"test_indices_end":[25,41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in general , patient in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"also of note was the distal lateral wall hypokinesis .","problem":["the distal lateral wall hypokinesis"],"test":[],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"echocardiogram was obtained which showed moderately depressed left ventricular systolic function as well as hypokinesis of the lower half of septum and apex .","problem":["hypokinesis of the lower half of septum and apex","moderately depressed left ventricular systolic function"],"test":["echocardiogram"],"treatment":[],"problem_indices_start":[41,108],"problem_indices_end":[96,156],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"diuresis was halted and without improvement in creatinine .","problem":[],"test":["creatinine"],"treatment":["diuresis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[47],"test_indices_end":[57],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"on admission , blood pressure 151\/61 , heart rate 75 , sao2 93% on room air .","problem":[],"test":["sao2","blood pressure","heart rate"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[15,39,55],"test_indices_end":[29,49,59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"jugular venous pressure notable at the mid neck upright about 80 degree angles .","problem":[],"test":["jugular venous pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"crackles bilaterally one-third to one-half the way up .","problem":["crackles bilaterally"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was admitted to the cardiac medicine service and treated for presumed diastolic and systolic dysfunction .","problem":["diastolic and systolic dysfunction"],"test":[],"treatment":[],"problem_indices_start":[82],"problem_indices_end":[116],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was started on _________ with excellent diuresis , however , her renal functioning worsening .","problem":["her renal functioning worsening"],"test":[],"treatment":[],"problem_indices_start":[65],"problem_indices_end":[96],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiovascular regular rate and rhythm with a 1-2\/6 holosystolic murmur .","problem":["a 1-2\/6 holosystolic murmur"],"test":[],"treatment":[],"problem_indices_start":[44],"problem_indices_end":[71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it showed a right kidney size of 6.3 cm and a left kidney size of 8.4 cm .","problem":[],"test":["a left kidney size","a right kidney size"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10,44],"test_indices_end":[29,62],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. aspirin 325 mg p.o. q. day .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"she has not required hemodialysis at this time .","problem":[],"test":[],"treatment":["hemodialysis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[33]}
{"text":"2. norvasc 10 mg p.o. q. day .","problem":[],"test":[],"treatment":["norvasc"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"no coronary artery disease .","problem":["coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"throughout hospital course patient 's troponin trended down to less than 0.3 .","problem":[],"test":["patient 's troponin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[27],"test_indices_end":[46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"positive for diabetes .","problem":["diabetes"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , her creatinine continued to increase .","problem":[],"test":["her creatinine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was also moderate to severe focal stenosis of the left renal artery approximately 1.3 cm from its origin .","problem":["moderate to severe focal stenosis of the left renal artery"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[73],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"given her hypertension which was very difficult to control , it was felt that she had renal artery stenosis and thus she underwent mra of the kidney which showed severe right renal artery stenosis at its origin .","problem":["severe right renal artery stenosis at its origin","renal artery stenosis","her hypertension"],"test":["mra of the kidney"],"treatment":[],"problem_indices_start":[6,86,162],"problem_indices_end":[22,107,210],"test_indices_start":[131],"test_indices_end":[148],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was continued with aggressive diuresis .","problem":[],"test":[],"treatment":["aggressive diuresis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[42]}
{"text":"on 05-25 she underwent catheterization and subsequent stenting of the left renal artery .","problem":[],"test":["catheterization"],"treatment":["subsequent stenting of the left renal artery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[23],"test_indices_end":[38],"treatment_indices_start":[43],"treatment_indices_end":[87]}
{"text":"the wall motion abnormalities were noted to be new .","problem":["the wall motion abnormalities"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she denies chest pain , orthopnea , paroxysmal nocturnal dyspnea .","problem":["chest pain","orthopnea","paroxysmal nocturnal dyspnea"],"test":[],"treatment":[],"problem_indices_start":[11,24,36],"problem_indices_end":[21,33,64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. ___________ dinitrate 20 mg p.o. t.i.d.","problem":[],"test":[],"treatment":["dinitrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[24]}
{"text":"1. aspirin 325 mg p.o. q. day .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"6. carvedilol 3.125 p.o. b.i.d.","problem":[],"test":[],"treatment":["carvedilol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"due to dye load required to assess the coronary disease were not visualized .","problem":["the coronary disease"],"test":[],"treatment":["dye load"],"problem_indices_start":[35],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[7],"treatment_indices_end":[15]}
{"text":"9. calcium acetate tums one p.o. t.i.d. with meals .","problem":[],"test":[],"treatment":["calcium acetate tums"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[23]}
{"text":"4. terazosin 1 mg p.o. q. day .","problem":[],"test":[],"treatment":["terazosin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"8. erythropoietin 10,000 units two times a week tuesday and saturday .","problem":[],"test":[],"treatment":["erythropoietin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[17]}
{"text":"4. protonix 20 mg p.o. q. day .","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"3. atorvastatin 10 mg p.o. q. day .","problem":[],"test":[],"treatment":["atorvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"she was transferred to the unit overnight to assess volume which was noted to be optimal .","problem":[],"test":["volume"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[52],"test_indices_end":[58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a renal ultrasound was obtained .","problem":[],"test":["a renal ultrasound"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. multivitamin one p.o. q. day .","problem":[],"test":[],"treatment":["multivitamin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"11. iron sulfate 325 mg p.o. q. day .","problem":[],"test":[],"treatment":["iron sulfate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[16]}
{"text":"12. colace 100 mg p.o. b.i.d.","problem":[],"test":[],"treatment":["colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"10. tylenol 325 mg p.o. q. 4-6 h. p.r.n.","problem":[],"test":[],"treatment":["tylenol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[11]}
{"text":"14. plavix 75 mg p.o. q. day times 30 days .","problem":[],"test":[],"treatment":["plavix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[10]}
{"text":"of note , she has had recent medication changes which included discontinuing diovan and starting terazosin .","problem":[],"test":[],"treatment":["terazosin","diovan","recent medication changes"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,77,97],"treatment_indices_end":[47,83,106]}
{"text":"13. hydralazine 10 mg p.o. q. 6h.","problem":[],"test":[],"treatment":["hydralazine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[15]}
{"text":"however , her creatinine has worsened up to 4.2 .","problem":["worsened"],"test":["her creatinine"],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[37],"test_indices_start":[10],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"however , her urine output has improved .","problem":[],"test":["her urine output"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. non-q wave myocardial infarction .","problem":["non-q wave myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. acute renal failure .","problem":["acute renal failure"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"after the procedure the patient did well .","problem":[],"test":[],"treatment":["the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6],"treatment_indices_end":[19]}
{"text":"however , the patient has noted some abdominal pain , intermittent times a couple of days , none on the day of admission .","problem":["some abdominal pain"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. systolic and diastolic congestive heart failure .","problem":["systolic and diastolic congestive heart failure"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. bilateral renal artery stenosis status post stent left renal artery .","problem":["bilateral renal artery stenosis"],"test":[],"treatment":["stent left renal artery"],"problem_indices_start":[3],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47],"treatment_indices_end":[70]}
{"text":"5. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"denied nausea , vomiting , diaphoresis , bowel movement changes .","problem":["nausea","bowel movement changes","diaphoresis","vomiting"],"test":[],"treatment":[],"problem_indices_start":[7,16,27,41],"problem_indices_end":[13,24,38,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"troponin 4.7 , ck 101 , mb 3 .","problem":[],"test":["ck","troponin","mb"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,15,24],"test_indices_end":[8,17,26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. norvasc 10 mg p.o. q. day .","problem":[],"test":[],"treatment":["norvasc"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"3. osteoarthritis .","problem":["osteoarthritis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has noted increased urinary frequency .","problem":["increased urinary frequency"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. diabetes mellitus .","problem":["diabetes mellitus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"22 year old female transfer from outside hospital after a motor vehicle accident with diagnosed liver laceration by ct scan .","problem":["diagnosed liver laceration"],"test":["ct scan"],"treatment":[],"problem_indices_start":[86],"problem_indices_end":[112],"test_indices_start":[116],"test_indices_end":[123],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"glucose - 74 urea n - 9 creat - 0.7 sodium - 139 potassium - 3.5 chloride - 106 total co2 - 23 anion gap - 14","problem":[],"test":["glucose","sodium","creat","urea n","chloride","potassium","anion gap","total co2"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,24,36,49,65,80,95],"test_indices_end":[7,19,29,42,58,73,89,104],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"glucose - 75 urea n - 10 creat - 0.6 sodium - 137 potassium - 3.7 chloride - 103 total co2 - 23 anion gap - 15","problem":[],"test":["chloride","sodium","potassium","total co2","glucose","creat","anion gap","urea n"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,25,37,50,66,81,96],"test_indices_end":[7,19,30,43,59,74,90,105],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdominal pain predominally on the right upper quadrant , no signs of peritoneal irritation .","problem":["peritoneal irritation","abdominal pain"],"test":[],"treatment":[],"problem_indices_start":[0,70],"problem_indices_end":[14,91],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"alt(sgpt) - 318 * ast(sgot) - 307 * alk phos - 61 tot bili - 0.9","problem":[],"test":["alk phos","alt(sgpt)","ast(sgot)","tot bili"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,18,36,50],"test_indices_end":[9,27,44,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. docusate sodium 100 mg capsule sig : one ( 1 ) capsule po bid ( 2 times a day ) for 4 days .","problem":[],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"left forarm and right knee abrasions .","problem":["left forarm and right knee abrasions"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"call trauma clinic to coordinate the study , result and appointment dates (( 289 ) 411-5387 ).","problem":[],"test":["the study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[33],"test_indices_end":[42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- if any abdominal pain , fever or dizziness , go to the emergency room","problem":["dizziness","any abdominal pain","fever"],"test":[],"treatment":[],"problem_indices_start":[5,26,35],"problem_indices_end":[23,31,44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the liver enzimes come down , no signs of biliary stasis .","problem":["biliary stasis"],"test":["the liver enzimes"],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[56],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"calcium - 8.2 * phosphate - 3.1 magnesium - 2.2","problem":[],"test":["phosphate","magnesium","calcium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,32],"test_indices_end":[7,25,41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- follow up with trauma surgery clinic with the result from the ct scan abdomen","problem":[],"test":["the ct scan abdomen"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[60],"test_indices_end":[79],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- trauma surgery clinic in four weeks with ct abdomen results .","problem":[],"test":["ct abdomen"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[43],"test_indices_end":[53],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- call for appointment to ( 289 ) 411-5387 for the trauma clinic and abdominal ct scan of the abdomen in 4 weeks","problem":[],"test":["abdominal ct scan of the abdomen"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[69],"test_indices_end":[101],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. hydromorphone 2 mg tablet sig : one ( 1 ) tablet po q2h ( every 2 hours ) as needed for pain for 4 days .","problem":["pain"],"test":[],"treatment":["hydromorphone"],"problem_indices_start":[91],"problem_indices_end":[95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"patient was admited , pain was managed with a pca and later with po medication .","problem":["pain"],"test":[],"treatment":["a pca","po medication"],"problem_indices_start":[22],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[44,65],"treatment_indices_end":[49,78]}
{"text":"pt - 11.6 ptt - 26.0 inr(pt) - 0.9","problem":[],"test":["ptt","inr(pt)","pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,21],"test_indices_end":[2,13,28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the liver laceration was stable , no sign of rupture or further complication , did not required surgical managment .","problem":["the liver laceration","further complication","rupture"],"test":[],"treatment":["surgical managment"],"problem_indices_start":[0,45,56],"problem_indices_end":[20,52,76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[96],"treatment_indices_end":[114]}
{"text":"chest clear to auscultation bilateral , s1 s2 normal and with no murmors .","problem":["murmors"],"test":["auscultation"],"treatment":[],"problem_indices_start":[65],"problem_indices_end":[72],"test_indices_start":[15],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"wbc - 8.3 rbc - 3.64 * hgb - 12.6 hct - 36.1 mcv - 99 * mch - 34.7 * mchc - 35.0 rdw - 12.4","problem":[],"test":["mch","rdw","mchc","rbc","hct","hgb","mcv","wbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,23,34,45,56,69,81],"test_indices_end":[3,13,26,37,48,59,73,84],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"alt(sgpt) - 241 * ast(sgot) - 207 * alk phos - 51 tot bili - 0.8","problem":[],"test":["tot bili","alk phos","alt(sgpt)","ast(sgot)"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,18,36,50],"test_indices_end":[9,27,44,58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- analgesic ( percocet ) as needed","problem":[],"test":[],"treatment":["analgesic ( percocet )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[2],"treatment_indices_end":[24]}
{"text":"neck with cervical collar .","problem":[],"test":[],"treatment":["cervical collar"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10],"treatment_indices_end":[25]}
{"text":"cath lab at the pinewood , norfolk that evening where a stent procedure to the rca was complicated by guidewire entrapment inside of a stent requiring ct surgery to do a thoracotomy with bypass and excision of the wire .","problem":[],"test":[],"treatment":["ct surgery","bypass","a stent","a stent procedure to the rca","excision of the wire","a thoracotomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[54,133,151,168,187,198],"treatment_indices_end":[82,140,161,181,193,218]}
{"text":"the patient was taken emergently to the operating room on 2009-05-02 for his cabg , right coronary endarterectomy , removal of rca stents and retrieval of the aortic guidewire .","problem":[],"test":[],"treatment":["removal of rca stents","right coronary endarterectomy","retrieval of the aortic guidewire","his cabg"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[73,84,116,142],"treatment_indices_end":[81,113,137,175]}
{"text":"6. percocet one to two tablets q four h prn for pain .","problem":["pain"],"test":[],"treatment":["percocet"],"problem_indices_start":[48],"problem_indices_end":[52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"the case was complicated by an episode of coffee ground emesis and a bleed from femoral access site prior to ct surgery .","problem":["coffee ground emesis","a bleed from femoral access site"],"test":[],"treatment":["ct surgery"],"problem_indices_start":[42,67],"problem_indices_end":[62,99],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[109],"treatment_indices_end":[119]}
{"text":"5. colace 100 milligrams po bid .","problem":[],"test":[],"treatment":["colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"symptoms resolved spontaneously .","problem":["symptoms"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"postoperatively he did well and was transferred to the cardiac surgery intensive care unit where he was on pressor support of neo-synephrine and he was extubated .","problem":[],"test":[],"treatment":["pressor support","neo-synephrine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[107,126],"treatment_indices_end":[122,140]}
{"text":"the patient slowly weaned off neo-synephrine as tolerated .","problem":[],"test":[],"treatment":["neo-synephrine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30],"treatment_indices_end":[44]}
{"text":"8. aspirin 325 milligrams po q day .","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"he is a 39 year-old gentleman with hyperlipidemia and smoking who presented with acute onset of chest pain since five in the morning with radiation to the left arm and nausea .","problem":["chest pain","nausea","hyperlipidemia"],"test":[],"treatment":[],"problem_indices_start":[35,96,168],"problem_indices_end":[49,106,174],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gastroenterology was consulted and they recommended protonix and felt it was due to peptic ulcer disease .","problem":["peptic ulcer disease"],"test":[],"treatment":["protonix"],"problem_indices_start":[84],"problem_indices_end":[104],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[52],"treatment_indices_end":[60]}
{"text":"his electrolytes were repleted and the patient was discharged home on 2009-05-06 after tolerating a level v .","problem":[],"test":["his electrolytes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. fatty liver resolved .","problem":["fatty liver"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. plavix 75 milligrams po q day times three months .","problem":[],"test":[],"treatment":["plavix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"his chest tube had been discontinued .","problem":[],"test":[],"treatment":["his chest tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[14]}
{"text":"relatively unknown other than lipitor .","problem":[],"test":[],"treatment":["lipitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30],"treatment_indices_end":[37]}
{"text":"upon arrival to the floor the patient 's wires were discontinued on 2009-05-05 and his foley catheter was discontinued .","problem":[],"test":[],"treatment":["his foley catheter","the patient 's wires"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,83],"treatment_indices_end":[46,101]}
{"text":"allergies : he had no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. lasix 20 milligrams po times 30 days .","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"1. lopressor 25 milligrams po bid .","problem":[],"test":[],"treatment":["lopressor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"family history : not significant for coronary artery disease .","problem":["coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[37],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10. kcl 20 milliequivalents po q d times three days .","problem":[],"test":[],"treatment":["kcl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[7]}
{"text":"medications : his prescriptions shall include","problem":[],"test":[],"treatment":["his prescriptions"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[31]}
{"text":"1. hepatitis b .","problem":["hepatitis b"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. lipitor 20 milligrams po q hs .","problem":[],"test":[],"treatment":["lipitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"the patient was diagnosed as having an acute myocardial infarction .","problem":["an acute myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[36],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. hypercholesterolemia .","problem":["hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. protonix 40 milligrams po q day .","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"3. niferex 150 milligrams caplet one cap per day .","problem":[],"test":[],"treatment":["niferex"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"his intravenous fluids were discontinued at this time .","problem":[],"test":[],"treatment":["his intravenous fluids"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[22]}
{"text":"his pain was well controlled with oral medication at this time .","problem":["his pain"],"test":[],"treatment":["oral medication"],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[49]}
{"text":"his penrose drain was discontinued at this time .","problem":[],"test":[],"treatment":["his penrose drain"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[17]}
{"text":"his laboratories were checked and his hematocrit was noted to be stable .","problem":[],"test":["his hematocrit","his laboratories"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,34],"test_indices_end":[16,48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was discharged home with a foley catheter and he will follow-up with dr. ross in one to two weeks .","problem":[],"test":[],"treatment":["a foley catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28],"treatment_indices_end":[44]}
{"text":"on postoperative day number one , he was administered 1 mg coumadin per protocol as well as on the operative day 1 mg of coumadin .","problem":[],"test":[],"treatment":["coumadin","1 mg coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[54,121],"treatment_indices_end":[67,129]}
{"text":"the patient tolerated the procedure well .","problem":[],"test":[],"treatment":["the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[35]}
{"text":"status post radical retropubic prostatectomy .","problem":[],"test":[],"treatment":["radical retropubic prostatectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[44]}
{"text":"dr. marie anderson performed the surgery .","problem":[],"test":[],"treatment":["the surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[40]}
{"text":"the patient is a 64 year old gentleman with a history of elevated psa , prostate cancer .","problem":["elevated psa","prostate cancer"],"test":[],"treatment":[],"problem_indices_start":[57,72],"problem_indices_end":[69,87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was diagnosed with needle biopsy on either side of the prostate with 3+3 equals 6 on the right side and 3+4 equals 7 on the left side .","problem":[],"test":["needle biopsy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22],"test_indices_end":[35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient underwent radical retropubic prostatectomy on 2012-01-20 .","problem":[],"test":[],"treatment":["radical retropubic prostatectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[54]}
{"text":"prostate cancer .","problem":["prostate cancer"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"72 year old man with intraparenchymal bleed s\/p fall","problem":["intraparenchymal bleed"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt - 15.0 * ptt - 31.3 inr(pt) - 1.5","problem":[],"test":["inr(pt)","pt","ptt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,12,23],"test_indices_end":[2,15,30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"decision to continue dobhoff at rehab given continued clinical improvement and his poor candidacy for g\/j tube .","problem":[],"test":[],"treatment":["dobhoff","g\/j tube"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21,102],"treatment_indices_end":[28,110]}
{"text":"indication : intraparenchymal hemorrhage after fall .","problem":["intraparenchymal hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mental status improved with the discontinuation of his bensodiazapines .","problem":[],"test":[],"treatment":["his bensodiazapines"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[51],"treatment_indices_end":[70]}
{"text":"extensive carotid arterial calcifications are present in the bulb regions bilaterally .","problem":["extensive carotid arterial calcifications"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient tolerated decreasing ventillary support.","problem":[],"test":[],"treatment":["decreasing ventillary support."],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[48]}
{"text":"2014-11-11 : tracheostomy performed without complication .","problem":["complication"],"test":[],"treatment":["tracheostomy"],"problem_indices_start":[44],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[25]}
{"text":"prevertebral soft tissue swelling cannot be excluded secondary to intubation .","problem":["prevertebral soft tissue swelling"],"test":[],"treatment":["intubation"],"problem_indices_start":[0],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[66],"treatment_indices_end":[76]}
{"text":"cva 2012 w\/ right sided weakness","problem":["right sided weakness","cva"],"test":[],"treatment":[],"problem_indices_start":[0,12],"problem_indices_end":[3,32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"plt count - 207","problem":[],"test":["plt count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"impression : minimally displaced , comminuted fractures of the left c7 and t1 transverse processes .","problem":["minimally displaced , comminuted fractures of the left c7 and t1 transverse processes"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in tsicu , developed mrsa pneumonia with question of aspiration , treated zosyn --> vanc \/ levo --> then 2 week course of linazolid with resolution of fevers and decreased pulmonary secretions .","problem":["aspiration","mrsa pneumonia","decreased pulmonary secretions","fevers"],"test":[],"treatment":["zosyn","linazolid","levo","vanc"],"problem_indices_start":[21,53,151,162],"problem_indices_end":[35,63,157,192],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[74,84,91,122],"treatment_indices_end":[79,88,95,131]}
{"text":"wbc - 6.5 rbc - 3.68 * hgb - 11.6 * hct - 32.5 * mcv - 88 mch - 31.5 mchc - 35.6 * rdw - 13.6","problem":[],"test":["rdw","mchc","mch","hct","hgb","mcv","rbc","wbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,23,36,49,58,69,83],"test_indices_end":[3,13,26,39,52,61,73,86],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no atlantoaxial subluxation .","problem":["atlantoaxial subluxation"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct c - spine w\/o contrast ; ct reconstruction","problem":[],"test":["ct c - spine w\/o contrast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"type - art temp - 36.6 rates - 14 \/ tidal vol - 550 peep - 5 o2 - 100 po2 - 416 * pco2 - 39 ph - 7.41 total co2 - 26 base xs - 0 aado2 - 279 req o2 - 52 - assist \/ con intubated - intubated","problem":[],"test":["total co2","po2","pco2","temp","ph","rates","aado2","tidal vol","base xs","req o2"],"treatment":["peep","o2"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11,23,36,70,82,92,102,117,129,141],"test_indices_end":[15,28,45,73,86,94,111,124,134,147],"treatment_indices_start":[52,61],"treatment_indices_end":[56,63]}
{"text":"asa - neg ethanol - neg acetmnphn - neg bnzodzpn - neg barbitrt - neg tricyclic - neg","problem":[],"test":["bnzodzpn","ethanol","asa","tricyclic","barbitrt","acetmnphn"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,24,40,55,70],"test_indices_end":[3,17,33,48,63,79],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct c - spine w\/o contrast","problem":[],"test":["ct c - spine w\/o contrast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bnzodzpn - neg barbitrt - neg opiates - neg cocaine - neg amphetmn - neg mthdone - neg","problem":[],"test":["amphetmn","mthdone","cocaine","opiates","barbitrt","bnzodzpn"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,15,30,44,58,73],"test_indices_end":[8,23,37,51,66,80],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"conclusion : improvement in congestion from edema with no worsening , but no significant improvement , in the right upper lobe pneumonia .","problem":["edema","congestion","the right upper lobe pneumonia"],"test":[],"treatment":[],"problem_indices_start":[28,44,106],"problem_indices_end":[38,49,136],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. bisacodyl 5 mg tablet , delayed release ( e.c. ) sig : two ( 2 ) tablet , delayed release ( e.c. ) po daily ( daily ) as needed for constipation .","problem":["constipation"],"test":[],"treatment":["bisacodyl"],"problem_indices_start":[135],"problem_indices_end":[147],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"7. docusate sodium 150 mg \/ 15 ml liquid sig : one ( 1 ) po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"5. metoprolol tartrate 25 mg tablet sig : one ( 1 ) tablet po tid ( 3 times a day ).","problem":[],"test":[],"treatment":["metoprolol tartrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"2014-10-21 09:35 am urine","problem":[],"test":["urine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. digoxin 125 mcg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["digoxin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"3. lansoprazole 30 mg susp , delayed release for recon sig : one ( 1 ) po daily ( daily ).","problem":[],"test":[],"treatment":["lansoprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"4. linezolid 600 mg tablet sig : one ( 1 ) tablet po q12h ( every 12 hours ): last dose 2014-11-20 .","problem":[],"test":[],"treatment":["linezolid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"ulcerative colitis w\/ colostomy","problem":["ulcerative colitis"],"test":[],"treatment":["colostomy"],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[31]}
{"text":"2. lisinopril 15 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"pacemaker","problem":[],"test":[],"treatment":["pacemaker"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"2. ovoid 18 - mm density within the atrium of the right lateral ventricle .","problem":["ovoid 18 - mm density within the atrium"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"serial ct head revealed decreased blood through 2014-11-14 .","problem":["decreased blood"],"test":["serial ct head"],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[39],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"findings were discussed with dr. leanne vazquez at the time this study was performed , but the study was not dictated until the morning of 2014-10-22 , due to pacs malfunction .","problem":[],"test":["the study","this study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[60,91],"test_indices_end":[70,100],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"technique : noncontrast cervical spine ct .","problem":[],"test":["noncontrast cervical spine ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12],"test_indices_end":[41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. heparin ( porcine ) 5,000 unit\/ml solution sig : one ( 1 ) injection tid ( 3 times a day ).","problem":[],"test":[],"treatment":["heparin ( porcine )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"positioning limits assessment of alignment due to extreme head tilting to the right , but this is likely the best obtainable secondary to intubation and nasogastric tube placement .","problem":["extreme head tilting to the right"],"test":["assessment of alignment"],"treatment":["nasogastric tube placement","intubation"],"problem_indices_start":[50],"problem_indices_end":[83],"test_indices_start":[19],"test_indices_end":[42],"treatment_indices_start":[138,153],"treatment_indices_end":[148,179]}
{"text":"bronchoscopy 2014-11-05","problem":[],"test":["bronchoscopy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"progressed adequately with physical \/ occupational therapy , however was noted to develop an early bilateral upper extermity contracture at the elbows and wrists .","problem":["an early bilateral upper extermity contracture at the elbows and wrists"],"test":[],"treatment":["physical \/ occupational therapy"],"problem_indices_start":[90],"problem_indices_end":[161],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[58]}
{"text":"there is diffuse brain atrophy and chronic microvascular infarction throughout the white matter .","problem":["diffuse brain atrophy","chronic microvascular infarction throughout the white matter"],"test":[],"treatment":[],"problem_indices_start":[9,35],"problem_indices_end":[30,95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"by report , the patient has an outside study .","problem":[],"test":["an outside study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[28],"test_indices_end":[44],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"supporting tubes and lines are in unchanged position and the patient has a single lead pacemaker projected on the left .","problem":[],"test":[],"treatment":["supporting tubes and lines","a single lead pacemaker"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,73],"treatment_indices_end":[26,96]}
{"text":"technique : non-contrast head ct .","problem":[],"test":["non-contrast head ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"comparison : no prior studies are available .","problem":[],"test":["prior studies"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"assess for hemorrhage .","problem":["hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is opacification of the posterior nasal cavity and nasopharynx but an ng tube is present , and the patient is intubated .","problem":["opacification of the posterior nasal cavity and nasopharynx"],"test":[],"treatment":["an ng tube"],"problem_indices_start":[9],"problem_indices_end":[68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[73],"treatment_indices_end":[83]}
{"text":"left rib fractures 05-22","problem":["left rib fractures"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is a small amount of blood layering in both lateral ventricles , and this has decreased since the previous study .","problem":["a small amount of blood layering in both lateral ventricles"],"test":["the previous study"],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[68],"test_indices_start":[100],"test_indices_end":[118],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bleed ?","problem":["bleed"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[5],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"reason : bleed ?","problem":["bleed"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"c7 & t1 mimimally displaced transverse process fracture","problem":["c7 & t1 mimimally displaced transverse process fracture"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there are numerous areas of decreased attenuation in the periventricular and subcortical white matter of both cerebral hemispheres , indicating chronic microvascular infarction .","problem":["chronic microvascular infarction","decreased attenuation in the periventricular and subcortical white matter"],"test":[],"treatment":[],"problem_indices_start":[28,144],"problem_indices_end":[101,176],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"multiple left-sided rib fractures are seen .","problem":["multiple left-sided rib fractures"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct head w\/o contrast","problem":[],"test":["ct head w\/o contrast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no evidence of surrounding edema .","problem":["surrounding edema"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"subarachnoid hemorrhage w\/ bilateral intraventricular hemorrhage","problem":["bilateral intraventricular hemorrhage","subarachnoid hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[0,27],"problem_indices_end":[23,64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"located within the atrium of the right lateral ventricle is an 18 x 10 mm nodular area of increased density which is separate from the choroid plexus .","problem":["an 18 x 10 mm nodular area of increased density"],"test":[],"treatment":[],"problem_indices_start":[60],"problem_indices_end":[107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"intubated and sedated for desats on 2014-10-27 .","problem":["desats"],"test":[],"treatment":["intubated","sedated"],"problem_indices_start":[26],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,14],"treatment_indices_end":[9,21]}
{"text":"non-contrast head ct : there is a small amount of hemorrhage within the occipital horns of both lateral ventricles , right greater than left .","problem":["a small amount of hemorrhage"],"test":["non-contrast head ct"],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[60],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left t1 transverse process fracture","problem":["left t1 transverse process fracture"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the ventricles do not appear dilated relative to the sulci , and there is no shift of normally midline structures .","problem":["shift of normally midline structures"],"test":[],"treatment":[],"problem_indices_start":[77],"problem_indices_end":[113],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. magnesium hydroxide 400 mg \/ 5 ml suspension sig : thirty ( 30 ) ml po q6h ( every 6 hours ) as needed for consitpation .","problem":["consitpation"],"test":[],"treatment":["magnesium hydroxide"],"problem_indices_start":[110],"problem_indices_end":[122],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"note : this study was initially performed on the morning of 10-21 , and is being dictated on the morning of 10-22 due to pacs malfunction .","problem":[],"test":["this study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[7],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no evidence of subarachnoid hemorrhage or acute major vascular territorial infarction .","problem":["acute major vascular territorial infarction","subarachnoid hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[24,51],"problem_indices_end":[47,94],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"should this become available , an addendum will be issued to this report following the comparison with the outside examination .","problem":[],"test":["the outside examination"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[103],"test_indices_end":[126],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tracheostomy 2014-11-11","problem":[],"test":[],"treatment":["tracheostomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"iodine ; iodine containing","problem":[],"test":[],"treatment":["iodine containing","iodine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,9],"treatment_indices_end":[6,26]}
{"text":"some interstitial edema still persists , but there is no central pulmonary vascular congestion .","problem":["some interstitial edema","central pulmonary vascular congestion"],"test":[],"treatment":[],"problem_indices_start":[0,57],"problem_indices_end":[23,94],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"noncontrast cervical spine ct : there are minimally displaced and comminuted fractures through the left c7 and t1 transverse processes .","problem":["minimally displaced and comminuted fractures through the left c7 and t1 transverse processes"],"test":["noncontrast cervical spine ct"],"treatment":[],"problem_indices_start":[42],"problem_indices_end":[134],"test_indices_start":[0],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"failed swallow study x 2 in early november .","problem":["failed swallow study"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"note : this study was initially performed on 2014-10-21 .","problem":[],"test":["this study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[7],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no evidence of extension into the foramina transversaria .","problem":["extension into the foramina transversaria"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"admitted to tsicu for subarachnoid hemorrhage and multiple spinal fractures .","problem":["multiple spinal fractures","subarachnoid hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[22,50],"problem_indices_end":[45,75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct head w\/o contrast","problem":[],"test":["ct head w\/o contrast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"also noted is sclerosis and opacification of the visualized left mastoid air cells and mastoid tip , likely chronic inflammatory","problem":["opacification of the visualized left mastoid air cells and mastoid tip","sclerosis"],"test":[],"treatment":[],"problem_indices_start":[14,28],"problem_indices_end":[23,98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"portable supine chest radiograph shows improvement in edema compared to studies from four and five days earlier with no significant radiographic change in right upper lobe consolidation consistent with pneumonia .","problem":["pneumonia","right upper lobe consolidation","edema","significant radiographic change"],"test":["studies","portable supine chest radiograph"],"treatment":[],"problem_indices_start":[54,120,155,202],"problem_indices_end":[59,151,185,211],"test_indices_start":[0,72],"test_indices_end":[32,79],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"disease .","problem":["disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"biapical lung scarring and mild bronchiectasis are present .","problem":["mild bronchiectasis","biapical lung scarring"],"test":[],"treatment":[],"problem_indices_start":[0,27],"problem_indices_end":[22,46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"supporting lines and tubes in unchanged position .","problem":[],"test":[],"treatment":["supporting lines and tubes"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[26]}
{"text":"this could represent either an atypically located blood clot or an intraventricular mass , and further evaluation with contrast - enhanced mri of the brain , when clinically feasible , is recommended .","problem":["an intraventricular mass","an atypically located blood clot"],"test":["contrast - enhanced mri of the brain"],"treatment":[],"problem_indices_start":[28,64],"problem_indices_end":[60,88],"test_indices_start":[119],"test_indices_end":[155],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"atrial fibrillation ( on coumadin )","problem":["atrial fibrillation"],"test":[],"treatment":["coumadin"],"problem_indices_start":[0],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[25],"treatment_indices_end":[33]}
{"text":"1. small amount of intraventricular hemorrhage .","problem":["intraventricular hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct head w\/o contrast","problem":[],"test":["ct head w\/o contrast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct head w\/o contrast","problem":[],"test":["ct head w\/o contrast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"history : trauma , congestive heart failure , fever , pneumonia .","problem":["trauma","fever","congestive heart failure","pneumonia"],"test":[],"treatment":[],"problem_indices_start":[10,19,46,54],"problem_indices_end":[16,43,51,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is a remote right frontal infarct .","problem":["a remote right frontal infarct"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you must continue to wear your cervical collar for the next 4 weeks ( through 12-11 ).","problem":[],"test":[],"treatment":["your cervical collar"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26],"treatment_indices_end":[46]}
{"text":"opacified and sclerotic left mastoid air cells are noted .","problem":["opacified and sclerotic left mastoid air cells"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no skull fracture .","problem":["skull fracture"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is also an old right frontal lobe cortical infarction .","problem":["an old right frontal lobe cortical infarction"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a small right occipital lobe chronic infarction is also evident .","problem":["a small right occipital lobe chronic infarction"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is some fluid or mucosal thickening in the ethmoid and sphenoid sinuses .","problem":["some fluid","mucosal thickening in the ethmoid and sphenoid sinuses"],"test":[],"treatment":[],"problem_indices_start":[9,23],"problem_indices_end":[19,77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hypertension","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no new hemorrhage is observed .","problem":["new hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is opacification of the mastoid air cells , greater on the left than the right .","problem":["opacification of the mastoid air cells"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"altered mental status","problem":["altered mental status"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coronary artery disease","problem":["coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"reason : altered mental status","problem":["altered mental status"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"comparison is made to a previous study from 2014-10-27 .","problem":[],"test":["a previous study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22],"test_indices_end":[38],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"indication : 72-year-old male with altered mental status .","problem":["altered mental status"],"test":[],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cataracts , s\/p cataract surgery","problem":["cataracts"],"test":[],"treatment":["cataract surgery"],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[32]}
{"text":"technique : axial noncontrast ct scans of the brain were obtained .","problem":[],"test":["axial noncontrast ct scans of the brain"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12],"test_indices_end":[51],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest ( portable ap )","problem":[],"test":["chest ( portable ap )"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"occasionally required haldol \/ ativan at night for agitation .","problem":["agitation"],"test":[],"treatment":["ativan","haldol"],"problem_indices_start":[51],"problem_indices_end":[60],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,31],"treatment_indices_end":[28,37]}
{"text":"chest ( portable ap )","problem":[],"test":["chest ( portable ap )"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"reason : fever , f\/u infiltrte","problem":["fever","infiltrte"],"test":[],"treatment":[],"problem_indices_start":[9,21],"problem_indices_end":[14,30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"communicating by speech s\/p pmv placement .","problem":[],"test":[],"treatment":["pmv placement"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28],"treatment_indices_end":[41]}
{"text":"72 yo m with rib fx s\/p trauma , failure on previous cxr , now with fever .","problem":["fever","rib fx","trauma"],"test":["previous cxr"],"treatment":[],"problem_indices_start":[13,24,68],"problem_indices_end":[19,30,73],"test_indices_start":[44],"test_indices_end":[56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"glucose - 126 * urea n - 9 creat - 0.8 sodium - 135 potassium - 3.4 chloride - 99 total co2 - 25 anion gap - 14","problem":[],"test":["creat","sodium","potassium","glucose","urea n","chloride","anion gap","total co2"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,27,39,52,68,82,97],"test_indices_end":[7,22,32,45,61,76,91,106],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"impression : no new cortical territorial infarction or hemorrhage is identified .","problem":["hemorrhage","new cortical territorial infarction"],"test":[],"treatment":[],"problem_indices_start":[16,55],"problem_indices_end":[51,65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is decreased intraventricular blood , compared to the previous study , and there are no signs of hydrocephalus .","problem":["decreased intraventricular blood","hydrocephalus"],"test":["the previous study"],"treatment":[],"problem_indices_start":[9,103],"problem_indices_end":[41,116],"test_indices_start":[56],"test_indices_end":[74],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"s\/p turp","problem":[],"test":[],"treatment":["turp"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[8]}
{"text":"evaluated by orthopedic spine surgeons with recommendations for soft c-collar for comfort .","problem":[],"test":[],"treatment":["soft c-collar"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[64],"treatment_indices_end":[77]}
{"text":"ct head remained stable for sah .","problem":["sah"],"test":["ct head"],"treatment":[],"problem_indices_start":[28],"problem_indices_end":[31],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"calcium - 8.2 * phosphate - 2.1 * magnesium - 1.9","problem":[],"test":["phosphate","magnesium","calcium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,34],"test_indices_end":[7,25,43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac size is unchanged .","problem":[],"test":["cardiac size"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the amount of fluid layering at the apices and the pleural spaces appear slightly decreased .","problem":["fluid layering at the apices and the pleural spaces"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"calcification is seen at both carotid bifurcations .","problem":["calcification"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"fever , f\/u infiltrte","problem":["fever","infiltrte"],"test":[],"treatment":[],"problem_indices_start":[0,12],"problem_indices_end":[5,21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no air-fluid levels to suggest occult facial fractures .","problem":["occult facial fractures"],"test":["air-fluid levels"],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[54],"test_indices_start":[3],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his right tib \/ fib fracture was repaired by orthopedics on 10-27 ; postoperatively there were no complications .","problem":["complications","his right tib \/ fib fracture"],"test":[],"treatment":[],"problem_indices_start":[0,98],"problem_indices_end":[28,111],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was transfused with 3 u packed cells for a hematocrit of 21 , post transfusion hct was 26.1 ; there was a questionable transfusion reaction at the end of his first unit of packed cells ; he did subsequently receive the remaining 2 units without any further reaction .","problem":["any further reaction","transfusion reaction"],"test":["a hematocrit","post transfusion hct"],"treatment":["3 u packed cells","his first unit of packed cells","the remaining 2 units"],"problem_indices_start":[122,248],"problem_indices_end":[142,268],"test_indices_start":[44,65],"test_indices_end":[56,85],"treatment_indices_start":[23,157,218],"treatment_indices_end":[39,187,239]}
{"text":"he was fitted with a hinged mcdonald brace for his lle .","problem":["his lle"],"test":[],"treatment":["a hinged mcdonald brace"],"problem_indices_start":[47],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[42]}
{"text":"return to the emergency room if you develop fevers , chills , severe headaches , visual disturbances , nause , vomiting and \/ or any other symptoms that are concerning to you .","problem":["vomiting","nause","severe headaches","any other symptoms","fevers","visual disturbances","chills"],"test":[],"treatment":[],"problem_indices_start":[44,53,62,81,103,111,129],"problem_indices_end":[50,59,78,100,108,119,147],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"upon arrival gcs 15 , alert and oriented x3 .","problem":[],"test":["gcs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"subdural hematoma","problem":["subdural hematoma"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"inform the office that you will need a repeat head ct scan for this appointment .","problem":[],"test":["a repeat head ct scan"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[37],"test_indices_end":[58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his neurosurgical issues were nonoperative ; he was loaded with dilantin ; serial head ct scans were performed and were stable .","problem":["his neurosurgical issues"],"test":["serial head ct scans"],"treatment":["dilantin"],"problem_indices_start":[0],"problem_indices_end":[24],"test_indices_start":[75],"test_indices_end":[95],"treatment_indices_start":[64],"treatment_indices_end":[72]}
{"text":"he will need to follow up with dr. mckinney in 4 weeks for repeat head imaging and continue with dilantin for one month .","problem":[],"test":["repeat head imaging"],"treatment":["dilantin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[59],"test_indices_end":[78],"treatment_indices_start":[97],"treatment_indices_end":[105]}
{"text":"impression : no evidence of significant abnormality .","problem":["significant abnormality"],"test":[],"treatment":[],"problem_indices_start":[28],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"reason : follow up ct","problem":[],"test":["follow up ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[9],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"glucose - 101 lactate - 2.9 * na+ - 142 k+ - 3.6 cl- - 102 tco2 - 26","problem":[],"test":["tco2","k+","glucose","lactate","cl-","na+"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,14,30,40,49,59],"test_indices_end":[7,21,33,42,52,63],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"17 yo male pedestrian who was struck by auto at unknown speed ; +loc .","problem":["+loc"],"test":[],"treatment":[],"problem_indices_start":[64],"problem_indices_end":[68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"skull fracture","problem":["skull fracture"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"indication : fracture . assess for alignment .","problem":["fracture"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the lung apices are clear without pneumothorax .","problem":["pneumothorax"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you will need to conrtinue with your lovenox injections for at least 4-6 weeks as instructed by orthopedics","problem":[],"test":[],"treatment":["your lovenox injections"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32],"treatment_indices_end":[55]}
{"text":"wbc - 16.0 * rbc - 4.89 hgb - 14.5 hct - 40.4 mcv - 83 mch - 29.7 mchc - 35.9 * rdw - 13.4","problem":[],"test":["wbc","hct","mcv","mchc","rdw","hgb","mch","rbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,24,35,46,55,66,80],"test_indices_end":[3,16,27,38,49,58,70,83],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no shift of normally midline structures or hydrocephalus .","problem":["hydrocephalus","shift of normally midline structures"],"test":[],"treatment":[],"problem_indices_start":[12,52],"problem_indices_end":[48,65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no significant prevertebral soft tissue swelling .","problem":["significant prevertebral soft tissue swelling"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the pneumocephalus adjacent to the linear skull fracture appears to have decreased in size .","problem":["the linear skull fracture","pneumocephalus"],"test":[],"treatment":[],"problem_indices_start":[4,31],"problem_indices_end":[18,56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. oxycodone 5 mg tablet sig : two ( 2 ) tablet po q4h ( every 4 hours ) as needed for pain .","problem":["pain"],"test":[],"treatment":["oxycodone"],"problem_indices_start":[87],"problem_indices_end":[91],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"3. docusate sodium 100 mg capsule sig : one ( 1 ) capsule po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"multiple posterior right - sided mastoid air cells are opacified with blood .","problem":["opacified with blood"],"test":[],"treatment":[],"problem_indices_start":[55],"problem_indices_end":[75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is a non-displaced comminuted fracture of the proximal fibular diaphysis .","problem":["a non-displaced comminuted fracture of the proximal fibular diaphysis"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct c-spine w\/o contrast","problem":[],"test":["ct c-spine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is a linear right temporal calvarial fracture extending into the right temporal bones .","problem":["a linear right temporal calvarial fracture"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. phenytoin 50 mg tablet , chewable sig : two ( 2 ) tablet , chewable po three times a day for 1 months .","problem":[],"test":[],"treatment":["phenytoin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"2015-10-27 open reduction and internal fixation of right tib\/fib fractures","problem":["right tib\/fib fractures"],"test":[],"treatment":["open reduction","internal fixation"],"problem_indices_start":[51],"problem_indices_end":[74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[11,30],"treatment_indices_end":[25,47]}
{"text":"17 year old man with pneumocephalus s\/p cmed ccu v. mvc","problem":["pneumocephalus"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"discussed with trauma team during the study .","problem":[],"test":["the study"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[34],"test_indices_end":[43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"additionally , a side plate is seen medially fixating the fracture .","problem":["the fracture"],"test":[],"treatment":["a side plate"],"problem_indices_start":[54],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15],"treatment_indices_end":[27]}
{"text":"right tibia \/ fibula , ap and lateral views : an intramedullary rod is seen fixating a proximal diaphyseal comminuted tibial fracture with six proximal and two distal screws .","problem":["a proximal diaphyseal comminuted tibial fracture"],"test":["right tibia \/ fibula , ap and lateral views"],"treatment":["six proximal and two distal screws","an intramedullary rod"],"problem_indices_start":[85],"problem_indices_end":[133],"test_indices_start":[0],"test_indices_end":[43],"treatment_indices_start":[46,139],"treatment_indices_end":[67,173]}
{"text":"allergic to pcn and sulfa","problem":["allergic"],"test":[],"treatment":["sulfa","pcn"],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12,20],"treatment_indices_end":[15,25]}
{"text":"pt - 12.7 ptt - 23.8 inr(pt) - 1.1","problem":[],"test":["ptt","inr(pt)","pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,21],"test_indices_end":[2,13,28],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there are persistent bifrontal and right parietal hemorrhagic contusions with surrounding edema and possible small left frontal subarachnoid hemorrhage ( adjacent to falx ) which are largely unchanged .","problem":["surrounding edema","persistent bifrontal and right parietal hemorrhagic contusions","small left frontal subarachnoid hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[10,78,109],"problem_indices_end":[72,95,151],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is normal alignment of the cervical vertebral bodies without acute fracture or traumatic malalignment .","problem":["acute fracture","traumatic malalignment"],"test":[],"treatment":[],"problem_indices_start":[67,85],"problem_indices_end":[81,107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"56 year old man with open rle fx now s\/p fixation","problem":["open rle fx"],"test":[],"treatment":["s\/p fixation"],"problem_indices_start":[21],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37],"treatment_indices_end":[49]}
{"text":"indication : postoperative fever .","problem":["postoperative fever"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"technique : axial mdct images of the cervical spine with coronal and sagittal reformats without iv contrast .","problem":[],"test":["axial mdct images of the cervical spine"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12],"test_indices_end":[51],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"eval for fx","problem":["fx"],"test":["eval"],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[11],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was medflighted to the hospital for orthopedics for ongoing trauma care .","problem":[],"test":[],"treatment":["ongoing trauma care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[55],"treatment_indices_end":[74]}
{"text":"eval for alignment , post op changes","problem":[],"test":["eval for alignment , post op changes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"findings : the previously noted subdural hemorrhage in the right posterior fossa appears less conspicuous .","problem":["subdural hemorrhage in the right posterior fossa"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no shift of normally midline structures .","problem":["shift of normally midline structures"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"attention deficit disorder ( diagnosed @ 14 yrs of age )","problem":["attention deficit disorder"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urea n - 12 creat - 1.0","problem":[],"test":["urea n","creat"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,12],"test_indices_end":[6,17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"impression : linear right temporal calvarial fracture extending into the mastoid process with small associated right posterior convexity subdural hematoma and pneumocephalus .","problem":["pneumocephalus","small associated right posterior convexity subdural hematoma","linear right temporal calvarial fracture"],"test":[],"treatment":[],"problem_indices_start":[13,94,159],"problem_indices_end":[53,154,173],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2) linear right temporal calvarial fracture extending into the mastoid with a small right posterior convexity subdural hematoma and pneumocephalus ; see head ct report .","problem":["a small right posterior convexity subdural hematoma","pneumocephalus","linear right temporal calvarial fracture"],"test":["head ct"],"treatment":[],"problem_indices_start":[3,76,132],"problem_indices_end":[43,127,146],"test_indices_start":[153],"test_indices_end":[160],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. multifocal hemorrhagic contusions and surrounding edema are largely unchanged .","problem":["surrounding edema","multifocal hemorrhagic contusions"],"test":[],"treatment":[],"problem_indices_start":[3,41],"problem_indices_end":[36,58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. decreased size of right posterior subdural hemorrhage .","problem":["right posterior subdural hemorrhage"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sulfa ( sulfonamides ) \/ penicillins","problem":[],"test":[],"treatment":["penicillins","sulfa ( sulfonamides )"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,25],"treatment_indices_end":[22,36]}
{"text":"ct head w\/o contrast","problem":[],"test":["ct head"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the air- fluid level in the right sphenoid sinus and bilateral opacification of the mastoid air cells are unchanged .","problem":["bilateral opacification of the mastoid air cells"],"test":["the air- fluid level in the right sphenoid sinus"],"treatment":[],"problem_indices_start":[53],"problem_indices_end":[101],"test_indices_start":[0],"test_indices_end":[48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no other acute fractures are appreciated .","problem":["other acute fractures"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was admitted to the trauma service . orthopedics and neurosurgery were consulted because of his injuries .","problem":["his injuries"],"test":[],"treatment":[],"problem_indices_start":[95],"problem_indices_end":[107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is also a left occipital scalp contusion but no associated skull fracture .","problem":["a left occipital scalp contusion","associated skull fracture"],"test":[],"treatment":[],"problem_indices_start":[14,54],"problem_indices_end":[46,79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"technique : non-contrast head ct .","problem":[],"test":["non-contrast head ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is a small subdural hematoma with components of pneumocephalus tracking from the mastoid air cells .","problem":["pneumocephalus","a small subdural hematoma"],"test":[],"treatment":[],"problem_indices_start":[9,54],"problem_indices_end":[34,68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right comminuted tibia \/ fibula fracture","problem":["right comminuted tibia \/ fibula fracture"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"17 year old man with post-op fever .","problem":["post-op fever"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1) no acute cervical spine fracture .","problem":["acute cervical spine fracture"],"test":[],"treatment":[],"problem_indices_start":[6],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no evidence of chf .","problem":["chf"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"impression : comminuted proximal tibiofibular fractures status post orif of the tibia with an intramedullary rod and side plate .","problem":["comminuted proximal tibiofibular fractures"],"test":[],"treatment":["an intramedullary rod and side plate","status post orif of the tibia"],"problem_indices_start":[13],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[56,91],"treatment_indices_end":[85,127]}
{"text":"technique : axial mdct images of the brain without iv contrast .","problem":[],"test":["axial mdct images of the brain"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12],"test_indices_end":[42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"reason : please r\/o acute process .","problem":["acute process"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is surrounding soft tissue swelling .","problem":["soft tissue swelling"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. magnesium hydroxide 400 mg \/ 5 ml suspension sig : thirty ( 30 ) ml po q6h ( every 6 hours ) as needed for constipation .","problem":["constipation"],"test":[],"treatment":["magnesium hydroxide"],"problem_indices_start":[110],"problem_indices_end":[122],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"there are no pleural effusions or focal consolidations .","problem":["focal consolidations","pleural effusions"],"test":[],"treatment":[],"problem_indices_start":[13,34],"problem_indices_end":[30,54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"technique : pa and lateral views of the chest .","problem":[],"test":["pa and lateral views of the chest"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12],"test_indices_end":[45],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"eval for bleed","problem":["bleed"],"test":["eval"],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[14],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no evidence of immediate hardware complication .","problem":["immediate hardware complication"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please r\/o acute process .","problem":["acute process"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. lovenox 40 mg \/ 0.4 ml syringe sig : 0.4 ml 's subcutaneous once a day for 30 days .","problem":[],"test":[],"treatment":["lovenox"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"comparison : non-contrast head ct from 2015-10-27 .","problem":[],"test":["non-contrast head ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"findings : there is a linear nondepressed right temporal calvarial fracture extending into the mastoid process .","problem":["a linear nondepressed right temporal calvarial fracture"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"prominent sutures in this young patient , the right calvarial suture extending into the right temporal bones appears more prominent than its counterpart on the left , however , does not appear to represent an acute fracture .","problem":["an acute fracture"],"test":[],"treatment":["prominent sutures","the right calvarial suture"],"problem_indices_start":[206],"problem_indices_end":[223],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,42],"treatment_indices_end":[17,68]}
{"text":"follow up ct scan .","problem":[],"test":["follow up ct scan"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"asa - neg ethanol - neg acetmnphn - neg bnzodzpn - neg barbitrt - neg tricyclic - neg","problem":[],"test":["barbitrt","acetmnphn","bnzodzpn","asa","ethanol","tricyclic"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,24,40,55,70],"test_indices_end":[3,17,33,48,63,79],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct head w\/o contrast","problem":[],"test":["ct head w\/o contrast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"clinical history : history of pneumocephalus status post pedestrian versus motor vehicle collision .","problem":["pneumocephalus"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest ( pa & lat )","problem":[],"test":["chest ( pa & lat )"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"plt count - 247","problem":[],"test":["plt count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head injury to the occiput .","problem":["head injury to the occiput"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"amylase - 44","problem":[],"test":["amylase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"follow up ct","problem":[],"test":["follow up ct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tib \/ fib ( ap & lat ) soft tissue","problem":[],"test":["tib \/ fib ( ap & lat )"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"reason : eval for alignment , post op changes","problem":[],"test":["eval for alignment , post op changes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[9],"test_indices_end":[45],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"surgery","problem":[],"test":[],"treatment":["surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"he will need to continue on lovenox injections for at least 4-6 weeks .","problem":[],"test":[],"treatment":["lovenox injections"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28],"treatment_indices_end":[46]}
{"text":"there is small amount of mucosal thickening in the sphenoid sinuses .","problem":["mucosal thickening in the sphenoid sinuses"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please see detailed operative note for more information about the procedure .","problem":[],"test":[],"treatment":["the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[62],"treatment_indices_end":[75]}
{"text":"lungs clear to auscultation bilaterally .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[15],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient needs to have labs every monday and thursday including a cbc , chem-10 , ast , alt , alkaline phosphatase , albumin , total bilirubin and prograf level need to be obtained .","problem":[],"test":["alkaline phosphatase","a cbc","labs","albumin","alt","prograf level","chem-10","ast","total bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22,63,71,81,87,93,116,126,146],"test_indices_end":[26,68,78,84,90,113,123,141,159],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sclera mildly icteric .","problem":["sclera mildly icteric"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient did go to operating room on 2014-04-04 and the patient had cadaveric liver transplant performed by dr. michael sanders .","problem":[],"test":[],"treatment":["cadaveric liver transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[71],"treatment_indices_end":[97]}
{"text":"general : patient is in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient received mmf 1 gram b.i.d. , flagyl 500 mg iv x1 .","problem":[],"test":[],"treatment":["mmf","flagyl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21,41],"treatment_indices_end":[24,47]}
{"text":"lethargic , occasionally falling asleep .","problem":["lethargic"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient also received unasyn for 2 days , fluconazole , heparin , protonix , insulin , morphine , bactrim .","problem":[],"test":[],"treatment":["unasyn","fluconazole","insulin","bactrim","morphine","heparin","protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,46,60,70,81,91,102],"treatment_indices_end":[32,57,67,78,88,99,109]}
{"text":"weight was 122.5 .","problem":[],"test":["weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen : positive bowel sounds , soft , nondistended , nontender .","problem":["nondistended","nontender"],"test":[],"treatment":[],"problem_indices_start":[41,56],"problem_indices_end":[53,65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"nadolol 20 mg q. day .","problem":[],"test":[],"treatment":["nadolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"ultrasound was performed on 2014-04-01 demonstrating severe portal hypertension with massive peri splenic varices and splenorenal shunt .","problem":["severe portal hypertension","massive peri splenic varices"],"test":["ultrasound"],"treatment":["splenorenal shunt"],"problem_indices_start":[53,85],"problem_indices_end":[79,113],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[118],"treatment_indices_end":[135]}
{"text":"on 2014-04-04 , the transplant service was consulted because the patient was possibly going to the operating room for transplant on 2014-04-04 .","problem":[],"test":[],"treatment":["transplant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[118],"treatment_indices_end":[128]}
{"text":"the patient is to call 787-984-9608 if any fevers , chills , nausea and vomiting , abdominal pain , inability to take medications , inability to eat or drink .","problem":["chills","fevers","abdominal pain","vomiting","nausea","inability to eat or drink","inability to take medications"],"test":[],"treatment":[],"problem_indices_start":[43,52,61,72,83,100,132],"problem_indices_end":[49,58,67,80,97,129,157],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vital signs were stable .","problem":[],"test":["vital signs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"all cultures have been unremarkable .","problem":[],"test":["all cultures"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mother died of end stage renal disease .","problem":["end stage renal disease"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient is on insulin sliding scale with fixed dose .","problem":[],"test":[],"treatment":["insulin sliding scale"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[35]}
{"text":"urine culture and blood culture have been unremarkable on 2014-04-03 .","problem":[],"test":["blood culture","urine culture"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,18],"test_indices_end":[13,31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"repeat hepato fungal flare .","problem":["repeat hepato fungal flare"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cultures were obtained on 2014-03-31 .","problem":[],"test":["cultures"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 2014-04-02 , the patient was awake , alert and oriented , taking lactulose .","problem":[],"test":[],"treatment":["lactulose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[68],"treatment_indices_end":[77]}
{"text":"family history : father died of metastatic colon cancer .","problem":["metastatic colon cancer"],"test":[],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"also , the patient has a past medical history of hypertension , glucose intolerance , peripheral neuropathy .","problem":["peripheral neuropathy","glucose intolerance","hypertension"],"test":[],"treatment":[],"problem_indices_start":[49,64,86],"problem_indices_end":[61,83,107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lopressor 50 m b.i.d.","problem":[],"test":[],"treatment":["lopressor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"1+ edema bilaterally .","problem":["1+ edema bilaterally"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mmf 1000 mg b.i.d. .","problem":[],"test":[],"treatment":["mmf"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[3]}
{"text":"total bilirubin was 0.9 .","problem":[],"test":["total bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"denies any pain or discomfort .","problem":["discomfort","any pain"],"test":[],"treatment":[],"problem_indices_start":[7,19],"problem_indices_end":[15,29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"prednisone 20 mg q. day .","problem":[],"test":[],"treatment":["prednisone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"ast 82 .","problem":[],"test":["ast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was mild asterixis .","problem":["mild asterixis"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sodium of 138 ; potassium 3.5 ; 106 , 28 , 31 , 1.0 , glucose 134 .","problem":[],"test":["potassium","glucose","sodium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,54],"test_indices_end":[6,25,61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bactrim ss 1 tab q. day .","problem":[],"test":[],"treatment":["bactrim"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"on 2014-04-09 , fk level was 10.3 .","problem":[],"test":["fk level"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"four bands were placed without difficulty .","problem":[],"test":[],"treatment":["four bands"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"egd on 2013-12-08 demonstrated 5 cores of varices , grade 1 to 2 at the lower third of the esophagus .","problem":["5 cores of varices"],"test":["egd"],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[49],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"colace 100 mg b.i.d.","problem":[],"test":[],"treatment":["colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"abdomen : slightly distended , nontender .","problem":["nontender","slightly distended"],"test":[],"treatment":[],"problem_indices_start":[10,31],"problem_indices_end":[28,40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"underwent treatment with interferon 10 years ago .","problem":[],"test":[],"treatment":["interferon","treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10,25],"treatment_indices_end":[19,35]}
{"text":"alt 176 .","problem":[],"test":["alt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"alkaline phosphatase 78 which all have significantly decreased since postoperative day number 1 .","problem":[],"test":["alkaline phosphatase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"percocet 1 to 2 tabs q. 4 to 6 hours prn .","problem":[],"test":[],"treatment":["percocet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"normal s1 and s2 without murmurs or rubs .","problem":["murmurs","rubs"],"test":[],"treatment":[],"problem_indices_start":[25,36],"problem_indices_end":[32,40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"drains continued to put out significant amount of fluid .","problem":[],"test":[],"treatment":["drains"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"lasix 20 mg b.i.d.","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"the patient is a 49 year-old man with hepatitis c cirrhosis complicated by encephalopathy , positive esophageal varices , now with worsening confusion and lethargy .","problem":["lethargy","worsening confusion","hepatitis c cirrhosis","positive esophageal varices","encephalopathy"],"test":[],"treatment":[],"problem_indices_start":[38,75,92,131,155],"problem_indices_end":[59,89,119,150,163],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7.1 , hematocrit of 30.8 , platelets 90 .","problem":[],"test":["platelets","hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[6,27],"test_indices_end":[16,36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tacrolimus 3 mg b.i.d.","problem":[],"test":[],"treatment":["tacrolimus"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"he gets cold easily but denies fevers .","problem":["fevers","cold"],"test":[],"treatment":[],"problem_indices_start":[8,31],"problem_indices_end":[12,37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient continued on lactulose .","problem":[],"test":[],"treatment":["lactulose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[30]}
{"text":"hcv cirrhosis .","problem":["hcv cirrhosis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a heparin independent antibody was sent off on 2014-04-07 which was unremarkable .","problem":[],"test":["a heparin independent antibody"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"continue on rifaximine .","problem":[],"test":[],"treatment":["rifaximine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[22]}
{"text":"he denies any abdominal pain .","problem":["any abdominal pain"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has been compliant with his medications .","problem":[],"test":[],"treatment":["his medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36],"treatment_indices_end":[51]}
{"text":"continue lasix .","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[9],"treatment_indices_end":[14]}
{"text":"obvious ascites .","problem":["obvious ascites"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"valcyte 900 mg q. day .","problem":[],"test":[],"treatment":["valcyte"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"he has had night sweats for the past 2 weeks .","problem":["night sweats"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient also reports that he has had \" yellowish eyes , some shaking and his breath smelled more like ammonia over the past 3 days .\"","problem":["yellowish eyes","some shaking"],"test":[],"treatment":[],"problem_indices_start":[43,60],"problem_indices_end":[57,72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient continued getting acyclovir , prednisone , mmf one gram b.i.d .","problem":[],"test":[],"treatment":["acyclovir","prednisone","mmf"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,38,51],"treatment_indices_end":[35,48,54]}
{"text":"difficulty with word finding at times .","problem":["difficulty with word finding"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on postoperative day number 1 , duplex ultrasound of the patient 's liver was performed demonstrating normal appearing portal veins and hepatic arteries .","problem":[],"test":["duplex ultrasound of the patient 's liver"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[32],"test_indices_end":[73],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"wife reports that the patient has a history of lethargy and confusion , similar to the symptoms for which the patient was recently admitted .","problem":["lethargy","confusion","the symptoms"],"test":[],"treatment":[],"problem_indices_start":[47,60,83],"problem_indices_end":[55,69,95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"these findings may reflect thrombus within the left and right hepatic veins .","problem":["thrombus within the left and right hepatic veins"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[75],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"additionally , there is diminished color flow with confluence of the hepatic veins .","problem":["diminished color flow"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"waltham-ludlow drains put out on the 13th 620 and 380 .","problem":[],"test":[],"treatment":["waltham-ludlow drains"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[21]}
{"text":"caval narrowing is seen , most likely correlation to clinical history is recommended and further evaluation of the ct or short-term ultrasounds for follow-up was recommended .","problem":["caval narrowing"],"test":["short-term ultrasounds","the ct"],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[111,121],"test_indices_end":[117,143],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"testosterone 4 mg q. 24 hours .","problem":[],"test":[],"treatment":["testosterone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"omalley was consulted on 2014-04-08 for better glucose control since the patient was on steroids .","problem":[],"test":[],"treatment":["glucose control","steroids"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47,88],"treatment_indices_end":[62,96]}
{"text":"retazepine 50 mg q h.s.","problem":[],"test":[],"treatment":["retazepine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"pathology demonstrates that the pathology results of the liver were not finalized .","problem":[],"test":["the pathology results of the liver"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[28],"test_indices_end":[62],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient contracted hcv 20 years ago secondary to iv drug use .","problem":["hcv"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient 's labs from 2014-04-10 were the following :","problem":[],"test":["patient 's labs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was on fk 2 and 2 that was started on postoperative day number 2 .","problem":[],"test":[],"treatment":["fk 2"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[23]}
{"text":"today , on 2014-03-03 , the patient was seen in clinic with increased lethargy , confusion .","problem":["increased lethargy","confusion"],"test":[],"treatment":[],"problem_indices_start":[60,81],"problem_indices_end":[78,90],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was on propofol for 2 days .","problem":[],"test":[],"treatment":["propofol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[27]}
{"text":"history of hepatic encephalopathy .","problem":["hepatic encephalopathy"],"test":[],"treatment":[],"problem_indices_start":[11],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"patient was transfused 1 unit of platelets on 2014-04-08 for platelet count of 66 .","problem":[],"test":["platelet count"],"treatment":["1 unit of platelets"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[61],"test_indices_end":[75],"treatment_indices_start":[23],"treatment_indices_end":[42]}
{"text":"patient was started on lactulose and rifaximine which improved his mental status .","problem":[],"test":[],"treatment":["lactulose","rifaximine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23,37],"treatment_indices_end":[32,47]}
{"text":"alt 44 .","problem":[],"test":["alt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 2014-04-04 , labs were as follows :","problem":[],"test":["labs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"esophageal varices .","problem":["esophageal varices"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"trazodone stopped .","problem":[],"test":[],"treatment":["trazodone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"insulin regular .","problem":[],"test":[],"treatment":["insulin regular"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"infectious work-up was negative .","problem":[],"test":["infectious work-up"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was taken off of neurontin because it started to worsen his mental status .","problem":[],"test":[],"treatment":["neurontin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[38]}
{"text":"protonix 40 mg q. 24 .","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"lasix 40 mg q. day .","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"moltipine 5 mg q. day .","problem":[],"test":[],"treatment":["moltipine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"there appears to be a decreased and sluggish flow within the right and left hepatic veins with loss of normal respiratory variations , wave forms and the intrahepatic portion .","problem":["loss of normal respiratory variations , wave forms and the intrahepatic portion","a decreased and sluggish flow within the right and left hepatic veins"],"test":[],"treatment":[],"problem_indices_start":[20,95],"problem_indices_end":[89,174],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hepatitis viral load was 76,500 .","problem":[],"test":["hepatitis viral load"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"alkaline phosphatase 169 .","problem":[],"test":["alkaline phosphatase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"fluconazole 400 mg q. 24 hours .","problem":[],"test":[],"treatment":["fluconazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"wbc of 8.3 ; hematocrit of 30.6 ; platelets 69 ; sodium 132 ; 3.9 , 102 , 22 , serum creatinine of 13 and 1.1 .","problem":[],"test":["serum creatinine","hematocrit","wbc","sodium","platelets"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,13,34,49,79],"test_indices_end":[3,23,43,55,95],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hepatitis c cirrhosis .","problem":["hepatitis c cirrhosis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he stopped secondary to aggressive behavior .","problem":["aggressive behavior"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ast 87 .","problem":[],"test":["ast"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"glucose 114 .","problem":[],"test":["glucose"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"positive gynecomastia .","problem":["positive gynecomastia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt of 20.6 .","problem":[],"test":["pt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on 2014-04-09 , patient continued to do very well , ambulating , tolerating a diet , urinating without difficulty .","problem":["difficulty"],"test":[],"treatment":[],"problem_indices_start":[103],"problem_indices_end":[113],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lactulose 30 mg q.i.d.","problem":[],"test":[],"treatment":["lactulose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"inr of 2.0 .","problem":[],"test":["inr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neck : no lad .","problem":["lad"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ptt of 38.7 .","problem":[],"test":["ptt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has been admitted 5 x in the past to nantucket cottage hospital since 11-30 for encephalopathy .","problem":["encephalopathy"],"test":[],"treatment":[],"problem_indices_start":[92],"problem_indices_end":[106],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"protonix 20 mg q. 24 hours .","problem":[],"test":[],"treatment":["protonix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"liver transplant surgery service","problem":[],"test":[],"treatment":["liver transplant surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[24]}
{"text":"amlodipine 5 mg q. day .","problem":[],"test":[],"treatment":["amlodipine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"the feeney gann-burlington drain on postoperative day number demonstrated medial output of 780 with lateral output of 150 .","problem":[],"test":["lateral output","medial output"],"treatment":["the feeney gann-burlington drain"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[74,100],"test_indices_end":[87,114],"treatment_indices_start":[0],"treatment_indices_end":[32]}
{"text":"osamine 200 mg t.i.d.","problem":[],"test":[],"treatment":["osamine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"cbc had a white blood cell count of 9 , 17 polys , 0 bands , platelets of 326 .","problem":[],"test":["polys","a white blood cell count","bands","platelets","cbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,8,43,53,61],"test_indices_end":[3,32,48,58,70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"fetal screens , o positive , antibody negative , rpr nonreactive , rubella immune , hepatitis surface antigen negative , gbs unknown .","problem":[],"test":["fetal screens","rubella","antibody","hepatitis surface antigen","gbs","rpr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,29,49,67,84,121],"test_indices_end":[13,37,52,74,109,124],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"caffeine citrate was initiated on 11-14 for apnea and bradycardia of prematurity .","problem":["bradycardia of prematurity","apnea"],"test":[],"treatment":["caffeine citrate"],"problem_indices_start":[44,54],"problem_indices_end":[49,80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"ivf pregnancy complicated by iugr , 2 vessel cord , normal fetal echo reverse diastolic flow and demise of twin a at 27 weeks .","problem":["demise of twin a","2 vessel cord","ivf pregnancy","iugr"],"test":[],"treatment":[],"problem_indices_start":[0,29,36,97],"problem_indices_end":[13,33,49,113],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her most recent set of electrolytes were on 2015-11-13 with a sodium of 143 , a potassium of 6.3 hemolyzed , a chloride of 113 and a total co2 of 17 .","problem":[],"test":["a sodium","a potassium","a chloride","a total co2"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[60,78,109,131],"test_indices_end":[68,89,119,142],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hyperbilirubinemia resolving .","problem":["hyperbilirubinemia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she received 48 hours of ampicillin and gentamycin with negative blood cultures and antibiotics were discontinued .","problem":[],"test":["blood cultures"],"treatment":["ampicillin","antibiotics","gentamycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[65],"test_indices_end":[79],"treatment_indices_start":[25,40,84],"treatment_indices_end":[35,50,95]}
{"text":"apnea and bradycardia of prematurity .","problem":["apnea","bradycardia of prematurity"],"test":[],"treatment":[],"problem_indices_start":[0,10],"problem_indices_end":[5,36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heart ranges 130 s to 160 s.","problem":[],"test":["heart ranges"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she will need advance calorie density for better growth .","problem":[],"test":[],"treatment":["advance calorie density"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[37]}
{"text":"blood pressure most recently 60\/37 with a mean of 44 .","problem":[],"test":["blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abruption noted .","problem":["abruption"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"birth weight was 1670 grams 50 th percentile , length 43 cm 50 th percentile .","problem":[],"test":["birth weight","length"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,47],"test_indices_end":[12,53],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"immunizations : recommended synagis rsv prophylaxis should be considered from november through march for infants who meet any of the following 3 criteria , born at less than 32 weeks , born between 32 and 35 weeks with 2 of the following , daycare during rsv season , a smoker in the household , neuromuscular disease and weight abnormalities or school age siblings with chronic lung disease .","problem":["weight abnormalities","neuromuscular disease","chronic lung disease"],"test":[],"treatment":["immunizations","synagis rsv prophylaxis"],"problem_indices_start":[296,322,371],"problem_indices_end":[317,342,391],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,28],"treatment_indices_end":[13,51]}
{"text":"on admission weight 1670 grams approximately 50 th percentile , length 43 cm 50 th percentile , head circumference not done .","problem":[],"test":["length","head circumference","weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13,64,96],"test_indices_end":[19,70,114],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head circumference not done .","problem":[],"test":["head circumference"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"state newborn screen was sent on 2015-11-12 .","problem":[],"test":["state newborn screen"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"apgars were 6 and 9 .","problem":[],"test":["apgars"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sensory , hearing screen has not yet been performed , but should be done prior to discharge .","problem":[],"test":["sensory , hearing screen"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pprom with bleeding and transverse lie prompted cesarean section .","problem":["pprom","bleeding","transverse lie"],"test":[],"treatment":["cesarean section"],"problem_indices_start":[0,11,24],"problem_indices_end":[5,19,38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48],"treatment_indices_end":[64]}
{"text":"she remained on cpap for a total of 24 hours at which time she transitioned to room air and continues to be stable in room air .","problem":[],"test":[],"treatment":["cpap"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[20]}
{"text":"influenza immunization is recommended annually in the fall for all infants once they reach 6 months of age .","problem":[],"test":[],"treatment":["influenza immunization"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[22]}
{"text":"twin b with normal fetal survey was transferred to boston medical center at 26 and 2\/7 weeks with iugr of twin a was first noted , presented with preterm labor at 31 weeks .","problem":["iugr of twin a","preterm labor"],"test":[],"treatment":[],"problem_indices_start":[98,146],"problem_indices_end":[112,159],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"medications , continue caffeine citrate of 11 mg po every day .","problem":[],"test":[],"treatment":["caffeine citrate","medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,23],"treatment_indices_end":[11,39]}
{"text":"rule out sepsis with antibiotic .","problem":["sepsis"],"test":[],"treatment":["antibiotic"],"problem_indices_start":[9],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[31]}
{"text":"no hip click .","problem":["hip click"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"premature infant born at 31 and 6\/7 weeks gestation , resolved respiratory distress syndrome .","problem":["premature infant","respiratory distress syndrome"],"test":[],"treatment":[],"problem_indices_start":[0,63],"problem_indices_end":[16,92],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no sacral dimple .","problem":["sacral dimple"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head ultrasound was performed on 2015-11-16 and was normal .","problem":[],"test":["head ultrasound"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"continue 150 cc per kilo per day of special care 20 calories advancing caloric intake as required to maintain weight gain of 3 grams per kilogram per day .","problem":[],"test":[],"treatment":["special care 20 calories"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36],"treatment_indices_end":[60]}
{"text":"mother was on clindamycin since 11-04 .","problem":[],"test":[],"treatment":["clindamycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[25]}
{"text":"car seat position screening has not yet been done .","problem":[],"test":["car seat position screening"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"before this age and for the first 24 months of the child 's life immunizations against influenza is recommended for household contacts and out of home care givers .","problem":["influenza"],"test":[],"treatment":["the child 's life immunizations"],"problem_indices_start":[87],"problem_indices_end":[96],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47],"treatment_indices_end":[78]}
{"text":"positive vaginal tag .","problem":["vaginal tag"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"x-ray revealed mild respiratory distress syndrome .","problem":["mild respiratory distress syndrome"],"test":["x-ray"],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[49],"test_indices_start":[0],"test_indices_end":[5],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"immunizations received , infant has not received any immunizations to date .","problem":[],"test":[],"treatment":["immunizations","any immunizations"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,49],"treatment_indices_end":[13,66]}
{"text":"no murmur .","problem":["murmur"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"betamethasone complete at approximately 26 weeks and 31 weeks .","problem":[],"test":[],"treatment":["betamethasone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"no hepatosplenomegaly .","problem":["hepatosplenomegaly"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"state newborn screen was sent on day of life #3 and at discharge .","problem":[],"test":["state newborn screen"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"most recent bilirubin was on 11-14 of 4.8 \/ 0.3 .","problem":[],"test":["most recent bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"infant placed on cpap .","problem":[],"test":[],"treatment":["cpap"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17],"treatment_indices_end":[21]}
{"text":"nondysmorphic intact veliz .","problem":["nondysmorphic"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hematocrit on admission was 53.7 .","problem":[],"test":["hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"infant is under phototherapy , which was discontinued on 11-13 .","problem":[],"test":[],"treatment":["phototherapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[28]}
{"text":"anterior fontanel soft , flat , cap and prong cpap in place .","problem":[],"test":[],"treatment":["prong cpap"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40],"treatment_indices_end":[50]}
{"text":"infant was initially started on 80 cc per kilo per day of d10w .","problem":[],"test":[],"treatment":["d10w"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[58],"treatment_indices_end":[62]}
{"text":"a cbc and blood culture obtained on admission .","problem":[],"test":["blood culture","a cbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10],"test_indices_end":[5,23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she is currently receiving 150 cc per kilo per day of special care 20 .","problem":[],"test":[],"treatment":["special care 20"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[54],"treatment_indices_end":[69]}
{"text":"decrease tone , ruddy , warm , well perfused with peripheral iv in left hand .","problem":["decrease tone"],"test":[],"treatment":["peripheral iv in left hand"],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[50],"treatment_indices_end":[76]}
{"text":"infant achieved full enteral feedings by day of life 6 .","problem":[],"test":[],"treatment":["full enteral feedings"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[37]}
{"text":"her discharge weight is 1477 gm .","problem":[],"test":["her discharge weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"enteral feedings were initiated on day of life #1 .","problem":[],"test":[],"treatment":["enteral feedings"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"she has not required any blood transfusions .","problem":[],"test":[],"treatment":["any blood transfusions"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[43]}
{"text":"gi . bilirubin peaked on day of life #2 of 9.0 \/ 0.3 .","problem":[],"test":["gi . bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mills was admitted to the newborn intensive care unit with moderate respiratory distress .","problem":["moderate respiratory distress"],"test":[],"treatment":[],"problem_indices_start":[59],"problem_indices_end":[88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was empirically started on vanco\/zosyn for empiric hosp acquired pna coverage","problem":[],"test":[],"treatment":["vanco\/zosyn","empiric hosp acquired pna coverage"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[31,47],"treatment_indices_end":[42,81]}
{"text":"there was still concern for her effusion contributing to her sob at the osh so she was transferred for drainage and treatment of chf .","problem":["her effusion","her sob","chf"],"test":[],"treatment":["drainage","treatment"],"problem_indices_start":[28,57,129],"problem_indices_end":[40,64,132],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[103,116],"treatment_indices_end":[111,125]}
{"text":"the procedure team was called to consider doing a left thoracentesis , but she was declined because it was felt that her effusions were transudative , secondary to chf , and it was recommended to treat chf .","problem":["chf","her effusions","transudative","chf"],"test":[],"treatment":["a left thoracentesis"],"problem_indices_start":[117,136,164,202],"problem_indices_end":[130,148,167,205],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[48],"treatment_indices_end":[68]}
{"text":"in the last 12 hours of her life , her pulsus was 12 , and she was felt to likely to have aspect of tamponade physiology , since her preload was reduced .","problem":["tamponade physiology"],"test":["her preload","her pulsus"],"treatment":[],"problem_indices_start":[100],"problem_indices_end":[120],"test_indices_start":[35,129],"test_indices_end":[45,140],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt started on ctx 05-27 .","problem":[],"test":[],"treatment":["ctx"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[17]}
{"text":"she denies any cp \/ cough \/ fever , abdominal pain \/ diarrhea , black or bloody stools or headache .","problem":["fever","diarrhea","abdominal pain","headache","cp","black or bloody stools","cough"],"test":[],"treatment":[],"problem_indices_start":[15,20,28,36,53,64,90],"problem_indices_end":[17,25,33,50,61,86,98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the pt continued to have low urine output .","problem":["low urine output"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- see course of diuresis above .","problem":[],"test":[],"treatment":["diuresis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[24]}
{"text":"#. afib\/sss : she was a-paced , pacer placed 05-08 in dddr mode , complicated by ptx requiring chest tube which resolved and tube was removed during admit for pacer , no evidence of ptx on most recent cxr .","problem":["afib\/sss","ptx","ptx"],"test":["most recent cxr"],"treatment":["dddr mode","pacer","tube","pacer","chest tube","a-paced"],"problem_indices_start":[3,81,182],"problem_indices_end":[11,84,185],"test_indices_start":[189],"test_indices_end":[204],"treatment_indices_start":[22,32,54,95,125,159],"treatment_indices_end":[29,37,63,105,129,164]}
{"text":"- no transfusions , cmo\/dnr\/dni","problem":[],"test":[],"treatment":["transfusions"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[5],"treatment_indices_end":[17]}
{"text":"#. id : initially had leukocytosis at admission , with chest ct showing possible underlying consolidations vs. atelectasis , levoflox started 05-24 and subsequently stopped ( no consolidations on cxr and afebrile ).","problem":["consolidations","atelectasis","underlying consolidations","leukocytosis","afebrile"],"test":["cxr","chest ct"],"treatment":["levoflox"],"problem_indices_start":[22,81,111,178,204],"problem_indices_end":[34,106,122,192,212],"test_indices_start":[55,196],"test_indices_end":[63,199],"treatment_indices_start":[125],"treatment_indices_end":[133]}
{"text":"as she was felt by the ccu to be a poor candidate for right heart cath , was hemodynamically stable with blood pressure 110 s- 120 s systolic and pulse 70 s- 80 s , she was called out of the ccu and back to the cardiac floor without intervention .","problem":[],"test":["pulse","blood pressure","right heart cath","systolic"],"treatment":["intervention"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[54,105,133,146],"test_indices_end":[70,119,141,151],"treatment_indices_start":[233],"treatment_indices_end":[245]}
{"text":"pt now on iv ceftriaxone ( was on levoflox since 05-24 however ua now floridly positive ( more so than ua at osh ) so felt possibly levo-resistant .","problem":["levo-resistant","floridly positive"],"test":["ua","ua"],"treatment":["levoflox","iv ceftriaxone"],"problem_indices_start":[70,132],"problem_indices_end":[87,146],"test_indices_start":[63,103],"test_indices_end":[65,105],"treatment_indices_start":[10,34],"treatment_indices_end":[24,42]}
{"text":"then , on 05-29 , she demonstrated bilateral pleural effusions ( reaccumulated ), right lower lobe infiltrate ( started on vanco \/ zosyn )-> put on face mask , given lasix x 1 bolus 100 mg , responded somewhat and o2 sat stable in low 90 s.","problem":["bilateral pleural effusions","right lower lobe infiltrate"],"test":["o2 sat"],"treatment":["face mask","zosyn","lasix","vanco"],"problem_indices_start":[35,82],"problem_indices_end":[62,109],"test_indices_start":[214],"test_indices_end":[220],"treatment_indices_start":[123,131,148,166],"treatment_indices_end":[128,136,157,171]}
{"text":"since admission , she ruled out for mi by enzymes , and had a right sided thoracentesis which yielded transudative fluid .","problem":["transudative fluid","mi"],"test":["enzymes","a right sided thoracentesis"],"treatment":[],"problem_indices_start":[36,102],"problem_indices_end":[38,120],"test_indices_start":[42,60],"test_indices_end":[49,87],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"we continued her albuterol \/ atrovent nebs , diuresis with iv lasix drip and boluses .","problem":[],"test":[],"treatment":["atrovent nebs","boluses","iv lasix drip","diuresis","her albuterol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,29,45,59,77],"treatment_indices_end":[26,42,53,72,84]}
{"text":"she requested the patient be made comfort measures only .","problem":[],"test":[],"treatment":["comfort measures"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[50]}
{"text":"she continued to put out low amounts of urine throughout the admission , despite aggressive diuresis with iv lasix gtt and boluses .","problem":["low amounts of urine"],"test":[],"treatment":["boluses","iv lasix gtt","aggressive diuresis"],"problem_indices_start":[25],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[81,106,123],"treatment_indices_end":[100,118,130]}
{"text":"hypothyroidism","problem":["hypothyroidism"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mary studies c\/w transudate .","problem":["transudate"],"test":["mary studies"],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[27],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was given a lasix drip iv upon call-out of the icu , and additional boluses of iv lasix , 200 mg then 300 mg iv were given with a good response , however , she remained net positive fluid balance .","problem":["net positive fluid balance"],"test":[],"treatment":["a lasix drip iv","boluses of iv lasix"],"problem_indices_start":[173],"problem_indices_end":[199],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14,72],"treatment_indices_end":[29,91]}
{"text":"wbc s since admission were as high as 14,000 but normalized .","problem":[],"test":["wbc s"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[5],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"renal consultants did not feel there was an emergent need for dialysis .","problem":[],"test":[],"treatment":["dialysis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[62],"treatment_indices_end":[70]}
{"text":"her 05-27 cxr post procedure w\/o pnx , effusion much improved , yet her 05-28 cxr worse than 05-27 with some reaccumulation of right pleural effusion .","problem":["right pleural effusion","pnx","effusion"],"test":["her 05-28 cxr","her 05-27 cxr"],"treatment":[],"problem_indices_start":[33,39,127],"problem_indices_end":[36,47,149],"test_indices_start":[0,68],"test_indices_end":[13,81],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ecg : a paced at 70 bpm \/ nml axis , lbbb , no st or tw changes","problem":["lbbb","st or tw changes"],"test":["ecg"],"treatment":[],"problem_indices_start":[37,47],"problem_indices_end":[41,63],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heent : mmm , jvp at 14 cm , no bruits , supple","problem":["bruits"],"test":["jvp"],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[38],"test_indices_start":[14],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"renal consultants did not feel that there was an indication for urgent hemodialysis .","problem":[],"test":[],"treatment":["urgent hemodialysis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[64],"treatment_indices_end":[83]}
{"text":"#. sob : most consistent with chf by exam , although unknown what the severity of her copd is currently .","problem":["sob","chf","her copd"],"test":["exam"],"treatment":[],"problem_indices_start":[3,30,82],"problem_indices_end":[6,33,90],"test_indices_start":[37],"test_indices_end":[41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no hydronephrosis is seen .","problem":["hydronephrosis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"we started her on dilt for additional a fib control ( revert back to a fib on 05-29 ), which was stopped when the pt was made cmo .","problem":["a fib"],"test":[],"treatment":["additional a fib control","dilt"],"problem_indices_start":[69],"problem_indices_end":[74],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18,27],"treatment_indices_end":[22,51]}
{"text":"aranesp 100 mcg ( x1 05-26 )","problem":[],"test":[],"treatment":["aranesp"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"she has been gently diuresed but has worsening arf .","problem":["worsening arf"],"test":[],"treatment":[],"problem_indices_start":[37],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct chest at erich lindemann mental health center 05-25 : large pericardial effusion , bilat pleural eff with underlying consolidation which could represent pna vs. atelectasis","problem":["atelectasis","pna","bilat pleural eff","underlying consolidation","large pericardial effusion"],"test":["ct chest"],"treatment":[],"problem_indices_start":[57,86,109,156,164],"problem_indices_end":[83,103,133,159,175],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"#. oliguric arf : likely prerenal due to n\/v poor po intake and poor forward flow , however , need to continue diuresis .","problem":["n\/v","poor forward flow","poor po intake","oliguric arf"],"test":[],"treatment":["diuresis"],"problem_indices_start":[3,41,45,64],"problem_indices_end":[15,44,59,81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[111],"treatment_indices_end":[119]}
{"text":"lung volumes are low .","problem":["low"],"test":["lung volumes"],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[20],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her urine lytes consistent with atn , fena 4% .","problem":["atn"],"test":["her urine lytes","fena"],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[35],"test_indices_start":[0,38],"test_indices_end":[15,42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"82 y\/o f w h\/o afib , sss s\/p pacer 05-08 c\/b ptx requiring ct , cad , who was readmitted 05-24 with arf and lethargy , found to have a large pericardial effusion and bilateral pleural effusions , with echo showing no evidence of tamponade , who is transferred for possible pericardial effusion drainage and treatment of chf , as well as drainage of bilateral pleural effusions .","problem":["bilateral pleural effusions","sss","afib","cad","bilateral pleural effusions","a large pericardial effusion","arf","lethargy","chf","tamponade","ptx"],"test":["echo"],"treatment":["drainage","pericardial effusion drainage","treatment","pacer","ct"],"problem_indices_start":[15,22,46,65,101,109,134,167,230,321,350],"problem_indices_end":[19,25,49,68,104,117,162,194,239,324,377],"test_indices_start":[202],"test_indices_end":[206],"treatment_indices_start":[30,60,274,308,338],"treatment_indices_end":[35,62,303,317,346]}
{"text":"she also had 2 echocardiograms which revealed persistent pericardial effusions .","problem":["persistent pericardial effusions"],"test":["2 echocardiograms"],"treatment":[],"problem_indices_start":[46],"problem_indices_end":[78],"test_indices_start":[13],"test_indices_end":[30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"levothyroxine 50 mcg daily","problem":[],"test":[],"treatment":["levothyroxine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"it was felt that given her age , multiple co-morbidities , that her prognosis was poor even prior to ccu admission , possible pericardial drainage or repeat thoracenteses .","problem":["multiple co-morbidities"],"test":[],"treatment":["repeat thoracenteses","pericardial drainage"],"problem_indices_start":[33],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[126,150],"treatment_indices_end":[146,170]}
{"text":"she was admitted to cambridge hospital 2018-05-24 with arf ( cr 3.5 up from 0.9 ) and sob .","problem":["arf","sob"],"test":["cr"],"treatment":[],"problem_indices_start":[55,86],"problem_indices_end":[58,89],"test_indices_start":[61],"test_indices_end":[63],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"copd","problem":["copd"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[4],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was felt posthumously that her large pericardial effusion was most likely secondary to a complication of pacer placement , although this was not seen on imaging .","problem":["a complication","her large pericardial effusion"],"test":["imaging"],"treatment":["pacer placement"],"problem_indices_start":[30,90],"problem_indices_end":[60,104],"test_indices_start":[156],"test_indices_end":[163],"treatment_indices_start":[108],"treatment_indices_end":[123]}
{"text":"her o2 requirement has increased despite diuresis .","problem":["her o2 requirement"],"test":[],"treatment":["diuresis"],"problem_indices_start":[0],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[41],"treatment_indices_end":[49]}
{"text":"#. pericardial effusion : unclear etiology , osh had raised question of rv perforation from pacer , however she had a normal echo appearance of lead , no tamponade by exam .","problem":["tamponade","pericardial effusion","rv perforation"],"test":["exam"],"treatment":["pacer"],"problem_indices_start":[3,72,154],"problem_indices_end":[23,86,163],"test_indices_start":[167],"test_indices_end":[171],"treatment_indices_start":[92],"treatment_indices_end":[97]}
{"text":"tte at erich lindemann mental health center 05-26 : mod-lg circumferential pericardial eff , no evidence of rv diastolic collapse , no mv inflow evidence of tamponade , pacer lead located in rv apex","problem":["rv diastolic collapse","mod-lg circumferential pericardial eff","tamponade"],"test":["tte"],"treatment":["pacer lead"],"problem_indices_start":[52,108,157],"problem_indices_end":[90,129,166],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[169],"treatment_indices_end":[179]}
{"text":"we continued amiodarone until pt was made cmo .","problem":[],"test":[],"treatment":["amiodarone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[23]}
{"text":"gerd","problem":["gerd"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[4],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt is now s\/p drainage of right pleural effusion , diagnostic and therapeutic , with studies consistent with transudate , etiology most likely 02-15 chf .","problem":["transudate","chf","right pleural effusion"],"test":["studies"],"treatment":["drainage"],"problem_indices_start":[26,109,149],"problem_indices_end":[48,119,152],"test_indices_start":[85],"test_indices_end":[92],"treatment_indices_start":[14],"treatment_indices_end":[22]}
{"text":"according to her guardian she was discharged to her nh for a few days after her pacer was placed 05-08 , which was complicated by a ptx requiring ct placement which had been d\/c 'd in the hospital after resolution of her ptx .","problem":["a ptx","her ptx"],"test":[],"treatment":["ct placement","her pacer"],"problem_indices_start":[130,217],"problem_indices_end":[135,224],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[76,146],"treatment_indices_end":[85,158]}
{"text":"tte revealed large pericardial effusion .","problem":["large pericardial effusion"],"test":["tte"],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[39],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"legally blind","problem":["legally blind"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was guiaic negative .","problem":[],"test":["guiaic"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[8],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she underwent a tte at erich lindemann mental health center today ( 05-26 ) showing mod-lg circumferential pericardial effusion without evidence of rv diastolic collapse and no mv inflow evidence of tamponade , pacer wire located in rv apex .","problem":["rv diastolic collapse","tamponade","mod-lg circumferential pericardial effusion"],"test":["a tte"],"treatment":["pacer wire"],"problem_indices_start":[84,148,199],"problem_indices_end":[127,169,208],"test_indices_start":[14],"test_indices_end":[19],"treatment_indices_start":[211],"treatment_indices_end":[221]}
{"text":"codeine \/ iodine","problem":[],"test":[],"treatment":["codeine","iodine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,10],"treatment_indices_end":[7,16]}
{"text":"anticoagulation has not been given this admission .","problem":[],"test":[],"treatment":["anticoagulation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"amiodarone 200 mg daily","problem":[],"test":[],"treatment":["amiodarone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"1. pulmonary edema and hypoxic respiratory failure","problem":["hypoxic respiratory failure","pulmonary edema"],"test":[],"treatment":[],"problem_indices_start":[3,23],"problem_indices_end":[18,50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. coronary artery disease","problem":["coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mild pulmonary edema is unchanged .","problem":["mild pulmonary edema"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. sick sinus syndrome status post pacer placement","problem":["sick sinus syndrome"],"test":[],"treatment":["pacer placement"],"problem_indices_start":[3],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[35],"treatment_indices_end":[50]}
{"text":"abd : s\/nt\/slightly distended , dec bs , no cva tenderness","problem":["distended","cva tenderness","dec bs"],"test":[],"treatment":[],"problem_indices_start":[20,32,44],"problem_indices_end":[29,38,58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. paroxysmal atrial fibrillation","problem":["paroxysmal atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ext : 1+ le edema","problem":["1+ le edema"],"test":[],"treatment":[],"problem_indices_start":[6],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. congestive heart failure","problem":["congestive heart failure"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the setting of her ongoing pericardial effusion , she was transferred for closer observation to the ccu .","problem":["her ongoing pericardial effusion"],"test":[],"treatment":[],"problem_indices_start":[18],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. moderate bilateral pleural effusions","problem":["moderate bilateral pleural effusions"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"impression : no evidence of hydronephrosis .","problem":["hydronephrosis"],"test":[],"treatment":[],"problem_indices_start":[28],"problem_indices_end":[42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"82 f with h\/o copd , cad , pafib and sss s\/p pacer on 05-08 for symptomatic pauses is transferred for large pericardial effusion ? needing drainage and chf .","problem":["pafib","sss","cad","copd","symptomatic pauses","large pericardial effusion","chf"],"test":[],"treatment":["pacer","drainage"],"problem_indices_start":[14,21,27,37,64,102,152],"problem_indices_end":[18,24,32,40,82,128,155],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[45,139],"treatment_indices_end":[50,147]}
{"text":"2. large pericardial effusion","problem":["large pericardial effusion"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the ccu fellow and team declined to do pericardial drainage , as the pt was hemodynamically stable , without change in appearance of effusion by echo performed at bedside by cards fellow .","problem":["change in appearance of effusion"],"test":["echo"],"treatment":["pericardial drainage"],"problem_indices_start":[109],"problem_indices_end":[141],"test_indices_start":[145],"test_indices_end":[149],"treatment_indices_start":[39],"treatment_indices_end":[59]}
{"text":"albuterol-ipratroprium inh 2 sprays tid prn","problem":[],"test":[],"treatment":["albuterol-ipratroprium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[22]}
{"text":"diovan 160 mg daily","problem":[],"test":[],"treatment":["diovan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"odell does not believe the pt would want to be intubated , with central line , right heart cath , in the ccu .","problem":[],"test":[],"treatment":["central line","right heart cath"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[64,79],"treatment_indices_end":[76,95]}
{"text":"imdur 60 mg daily","problem":[],"test":[],"treatment":["imdur"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"her lasix gtt continued during this time .","problem":[],"test":[],"treatment":["her lasix gtt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"pepcid 20 mg daily","problem":[],"test":[],"treatment":["pepcid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"the pt will be made comfortable , with goals of care shifted towards suppressing her air hunger and pain .","problem":["pain","her air hunger"],"test":[],"treatment":[],"problem_indices_start":[81,100],"problem_indices_end":[95,104],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"levofloxacin 250 mg iv daily ( started 05-24 )","problem":[],"test":[],"treatment":["levofloxacin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"ec asa 81 mg daily","problem":[],"test":[],"treatment":["ec asa"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"diltiazem cd 240 mg","problem":[],"test":[],"treatment":["diltiazem cd"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"pacer seen in rv apex , but cannot exclude perforation .","problem":["perforation"],"test":[],"treatment":["pacer"],"problem_indices_start":[43],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"the bladder appears unremarkable and contains a foley catheter .","problem":[],"test":[],"treatment":["a foley catheter"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[46],"treatment_indices_end":[62]}
{"text":"paxil 20 mg daily","problem":[],"test":[],"treatment":["paxil"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[5]}
{"text":"head ct at erich lindemann mental health center 05-24 : atrophy , dense calcification of the tentorium , most likely of metabolic etiology","problem":["atrophy","dense calcification of the tentorium"],"test":["head ct"],"treatment":[],"problem_indices_start":[56,66],"problem_indices_end":[63,102],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"renal u\/s negative for hydronephrosis .","problem":["hydronephrosis"],"test":["renal u\/s"],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[37],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"#. access : piv","problem":[],"test":[],"treatment":["piv"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[15]}
{"text":"she was afebrile .","problem":["afebrile"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on call out from the ccu , the pt was satting 93% on 4-5l nc , and through the following night , her oxygen requirement increased to nrb , wherein she was satting upper 80 s- low 90 s.","problem":["her oxygen requirement"],"test":["satting","satting"],"treatment":["nc","nrb"],"problem_indices_start":[97],"problem_indices_end":[119],"test_indices_start":[38,155],"test_indices_end":[45,162],"treatment_indices_start":[58,133],"treatment_indices_end":[60,136]}
{"text":"at erich lindemann mental health center she was discovered to have arf , a large pericardial effusion , and bilateral pleural effusions .","problem":["bilateral pleural effusions","arf","a large pericardial effusion"],"test":[],"treatment":[],"problem_indices_start":[67,73,108],"problem_indices_end":[70,101,135],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the morning of 5\/17 , her pulsus parodoxicus was 12 .","problem":[],"test":["her pulsus parodoxicus"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[22],"test_indices_end":[44],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"u\/a on 05-27 c\/w uti .","problem":["uti"],"test":["u\/a"],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[20],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vancomycin and zosyn were started .","problem":[],"test":[],"treatment":["zosyn","vancomycin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,15],"treatment_indices_end":[10,20]}
{"text":"she was treated with ivf for her arf .","problem":["her arf"],"test":[],"treatment":["ivf"],"problem_indices_start":[29],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21],"treatment_indices_end":[24]}
{"text":"because of her abg , and declining clinical status , the ccu was notified for possible transfer .","problem":[],"test":["her abg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[11],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- possible opacity on cxr - along w\/ leukocytosis .","problem":["opacity","leukocytosis"],"test":["cxr"],"treatment":[],"problem_indices_start":[11,37],"problem_indices_end":[18,49],"test_indices_start":[22],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"echo 2018-05-28","problem":[],"test":["echo"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[4],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"explained to lewin that pt will likely need to be intubated , as she cannot lie flat , and most likely cannot undergo pericardial drainage , thoracentesis , or right heart cath with bipap ( which would have been the next measure after nrb , and prior to intubation ).","problem":[],"test":[],"treatment":["thoracentesis","pericardial drainage","nrb","bipap","right heart cath","intubation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[118,141,160,182,235,254],"treatment_indices_end":[138,154,176,187,238,264]}
{"text":"cva","problem":["cva"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a cxr was performed the evening of 5\/16 , showing moderate sized bilateral pleural effusions , stable cardiomegaly and a possible rll infiltrate .","problem":["stable cardiomegaly","rll infiltrate","moderate sized bilateral pleural effusions"],"test":["a cxr"],"treatment":[],"problem_indices_start":[50,95,130],"problem_indices_end":[92,114,144],"test_indices_start":[0],"test_indices_end":[5],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"#. pleural effusions : likely due to chf although had some leukocytosis at admission to osh .","problem":["some leukocytosis","pleural effusions","chf"],"test":[],"treatment":[],"problem_indices_start":[3,37,54],"problem_indices_end":[20,40,71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"large pericardial effusion , transfer from osh","problem":["large pericardial effusion"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she denies any cp \/ cough \/ fever \/ abd pain \/ diarrhea \/ black or bloody stools \/ headache .","problem":["any cp","diarrhea","black or bloody stools","headache","cough","fever","abd pain"],"test":[],"treatment":[],"problem_indices_start":[11,20,28,36,47,58,83],"problem_indices_end":[17,25,33,44,55,80,91],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had some nausea \/ vomiting and generally was taking poor pos at her nh .","problem":["vomiting","nausea"],"test":[],"treatment":[],"problem_indices_start":[13,22],"problem_indices_end":[19,30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there had been some concern her nausea was due to her amiodarone which had been discontinued about 1 week ago .","problem":["her nausea"],"test":[],"treatment":["her amiodarone"],"problem_indices_start":[28],"problem_indices_end":[38],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[50],"treatment_indices_end":[64]}
{"text":"detrol la 4 mg daily","problem":[],"test":[],"treatment":["detrol la"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"imaging at providence behavioral health hospital :","problem":[],"test":["imaging"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cxr at erich lindemann mental health center 05-26 : bilateral pleural eff and pericardial eff","problem":["pericardial eff","bilateral pleural eff"],"test":["cxr"],"treatment":[],"problem_indices_start":[52,78],"problem_indices_end":[73,93],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abg that evening was 7.29\/51\/56 on 4l nc and early the next morning , was 7.25\/62\/64 on nrb .","problem":[],"test":["abg"],"treatment":["nrb","nc"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[38,88],"treatment_indices_end":[40,91]}
{"text":"she was then sent to franklin medical center 05-24 with lethargy and n\/v .","problem":["n\/v","lethargy"],"test":[],"treatment":[],"problem_indices_start":[56,69],"problem_indices_end":[64,72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"impression : unchanged moderate bilateral pleural effusions and mild chf .","problem":["mild chf","unchanged moderate bilateral pleural effusions"],"test":[],"treatment":[],"problem_indices_start":[13,64],"problem_indices_end":[59,72],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"#. anemia : unclear source .","problem":["anemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"afib , sss","problem":["sss","afib"],"test":[],"treatment":[],"problem_indices_start":[0,7],"problem_indices_end":[4,10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- after she was made cmo , the pt was started on morphine gtt to maximize comfort and minimize air hunger .","problem":["air hunger"],"test":[],"treatment":["morphine gtt"],"problem_indices_start":[95],"problem_indices_end":[105],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49],"treatment_indices_end":[61]}
{"text":"bibasilar atelectasis is unchanged .","problem":["bibasilar atelectasis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"findings : the lung volumes are moderate bilateral pleural effusions are unchanged .","problem":["bilateral pleural effusions"],"test":["the lung volumes"],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[68],"test_indices_start":[11],"test_indices_end":[27],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- we continued asa \/ imdur \/ ccb \/ hold diovan until pt was made cmo .","problem":[],"test":[],"treatment":["ccb","imdur","asa","diovan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15,21,29,40],"treatment_indices_end":[18,26,32,46]}
{"text":"cad","problem":["cad"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her pacer wires in correct position .","problem":[],"test":[],"treatment":["her pacer wires"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"no urinary calculi are seen .","problem":["urinary calculi"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"findings : the right kidney measures 11 cm in length , the left kidney measures 9.7 cm in length .","problem":[],"test":["length","length"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[46,90],"test_indices_end":[52,96],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pacer dddr ( vitatron cl860 ) placed 05-08 for sss with symptomatic bradycardia , c\/b r ptx requiring chest tube","problem":["sss","symptomatic bradycardia","r ptx"],"test":[],"treatment":["pacer dddr ( vitatron cl860 )","chest tube"],"problem_indices_start":[47,56,86],"problem_indices_end":[50,79,91],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,102],"treatment_indices_end":[29,112]}
{"text":"renal us 2018-05-28","problem":[],"test":["renal us"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this has still be known to occur during the placement of pacemaker .","problem":[],"test":[],"treatment":["the placement of pacemaker"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40],"treatment_indices_end":[66]}
{"text":"pulm : no bs 01-15 way up bilat , no consolidation","problem":["consolidation"],"test":["bs"],"treatment":[],"problem_indices_start":[37],"problem_indices_end":[50],"test_indices_start":[10],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pulsus parodoxus = 6-8 mm","problem":["pulsus parodoxus"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"#. chf : normal ef on tte so possibly with diastolic dysfunction , ruled out for mi","problem":["chf","diastolic dysfunction","mi"],"test":["tte"],"treatment":[],"problem_indices_start":[3,43,81],"problem_indices_end":[6,64,83],"test_indices_start":[22],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"impression : moderate to large pericardial effusion ( minimal fluid anteriorly ( 1cm ), ? bloody ).","problem":["moderate to large pericardial effusion","minimal fluid anteriorly","bloody"],"test":[],"treatment":[],"problem_indices_start":[13,54,90],"problem_indices_end":[51,78,96],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"htn","problem":["htn"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a nitro drip was started in an effort to decrease her preload and afterload .","problem":[],"test":["afterload","preload"],"treatment":["a nitro drip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[54,66],"test_indices_end":[61,75],"treatment_indices_start":[0],"treatment_indices_end":[12]}
{"text":"her urine output decreased to nearly zero .","problem":["decreased"],"test":["her urine output"],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[26],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"exam : t 96.2 hr 70 bp 118\/46 r 24 sat 90% on 60%fm","problem":[],"test":["sat","t","r","bp","hr"],"treatment":["60%fm"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[7,14,20,30,35],"test_indices_end":[8,16,22,31,38],"treatment_indices_start":[46],"treatment_indices_end":[51]}
{"text":"today she only complains of some sob , which she says remains largely unchanged over the past few days .","problem":["some sob"],"test":[],"treatment":[],"problem_indices_start":[28],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"#. fen : check lytes , most recently normal .","problem":[],"test":["lytes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[15],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was given 200 mg iv lasix x 1 with an additional 100 cc of urine output the evening of 5\/16 .","problem":[],"test":["urine output"],"treatment":["200 mg iv lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[63],"test_indices_end":[75],"treatment_indices_start":[14],"treatment_indices_end":[29]}
{"text":"her oxygen sats did not improve .","problem":[],"test":["her oxygen sats"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no definite tamponade physiology .","problem":["definite tamponade physiology"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had a bnp of > 5000 on admission .","problem":[],"test":["a bnp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[8],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac\/renal diet","problem":[],"test":[],"treatment":["cardiac\/renal diet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[18]}
{"text":"explained that despite these invasive measures , she still has a very poor prognosis .","problem":[],"test":[],"treatment":["these invasive measures"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23],"treatment_indices_end":[46]}
{"text":"thoracentesis 2018-05-27","problem":[],"test":[],"treatment":["thoracentesis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"cxr 2018-05-30","problem":[],"test":["cxr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gen : mild resp distress speaking in full sentences but using accessory muscles","problem":["mild resp distress"],"test":[],"treatment":[],"problem_indices_start":[6],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cxr revealed evidence of cardiomegaly and pulm edema .","problem":["cardiomegaly","pulm edema"],"test":["cxr"],"treatment":[],"problem_indices_start":[25,42],"problem_indices_end":[37,52],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. lisinopril 20 mg daily","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"you were treated with medications to improve your blood pressure .","problem":[],"test":["your blood pressure"],"treatment":["medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[45],"test_indices_end":[64],"treatment_indices_start":[22],"treatment_indices_end":[33]}
{"text":"he was treated w\/ asa 325 mg , lasix 10 mg iv , and hydralazine 10 mg iv x 2 .","problem":[],"test":[],"treatment":["asa","lasix","hydralazine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18,31,52],"treatment_indices_end":[21,36,63]}
{"text":"an echo performed on admission showed an lf ef of 25% .","problem":[],"test":["an lf ef","an echo"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,38],"test_indices_end":[7,46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ext : warm , 2+ dp b\/l , 2+ pitting edema to knees b\/l","problem":["2+ pitting edema to knees b\/l"],"test":["dp"],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[54],"test_indices_start":[16],"test_indices_end":[18],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"46 - yo-man w\/ active cocaine use presents w\/ le edema .","problem":["le edema"],"test":[],"treatment":[],"problem_indices_start":[46],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"you came in with hypertensive emergency .","problem":["hypertensive emergency"],"test":[],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"if clinically indicated a tee would be better able to define an abnormality of the aortic valve .","problem":["an abnormality of the aortic valve"],"test":["a tee"],"treatment":[],"problem_indices_start":[61],"problem_indices_end":[95],"test_indices_start":[24],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sclera anicteric .","problem":["sclera anicteric"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dyspnea","problem":["dyspnea"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- lower extremity edema improved","problem":["lower extremity edema"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- mild transaminitis likely 03-25 etoh and cocaine abuse","problem":["mild transaminitis"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cv : reg s1 , loud s2 , + 2\/6 systolic murmur radiating to axilla , no s3\/s4\/r","problem":["s3\/s4\/r","2\/6 systolic murmur radiating to axilla","loud s2"],"test":[],"treatment":[],"problem_indices_start":[14,26,71],"problem_indices_end":[21,65,78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- arf","problem":["arf"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[5],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no family history of premature coronary artery disease or sudden death .","problem":["premature coronary artery disease","sudden death"],"test":[],"treatment":[],"problem_indices_start":[30,67],"problem_indices_end":[63,79],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"renal failure : creatinine on admission was 1.6 likely acute hypertensive nephropathy plus probalbe long-standing hypertensive disease .","problem":["acute hypertensive nephropathy","long-standing hypertensive disease","renal failure"],"test":["creatinine"],"treatment":[],"problem_indices_start":[0,55,100],"problem_indices_end":[13,85,134],"test_indices_start":[16],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"- hypertensive emergency","problem":["hypertensive emergency"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ekg demonstrated nsr at 87 bpm , nl axis , nl int , lvh w\/ strain pattern , no ischemic changes .","problem":["lvh","strain pattern","ischemic changes"],"test":["ekg"],"treatment":[],"problem_indices_start":[52,59,79],"problem_indices_end":[55,73,95],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. lisinopril 20 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"mild ( 1+ ) mitral regurgitation is seen .","problem":["mild ( 1+ ) mitral regurgitation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cxr :","problem":[],"test":["cxr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. labetalol 200 mg tablet sig : two ( 2 ) tablet po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["labetalol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"2. hydrochlorothiazide 25 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["hydrochlorothiazide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"1. aspirin 325 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"it is hoped with good blood pressure control and use of an ace-i with follow up in addition to cocaine abstaining will improved his cardiac function .","problem":[],"test":[],"treatment":["an ace-i","good blood pressure control"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17,56],"treatment_indices_end":[44,64]}
{"text":"the aortic valve leaflets ( 3 ) are minimally thickened .","problem":["minimally thickened"],"test":[],"treatment":[],"problem_indices_start":[36],"problem_indices_end":[55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he responded well to lasix w\/ good uop , but diastolic bp remained elevated at 170 , prompting initiation of nitroprusside gtt .","problem":["elevated"],"test":["diastolic bp","uop"],"treatment":["lasix","nitroprusside gtt"],"problem_indices_start":[67],"problem_indices_end":[75],"test_indices_start":[35,45],"test_indices_end":[38,57],"treatment_indices_start":[21,109],"treatment_indices_end":[26,126]}
{"text":"please return to the deanna if you experience sob , chest pain , fevers , chills , dizziness , decreased urine output .","problem":["sob","chest pain","chills","fevers","dizziness","decreased urine output"],"test":[],"treatment":[],"problem_indices_start":[46,52,65,74,83,95],"problem_indices_end":[49,62,71,80,92,117],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"alt(sgpt) - 77 * ast(sgot) - 60 * ck(cpk) - 195 * alk phos - 104 amylase - 100 tot bili - 0.4","problem":[],"test":["ast(sgot)","amylase","alk phos","tot bili","alt(sgpt)","ck(cpk)"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,17,34,50,65,79],"test_indices_end":[9,26,41,58,72,87],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his lower extremity edema improved with diuresis .","problem":["his lower extremity edema"],"test":[],"treatment":["diuresis"],"problem_indices_start":[0],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40],"treatment_indices_end":[48]}
{"text":"no signs of end-organ damage at present except for elevated creatinine , which is more likely a chronic problem .","problem":["end-organ damage","elevated creatinine","a chronic problem"],"test":[],"treatment":[],"problem_indices_start":[12,51,94],"problem_indices_end":[28,70,111],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"very small circumferential pericardial effusion .","problem":["very small circumferential pericardial effusion"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"moderate to severe enlargement of the cardiac silhouette , and particularly the left atrium accompanied by pulmonary vascular congestion and mild pulmonary edema consistent with heart failure .","problem":["moderate to severe enlargement of the cardiac silhouette","pulmonary vascular congestion","mild pulmonary edema","heart failure"],"test":[],"treatment":[],"problem_indices_start":[0,107,141,178],"problem_indices_end":[56,136,161,191],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is no mitral valve prolapse .","problem":["mitral valve prolapse"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"drinks 3-4 beers a few times weekly , no h\/o withdrawal symptoms , seizures or dt s.","problem":["seizures","dt s.","withdrawal symptoms"],"test":[],"treatment":[],"problem_indices_start":[45,67,79],"problem_indices_end":[64,75,84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"moderate pulmonary arterial hypertension .","problem":["moderate pulmonary arterial hypertension"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tissue doppler imaging suggests an increased left ventricular filling pressure ( pcwp > 18 mmhg ).","problem":["an increased left ventricular filling pressure"],"test":["pcwp","tissue doppler imaging"],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[78],"test_indices_start":[0,81],"test_indices_end":[22,85],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his blood pressure was taken down from 230 systolic to approx 160 systolic \/ 100 diastolic on discharge .","problem":[],"test":["systolic","systolic","diastolic","his blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,43,66,81],"test_indices_end":[18,51,74,90],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the right ventricular cavity is mildly dilated with severe free wall hypokinesis .","problem":["severe free wall hypokinesis","mildly dilated"],"test":[],"treatment":[],"problem_indices_start":[32,52],"problem_indices_end":[46,80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hypertensive urgency :","problem":["hypertensive urgency"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is moderate symmetric left ventricular hypertrophy with mild cavity dilation and severe global hypokinesis .","problem":["moderate symmetric left ventricular hypertrophy","mild cavity dilation","severe global hypokinesis"],"test":[],"treatment":[],"problem_indices_start":[9,62,87],"problem_indices_end":[56,82,112],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no left ventricular thrombus is seen .","problem":["left ventricular thrombus"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gen : lying flat in bed , pleasant and conversational , nad","problem":["nad"],"test":[],"treatment":[],"problem_indices_start":[56],"problem_indices_end":[59],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"impression : moderate symmetric eft ventricular hypertrophy with severe global biventricular hypokinesis c\/w diffuse process ( toxin , metabolic , cannot exclude myocarditis ; in the absence of lvh on ecg , an infiltrative process should also be considered ).","problem":["lvh","myocarditis","moderate symmetric eft ventricular hypertrophy","severe global biventricular hypokinesis","diffuse process","toxin","an infiltrative process"],"test":["ecg"],"treatment":[],"problem_indices_start":[13,65,109,127,162,194,207],"problem_indices_end":[59,104,124,132,173,197,230],"test_indices_start":[201],"test_indices_end":[204],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"46 - yo-man w\/ cocaine abuse presents w\/ le edema and doe likely from diastolic heart failure in the setting of cocaine use complicated by hypertensive urgency .","problem":["le edema","doe","diastolic heart failure","hypertensive urgency"],"test":[],"treatment":[],"problem_indices_start":[41,54,70,139],"problem_indices_end":[49,57,93,159],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"penicillins","problem":[],"test":[],"treatment":["penicillins"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"bp 230\/170 on presentation , most likely from chronic htn exacerbated by cocaine use .","problem":["chronic htn"],"test":["bp"],"treatment":[],"problem_indices_start":[46],"problem_indices_end":[57],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was started on labetalol and lisinopril .","problem":[],"test":[],"treatment":["labetalol","lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,41],"treatment_indices_end":[36,51]}
{"text":"the left atrium is moderately dilated .","problem":["moderately dilated"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ck-mb - 4 probnp - 7489 *","problem":[],"test":["ck-mb","probnp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10],"test_indices_end":[5,16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"three days ago , he developed dyspnea on exertion when climbing stairs , assoc w\/ 2-pillow orthopnea and pnd .","problem":["pnd","2-pillow orthopnea","dyspnea"],"test":[],"treatment":[],"problem_indices_start":[30,82,105],"problem_indices_end":[37,100,108],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is a very small circumferential pericardial effusion .","problem":["a very small circumferential pericardial effusion"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he denies any recent chest pain , palpitations , headache , confusion , weakness , numbness , abd pain , or hematuria .","problem":["any recent chest pain","palpitations","weakness","numbness","headache","confusion","hematuria","abd pain"],"test":[],"treatment":[],"problem_indices_start":[10,34,49,60,72,83,94,108],"problem_indices_end":[31,46,57,69,80,91,102,117],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there is moderate pulmonary artery systolic hypertension .","problem":["moderate pulmonary artery systolic hypertension"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10 days ago , he developed b\/l le edema that has gotten progressively worse until now .","problem":["b\/l le edema"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"wbc - 7.7 rbc - 5.00 hgb - 15.0 hct - 42.8 mcv - 86 mch - 30.0 mchc - 35.0 rdw - 14.6","problem":[],"test":["rdw","mcv","mch","mchc","wbc","rbc","hgb","hct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,10,21,32,43,52,63,75],"test_indices_end":[3,13,24,35,46,55,67,78],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"today , his wife convinced him to present to the deanna for evaluation .","problem":[],"test":["evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[60],"test_indices_end":[70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"discharged on ace-i .","problem":[],"test":[],"treatment":["ace-i"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[19]}
{"text":"plt count - 315","problem":[],"test":["plt count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"possible abnormality on the aortic valve as described above without aortic regurgitation .","problem":["aortic regurgitation","abnormality on the aortic valve"],"test":[],"treatment":[],"problem_indices_start":[9,68],"problem_indices_end":[40,88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bnp was elevated at 7500 .","problem":[],"test":["bnp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vs : t, bp 181\/122 , hr 84 , rr 12 , o2 98% 2l\/m","problem":[],"test":["vs","t,","o2","bp","hr","rr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,5,8,21,29,37],"test_indices_end":[2,7,10,23,31,39],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mild mitral regurgitation .","problem":["mild mitral regurgitation"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ctropnt - 0.02 *","problem":[],"test":["ctropnt"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the deanna , his bp was 230\/170 .","problem":[],"test":["his bp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no recent viral syndromes or uri s.","problem":["recent viral syndromes","uri s."],"test":[],"treatment":[],"problem_indices_start":[3,29],"problem_indices_end":[25,35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. hctz 25 mg daily","problem":[],"test":[],"treatment":["hctz"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[7]}
{"text":"heent : ncat .","problem":["ncat"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abd : obese , +bs , soft , ntnd .","problem":["obese","ntnd"],"test":[],"treatment":[],"problem_indices_start":[6,27],"problem_indices_end":[11,31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. labetalol 400 mg bid","problem":[],"test":[],"treatment":["labetalol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"4. asa 162mg daily","problem":[],"test":[],"treatment":["asa"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[6]}
{"text":"neck : supple with jvp of 8 cm .","problem":[],"test":["jvp"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it is extremely important for you to take these medications .","problem":[],"test":[],"treatment":["these medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[42],"treatment_indices_end":[59]}
{"text":"no aortic stenosis or aortic regurgitation is seen .","problem":["aortic stenosis","aortic regurgitation"],"test":[],"treatment":[],"problem_indices_start":[3,22],"problem_indices_end":[18,42],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pulm : cta b\/l w\/ no crackles or wheezing","problem":["crackles","wheezing"],"test":[],"treatment":[],"problem_indices_start":[21,33],"problem_indices_end":[29,41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest : mild intercostal and sternal retractions .","problem":["mild intercostal and sternal retractions"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"waltham was monitored for 90 minutes without any episodes of apnea or oxygen desaturation .","problem":["apnea","oxygen desaturation"],"test":[],"treatment":[],"problem_indices_start":[61,70],"problem_indices_end":[66,89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood type a positive , antibody negative , rubella immune , rpr nonreactive , hepatitis b surface antigen negative , group beta strep status unknown .","problem":[],"test":["rubella","antibody","rpr","hepatitis b surface antigen","group beta strep status","blood type"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,24,44,61,79,118],"test_indices_end":[10,32,51,64,106,141],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. car seat position screening was performed .","problem":[],"test":["car seat position screening"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[30],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"discharge weight is 1.89 kg .","problem":[],"test":["discharge weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"beverly was initially npo and maintained on intravenous fluids .","problem":[],"test":[],"treatment":["intravenous fluids","npo"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22,44],"treatment_indices_end":[25,62]}
{"text":"2. medications : ferrous sulfate 0.15 cc po q day 25 mg \/ ml dilution .","problem":[],"test":[],"treatment":["medications","ferrous sulfate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,17],"treatment_indices_end":[14,32]}
{"text":"4. gastrointestinal : boston required treatment for unconjungated hyperbilirubinemia with phototherapy .","problem":["unconjungated hyperbilirubinemia"],"test":[],"treatment":["treatment","phototherapy"],"problem_indices_start":[52],"problem_indices_end":[84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38,90],"treatment_indices_end":[47,102]}
{"text":"general : nondysmorphic preterm male in mild respiratory distress .","problem":["nondysmorphic","mild respiratory distress"],"test":[],"treatment":[],"problem_indices_start":[10,40],"problem_indices_end":[23,65],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ken nansteel-miller is the triplet #3 of a spontaneous triamniotic-trichorionic triplet pregnancy born to a 39-year-old g4 p1 spontaneous abortion 2 woman .","problem":["a spontaneous triamniotic-trichorionic triplet pregnancy"],"test":[],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[97],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was treated with bed rest and prn terbutaline .","problem":[],"test":[],"treatment":["bed rest","terbutaline"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[21,38],"treatment_indices_end":[29,49]}
{"text":"he received phototherapy for approximately 72 hours .","problem":[],"test":[],"treatment":["phototherapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[24]}
{"text":"rebound bilirubin on day of life #7 was 6.6 , and total was 0.2 direct .","problem":[],"test":["rebound bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"femoral pulses +2 .","problem":[],"test":["femoral pulses"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"plan is to receive hepatitis b in the pediatrician 's office , once he reaches a weight of 2 kg .","problem":[],"test":[],"treatment":["hepatitis b"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[30]}
{"text":"no murmurs have been noted .","problem":["murmurs"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"influenza immunization should be considered annually in the fall for preterm infants with chronic lung disease once they reach six months of age .","problem":["chronic lung disease"],"test":[],"treatment":["influenza immunization"],"problem_indices_start":[90],"problem_indices_end":[110],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[22]}
{"text":"cardiovascular : regular , rate , and rhythm , no murmur .","problem":["murmur"],"test":[],"treatment":[],"problem_indices_start":[50],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. immunizations recommended : synagis rsv prophylaxis should be considered from october through april for infants who meet any of the following three criteria :","problem":[],"test":[],"treatment":["synagis rsv prophylaxis","immunizations"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,31],"treatment_indices_end":[16,54]}
{"text":"3) with chronic lung disease .","problem":["chronic lung disease"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. prematurity at 34 weeks gestation .","problem":["prematurity at 34 weeks gestation"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. no immunizations administered .","problem":[],"test":[],"treatment":["immunizations"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6],"treatment_indices_end":[19]}
{"text":"breath sounds equal with fair aeration .","problem":[],"test":["breath sounds"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[13],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. state newborn screens were sent on 09-27 and 2011-10-05 with no notification of abnormal results to date .","problem":["abnormal results"],"test":["state newborn screens"],"treatment":[],"problem_indices_start":[83],"problem_indices_end":[99],"test_indices_start":[3],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"before this age , the family and other caregivers should be considered for immunization against influenza to protect the infant .","problem":["influenza"],"test":[],"treatment":["immunization"],"problem_indices_start":[96],"problem_indices_end":[105],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[75],"treatment_indices_end":[87]}
{"text":"weight 1.7 kg , length 41.5 cm , head circumference 29 cm , all 10th-25th percentile for 34 weeks .","problem":[],"test":["weight","head circumference","length"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16,33],"test_indices_end":[6,22,51],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"positive red reflex bilaterally .","problem":[],"test":["red reflex"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[9],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. unconjugated hyperbilirubinemia .","problem":["unconjugated hyperbilirubinemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. cardiovascular : falmouth has maintained normal heart rates and blood pressures .","problem":[],"test":["blood pressures"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[67],"test_indices_end":[82],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. respiratory : lincoln required nasal cannula o2 for approximately the first 8-12 hours of life .","problem":[],"test":[],"treatment":["nasal cannula o2"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[50]}
{"text":"he was admitted to the neonatal intensive care unit for treatment of prematurity .","problem":["prematurity"],"test":[],"treatment":["treatment"],"problem_indices_start":[69],"problem_indices_end":[80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[56],"treatment_indices_end":[65]}
{"text":"his peak serum bilirubin occurred on day of life three with a total of 8.3 \/ 0.2 direct , 8.1 indirect mg\/dl .","problem":[],"test":["his peak serum bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was admitted on 2011-08-25 for nausea , vomiting , and a shortened cervix .","problem":["nausea","vomiting","a shortened cervix"],"test":[],"treatment":[],"problem_indices_start":[35,44,59],"problem_indices_end":[41,52,77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the mother was followed closely and received betamethasone 2011-08-22 .","problem":[],"test":[],"treatment":["betamethasone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[45],"treatment_indices_end":[58]}
{"text":"he has had no episodes of spontaneous apnea during admission .","problem":["spontaneous apnea"],"test":[],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"throughout admission , there are no neurological concerns at the time of discharge .","problem":["neurological concerns"],"test":[],"treatment":[],"problem_indices_start":[36],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"other medications including prozac .","problem":[],"test":[],"treatment":["other medications","prozac"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,28],"treatment_indices_end":[17,34]}
{"text":"this triplet #3 emerged with spontaneous respirations , and required blow-by oxygen in the delivery room .","problem":[],"test":[],"treatment":["blow-by oxygen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[69],"treatment_indices_end":[83]}
{"text":"abdomen is soft , nontender , nondistended , no masses , positive bowel sounds .","problem":["nondistended","nontender","masses"],"test":[],"treatment":[],"problem_indices_start":[18,30,48],"problem_indices_end":[27,42,54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the babies were born by elective cesarean section at 34 weeks gestation .","problem":[],"test":[],"treatment":["elective cesarean section"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[49]}
{"text":"apgars were seven at one minute and eight at five minutes .","problem":[],"test":["apgars"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"enteral feeds were started on day of life #1 , and gradually advanced to full volume .","problem":[],"test":[],"treatment":["enteral feeds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[13]}
{"text":"audiology : hearing screening was performed with automated auditory brain stem responses .","problem":[],"test":["hearing screening"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"distant heart sounds , rrr","problem":["distant heart sounds"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10-01 cabg x 3","problem":[],"test":[],"treatment":["cabg"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[6],"treatment_indices_end":[10]}
{"text":"5. oxycodone - acetaminophen 5-325 mg tablet sig : 1-2 tablets po every 4-6 hours as needed for pain .","problem":["pain"],"test":[],"treatment":["oxycodone","acetaminophen"],"problem_indices_start":[96],"problem_indices_end":[100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,15],"treatment_indices_end":[12,28]}
{"text":"60 yo m with exertional angina -> positive ett -> cath with severe 3vd","problem":["severe 3vd","positive ett","exertional angina"],"test":["cath"],"treatment":[],"problem_indices_start":[13,34,60],"problem_indices_end":[30,46,70],"test_indices_start":[50],"test_indices_end":[54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"8. glipizide 5 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["glipizide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"2019-10-07 05:30 am blood glucose - 156 * urean - 20 creat - 1.0 na - 140 k - 3.8 cl - 99 hco3 - 31 angap - 14","problem":[],"test":["na","hco3","k","creat","urean","cl","glucose","blood","angap"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,42,53,65,74,82,90,100],"test_indices_end":[25,33,47,58,67,75,84,94,105],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-10-07 05:30 am blood wbc - 6.5 rbc - 3.23 * hgb - 9.5 * hct - 27.6 * mcv - 86 mch - 29.4 mchc - 34.4 rdw - 14.0 plt ct - 356 #","problem":[],"test":["plt ct","mch","mcv","rdw","mchc","rbc","wbc","hct","blood","hgb"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,36,49,61,74,83,94,106,117],"test_indices_end":[25,29,39,52,64,77,86,98,109,123],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. docusate sodium 150 mg \/ 15 ml liquid sig : one ( 1 ) po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["docusate sodium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"6. clopidogrel 75 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["clopidogrel"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"? tia","problem":["tia"],"test":[],"treatment":[],"problem_indices_start":[2],"problem_indices_end":[5],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lisinopril , protonix , glipizide , metformin , asa","problem":[],"test":[],"treatment":["metformin","asa","lisinopril","protonix","glipizide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,13,24,36,48],"treatment_indices_end":[10,21,33,45,51]}
{"text":"1. aspirin 81 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po daily ( daily ).","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"7. atorvastatin 10 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["atorvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"urinary incontinence","problem":["urinary incontinence"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. metoprolol tartrate 50 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ).","problem":[],"test":[],"treatment":["metoprolol tartrate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"extrem warm , no edema , no varicosities , 2+ pedal pulses","problem":["extrem warm","edema","varicosities"],"test":["pedal pulses"],"treatment":[],"problem_indices_start":[0,17,28],"problem_indices_end":[11,22,40],"test_indices_start":[46],"test_indices_end":[58],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was seen by speech and swallowing who recommended npo , he then underwent a video swallow after which he was changed to a diet of thin liquids and soft solids , and felt that his eeating may be limited by his loose teeth .","problem":["his loose teeth"],"test":["a video swallow"],"treatment":["a diet of thin liquids and soft solids","npo"],"problem_indices_start":[208],"problem_indices_end":[223],"test_indices_start":[77],"test_indices_end":[92],"treatment_indices_start":[53,123],"treatment_indices_end":[56,161]}
{"text":"patient recorded as having no known allergies to drugs","problem":["known allergies to drugs"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[54],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. lisinopril 10 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"exertional angina","problem":["exertional angina"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was taken to the operating room on 2019-10-01 where he underwent a cabg x 3 .","problem":[],"test":[],"treatment":["a cabg"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[68],"treatment_indices_end":[74]}
{"text":"nad 76 184\/87 18","problem":[],"test":["nad"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was weaned from his vasoactive drips and transferred to the floor on pod #2 .","problem":[],"test":[],"treatment":["his vasoactive drips"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[39]}
{"text":"dm","problem":["dm"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[2],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"call with fever , redness or drainage from incision or weight gain more than 2 pounds in one day or five in one week .","problem":["weight gain","drainage from incision","redness","fever"],"test":[],"treatment":[],"problem_indices_start":[10,18,29,55],"problem_indices_end":[15,25,51,66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-10-07 05:30 am blood plt ct - 356 #","problem":[],"test":["plt ct","blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26],"test_indices_end":[25,32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"shower , no baths , no lotions , creams or powders to incisions .","problem":["incisions"],"test":[],"treatment":["powders","lotions","creams"],"problem_indices_start":[54],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23,33,43],"treatment_indices_end":[30,39,50]}
{"text":"cad","problem":["cad"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"father with ? mi at unknown age","problem":["mi"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2019-10-04 06:50 am blood pt - 13.2 * ptt - 32.1 inr(pt) - 1.2 *","problem":[],"test":["inr(pt)","ptt","pt","blood"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,26,38,49],"test_indices_end":[25,28,41,56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"dm","problem":["dm"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[2],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"teeth in poor repair","problem":["teeth in poor repair"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cataracts s\/p removal c\/b enucleated left cmed csru","problem":["cataracts"],"test":[],"treatment":["removal"],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[21]}
{"text":"urinary incontinence","problem":["urinary incontinence"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"10. hydrochlorothiazide 25 mg tablet sig : one ( 1 ) tablet po once a day .","problem":[],"test":[],"treatment":["hydrochlorothiazide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[23]}
{"text":"cataracts s\/p removal of in mayotte c\/b enucleated cmed csru","problem":["cataracts"],"test":[],"treatment":["removal"],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[21]}
{"text":"htn","problem":["htn"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. pantoprazole 40 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po q24h ( every 24 hours ).","problem":[],"test":[],"treatment":["pantoprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"htn","problem":["htn"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"following evaluation and treatment , the patient 's disposition at the end of the visit was admitted as an inpatient to bri health .","problem":[],"test":["evaluation"],"treatment":["treatment"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10],"test_indices_end":[20],"treatment_indices_start":[25],"treatment_indices_end":[34]}
{"text":"the patient presented with a chief complaint of found down .","problem":["found down"],"test":[],"treatment":[],"problem_indices_start":[48],"problem_indices_end":[58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"your patient was admitted under the care of reefraup , ja y with a preliminary diagnosis of syncope .","problem":["syncope"],"test":[],"treatment":[],"problem_indices_start":[92],"problem_indices_end":[99],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. coronary artery disease : the patient was taken to cardiac catheterization where she was found to have two vessel disease .","problem":["two vessel disease","coronary artery disease"],"test":["cardiac catheterization"],"treatment":[],"problem_indices_start":[3,106],"problem_indices_end":[26,124],"test_indices_start":[54],"test_indices_end":[77],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. lisinopril 5 q.d.","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"she will follow-up with dr. welch with an echocardiogram on 2015-07-24 in a meeting to discuss risk stratification for sudden cardiac death and possible icd placement .","problem":["sudden cardiac death"],"test":["an echocardiogram"],"treatment":["icd placement"],"problem_indices_start":[119],"problem_indices_end":[139],"test_indices_start":[39],"test_indices_end":[56],"treatment_indices_start":[153],"treatment_indices_end":[166]}
{"text":"4. coumadin 5 q.d.","problem":[],"test":[],"treatment":["coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"the patient was already on an aspirin and plavix should this represent a small stroke .","problem":["a small stroke"],"test":[],"treatment":["plavix","an aspirin"],"problem_indices_start":[71],"problem_indices_end":[85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27,42],"treatment_indices_end":[37,48]}
{"text":"the patient had no evidence for weakness on examination with good proximal and distal strength in the lower extremities as well as intact sensation .","problem":["weakness"],"test":["examination"],"treatment":[],"problem_indices_start":[32],"problem_indices_end":[40],"test_indices_start":[44],"test_indices_end":[55],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. toprol xl 100 q.d.","problem":[],"test":[],"treatment":["toprol xl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"she reports that it had essentially started earlier in the day with some gerd-like symptoms .","problem":["some gerd-like symptoms"],"test":[],"treatment":[],"problem_indices_start":[68],"problem_indices_end":[91],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"laboratory and radiologic data : on admission , white count 10.8 , hematocrit 38.2 , platelets 324,000 .","problem":[],"test":["platelets","hematocrit","white count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[48,67,85],"test_indices_end":[59,77,94],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. lovenox 60 mg b.i.d. until therapeutic on coumadin .","problem":[],"test":[],"treatment":["lovenox","coumadin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,45],"treatment_indices_end":[10,53]}
{"text":"5. plavix 75 q.d.","problem":[],"test":[],"treatment":["plavix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"4. neurology : the patient complained of left lower extremity weakness with ambulation two days after her cardiac catheterization .","problem":["left lower extremity weakness"],"test":["her cardiac catheterization"],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[70],"test_indices_start":[102],"test_indices_end":[129],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. hematology : the patient was discharged on coumadin for apical akinesis and stroke risk .","problem":["apical akinesis","stroke risk"],"test":[],"treatment":["coumadin"],"problem_indices_start":[59,79],"problem_indices_end":[74,90],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[46],"treatment_indices_end":[54]}
{"text":"the dorsalis pedis pulses were 2+ bilaterally .","problem":[],"test":["the dorsalis pedis pulses"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extremities : there was no edema in the extremities .","problem":["edema in the extremities"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"follow-up plans : the patient will follow-up with her primary care physician in the week following discharge for further monitoring of her inr and adjustment of her coumadin dose .","problem":[],"test":["her inr"],"treatment":["her coumadin dose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[135],"test_indices_end":[142],"treatment_indices_start":[161],"treatment_indices_end":[178]}
{"text":"she reports that the pain shot through her back .","problem":["the pain"],"test":[],"treatment":[],"problem_indices_start":[17],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"abdomen : soft , nontender , nondistended , good bowel sounds .","problem":["nontender","nondistended"],"test":[],"treatment":[],"problem_indices_start":[17,29],"problem_indices_end":[26,41],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"discharge diagnosis : st elevation myocardial infarction , status post left anterior descending artery stent .","problem":["st elevation myocardial infarction"],"test":[],"treatment":["left anterior descending artery stent"],"problem_indices_start":[22],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[71],"treatment_indices_end":[108]}
{"text":"she was also able to ascend stairs without difficulty .","problem":["difficulty"],"test":[],"treatment":[],"problem_indices_start":[43],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. aspirin 325 q.d.","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"this will be further monitored by her primary care physician , dr. banks , who will adjust her coumadin dose .","problem":[],"test":[],"treatment":["her coumadin dose"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[91],"treatment_indices_end":[108]}
{"text":"general : the patient was a well appearing female in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[56],"problem_indices_end":[70],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was found to have an ejection fraction of 30-35% as well as an akinetic apex and apical mid and septal akinesis .","problem":["an akinetic apex","apical mid and septal akinesis"],"test":["an ejection fraction"],"treatment":[],"problem_indices_start":[64,85],"problem_indices_end":[80,115],"test_indices_start":[22],"test_indices_end":[42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no murmurs were appreciated .","problem":["murmurs"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[10],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lungs : clear to auscultation bilaterally .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on discharge , the patient was given lovenox injections which should be continued until the patient reaches a therapeutic dose of coumadin .","problem":[],"test":[],"treatment":["coumadin","lovenox injections"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37,130],"treatment_indices_end":[55,138]}
{"text":"on admission , the patient was afebrile , blood pressure 146\/88 , pulse 71 , respirations 18 .","problem":["afebrile"],"test":["blood pressure","pulse","respirations"],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[39],"test_indices_start":[42,66,77],"test_indices_end":[56,71,89],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had an ep evaluation and will be followed-up by dr. welch .","problem":[],"test":["an ep evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[16],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. rhythm : the patient was monitored on telemetry throughout her hospitalization with no significant events .","problem":["significant events"],"test":["telemetry"],"treatment":[],"problem_indices_start":[90],"problem_indices_end":[108],"test_indices_start":[41],"test_indices_end":[50],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"14-087 , the patient had a signal-averaged ekg .","problem":[],"test":["a signal-averaged ekg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[25],"test_indices_end":[46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. uniretic 15\/25 .","problem":[],"test":[],"treatment":["uniretic"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"allergies : the patient has no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. gerd .","problem":["gerd"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. atenolol 25 .","problem":[],"test":[],"treatment":["atenolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"however , there was no evidence for neurologic deficit on examination and this will be followed-up by her primary care physician .","problem":["neurologic deficit"],"test":["examination"],"treatment":[],"problem_indices_start":[36],"problem_indices_end":[54],"test_indices_start":[58],"test_indices_end":[69],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. crestor 10 q.d.","problem":[],"test":[],"treatment":["crestor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"given the fact that the patient had significant apical akinesis , she was started on heparin with a transition to coumadin for anticoagulation for stroke prevention in the setting of apical akinesis .","problem":["significant apical akinesis","apical akinesis"],"test":[],"treatment":["coumadin","heparin","stroke prevention","anticoagulation"],"problem_indices_start":[36,183],"problem_indices_end":[63,198],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[85,114,127,147],"treatment_indices_end":[92,122,142,164]}
{"text":"1. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was found to have 5057 e. sixth blvd. elevations in i , avl , and v1 through v2 and st depressions in ii , iii , and avf .","problem":["st depressions in ii , iii , and avf","elevations in i , avl , and v1 through v2"],"test":[],"treatment":[],"problem_indices_start":[50,96],"problem_indices_end":[91,132],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. carpal tunnel syndrome .","problem":["carpal tunnel syndrome"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[25],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient also had proximal rca lesion of 80% and a mid rca lesion of 80-90% which were not intervened upon .","problem":["proximal rca lesion of 80%","a mid rca lesion of 80-90%"],"test":[],"treatment":[],"problem_indices_start":[21,52],"problem_indices_end":[47,78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. chondrocalcinosis .","problem":["chondrocalcinosis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given an aspirin and plavix and in addition started on a beta elmore , maxine ace inhibitor , and these were titrated up as her blood pressure tolerated .","problem":[],"test":["her blood pressure"],"treatment":["an aspirin","plavix","maxine ace inhibitor","a beta elmore"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[140],"test_indices_end":[158],"treatment_indices_start":[22,37,71,87],"treatment_indices_end":[32,43,84,107]}
{"text":"2. hypercholesterolemia .","problem":["hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had twin lad stents to the lad diagonal and lad septal branches with taxus stents .","problem":[],"test":[],"treatment":["taxus stents","twin lad stents"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16,81],"treatment_indices_end":[31,93]}
{"text":"a tp3a inhibitor was not given for concern for dissection .","problem":["dissection"],"test":[],"treatment":["a tp3a inhibitor"],"problem_indices_start":[47],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[16]}
{"text":"in the emergency room , the patient was given lopressor , nitroglycerin , and aspirin .","problem":[],"test":[],"treatment":["aspirin","nitroglycerin","lopressor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[46,58,78],"treatment_indices_end":[55,71,85]}
{"text":"given the fact that the patient had issues with muscle cramping with atorvastatin in the past , she was started on pravastatin which should give less of these side effects .","problem":["muscle cramping","these side effects"],"test":[],"treatment":["atorvastatin","pravastatin"],"problem_indices_start":[48,153],"problem_indices_end":[63,171],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[69,115],"treatment_indices_end":[81,126]}
{"text":"the patient is a 57 - year-old female with a history of hypertension and hypercholesterolemia but no prior coronary artery disease history who presented with chest pain .","problem":["prior coronary artery disease history","chest pain","hypertension","hypercholesterolemia"],"test":[],"treatment":[],"problem_indices_start":[56,73,101,158],"problem_indices_end":[68,93,138,168],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient will follow-up with cardiology in one months time for further management of her coronary artery disease and further evaluation of her remaining rca lesions .","problem":["her coronary artery disease","her remaining rca lesions"],"test":["further evaluation"],"treatment":["further management"],"problem_indices_start":[88,142],"problem_indices_end":[115,167],"test_indices_start":[120],"test_indices_end":[138],"treatment_indices_start":[66],"treatment_indices_end":[84]}
{"text":"the pain was intermittent through the day and then at 4:00 p.m. increased and was also associated with nausea and diaphoresis .","problem":["nausea","diaphoresis","the pain"],"test":[],"treatment":[],"problem_indices_start":[0,103,114],"problem_indices_end":[8,109,125],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition to this , the patient will follow-up with cardiology , dr. foster , and dr. upshaw , on 2015-07-06 for further monitoring .","problem":[],"test":["further monitoring"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[115],"test_indices_end":[133],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at that time , the pain was unremitting .","problem":["the pain"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has never had these symptoms in the past .","problem":["these symptoms"],"test":[],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she had taken maalox but had no relief with this .","problem":[],"test":[],"treatment":["maalox"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[20]}
{"text":"the proximal lad was found to have a 90% lesion with a septal branch with a 95% stenosis and a diagonal branch with 99% stenosis .","problem":["a 90% lesion","a 95% stenosis","99% stenosis"],"test":[],"treatment":[],"problem_indices_start":[35,74,116],"problem_indices_end":[47,88,128],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. pravastatin 80 q.d.","problem":[],"test":[],"treatment":["pravastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"2. pump : the patient had an echocardiogram to assess her lv function .","problem":[],"test":["an echocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26],"test_indices_end":[43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient reports the pain began at 4:00 p.m. on the day of admission .","problem":["the pain"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the mother had received a complete course of betamethasone prior to delivery .","problem":[],"test":[],"treatment":["betamethasone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[45],"treatment_indices_end":[58]}
{"text":"the birth length was 44 centimeters , the 75th percentile and the birth head circumference was 30.6 centimeters , in the 65th percentile","problem":[],"test":["the birth length","the birth head circumference"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,62],"test_indices_end":[16,90],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has been taking from 130 to 160 cc. per kilo per day on an ad lib feeding plan .","problem":[],"test":[],"treatment":["an ad lib feeding plan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[60],"treatment_indices_end":[82]}
{"text":"this infant emerged with apgars of 8 at one minute and 8 at five minutes .","problem":[],"test":["apgars"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[25],"test_indices_end":[31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mother is a 37 year old gravida 1 , para 0 now 2 woman whose blood type is a negative , antibody negative , rubella immune , rpr nonreactive , hepatitis b surface antigen negative and group b streptococcus unknown .","problem":[],"test":["antibody","rubella","rpr","hepatitis b surface antigen","group b streptococcus","blood type"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[61,88,108,125,143,184],"test_indices_end":[71,96,115,128,170,205],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at the time of discharge , her weight is 2,200 grams ; her length is 49.5 centimeters ( 19.5 inches ) and her head circumference is 30.5 centimeters .","problem":[],"test":["her weight","her length","her head circumference"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[27,55,106],"test_indices_end":[37,65,128],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the antibiotics were discontinued after 48 hours when the infant was clinically well and the blood cultures remained negative .","problem":[],"test":["the blood cultures"],"treatment":["the antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[89],"test_indices_end":[107],"treatment_indices_start":[0],"treatment_indices_end":[15]}
{"text":"she had a head ultrasound on 2013-05-02 , that was completely within normal limits .","problem":[],"test":["a head ultrasound"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[8],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the birth weight was 1,980 grams , 80th percentile .","problem":[],"test":["the birth weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this pregnancy was achieved with in bartley fertilization .","problem":[],"test":[],"treatment":["bartley fertilization"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36],"treatment_indices_end":[57]}
{"text":"cesarean section was performed under spinal anesthesia .","problem":[],"test":[],"treatment":["spinal anesthesia","cesarean section"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,37],"treatment_indices_end":[16,54]}
{"text":"the infant was started on ampicillin and gentamycin at the time of admission for sepsis risk factor .","problem":["sepsis risk factor"],"test":[],"treatment":["ampicillin","gentamycin"],"problem_indices_start":[81],"problem_indices_end":[99],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,41],"treatment_indices_end":[36,51]}
{"text":"she started on enteral feeds on day of life number two and progressed without difficulty to full volume feedings by day of life five and then was advanced to calorie enhanced breast milk of 24 calories per ounce .","problem":[],"test":[],"treatment":["enteral feeds","full volume feedings","calorie enhanced breast milk"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15,92,158],"treatment_indices_end":[28,112,186]}
{"text":"a cerclage was placed at 18 weeks gestation .","problem":[],"test":[],"treatment":["a cerclage"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[10]}
{"text":"she has never received any blood products during this cmed csru stay .","problem":[],"test":[],"treatment":["blood products"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[41]}
{"text":"she is receiving supplemental iron to provide 2 mg per kilo per day as elemental iron .","problem":[],"test":[],"treatment":["elemental iron","supplemental iron"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17,71],"treatment_indices_end":[34,85]}
{"text":"her peak bilirubin occurred on day of life five and was total 12.1 , direct 0.3 ; the last bilirubin on day of life six was total 11.1 , direct 0.4 .","problem":[],"test":["total","total","direct","direct","her peak bilirubin","the last bilirubin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,56,69,82,124,137],"test_indices_end":[18,61,75,100,129,143],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her hematocrit at the time of admission was 45.4 , platelets were 360,000 .","problem":[],"test":["her hematocrit","platelets"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,51],"test_indices_end":[14,60],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she never required phototherapy .","problem":[],"test":[],"treatment":["phototherapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[31]}
{"text":"the infant is on breast milk with enfamil powder to provide 24 calories per ounce and on an ad lib feeding schedule .","problem":[],"test":[],"treatment":["an ad lib feeding schedule","breast milk with enfamil powder"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[17,89],"treatment_indices_end":[48,115]}
{"text":"2) influenza immunization should be considered annually in the fall for preterm infants with chronic lung disease once they reach six months of age .","problem":["chronic lung disease"],"test":[],"treatment":["influenza immunization"],"problem_indices_start":[93],"problem_indices_end":[113],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[25]}
{"text":"on admission , revealed a vigorous non-dysmorphic premature infant , with moderate subcostal retractions and some occasional grunting , normal s1 , s2 heart sounds , no murmur .","problem":["some occasional grunting","moderate subcostal retractions","murmur"],"test":[],"treatment":[],"problem_indices_start":[74,109,169],"problem_indices_end":[104,133,175],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the infant was intubated soon after admission to the cmed csru and received two doses of surfactant .","problem":[],"test":[],"treatment":["surfactant"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[89],"treatment_indices_end":[99]}
{"text":"smoker in the household , with preschool siblings , or with chronic lung disease ;","problem":["chronic lung disease"],"test":[],"treatment":[],"problem_indices_start":[60],"problem_indices_end":[80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. the infant received the hepatitis b vaccine on 2013-05-09 , and synagis on 2013-05-11 .","problem":[],"test":[],"treatment":["synagis","the hepatitis b vaccine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[23,67],"treatment_indices_end":[46,74]}
{"text":"1. prematurity at 31-6\/7 weeks gestation .","problem":["prematurity"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. state screens were sent on 04-27 and 2013-05-08 .","problem":[],"test":["state screens"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ferinsol 0.2 cc. to provide 5 mg a day .","problem":[],"test":[],"treatment":["ferinsol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[8]}
{"text":"richard williams , twin number ii , was born at 31-6\/7 weeks gestation by cesarean section for rupture of membranes of twin number i and progressive preterm labor .","problem":["rupture of membranes","progressive preterm labor"],"test":[],"treatment":["cesarean section"],"problem_indices_start":[95,137],"problem_indices_end":[115,162],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[74],"treatment_indices_end":[90]}
{"text":"her lung sounds are clear and equal .","problem":[],"test":["her lung sounds"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[15],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she has a normal s1 , s2 heart sound and no murmur .","problem":["murmur"],"test":[],"treatment":[],"problem_indices_start":[44],"problem_indices_end":[50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. status post respiratory distress syndrome .","problem":["respiratory distress syndrome"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1) synagis rsv prophylaxis should be considered from october through april for infants who meet any of the following three criteria :","problem":[],"test":[],"treatment":["synagis rsv prophylaxis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[26]}
{"text":"she has had no apnea , bradycardia or desaturation .","problem":["desaturation","apnea","bradycardia"],"test":[],"treatment":[],"problem_indices_start":[15,23,38],"problem_indices_end":[20,34,50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. sepsis , ruled out .","problem":["sepsis"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"her respirations are comfortable .","problem":[],"test":["her respirations"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"before this age , the family and other care givers should be considered for immunization against influenza to protect the infant .","problem":["influenza"],"test":[],"treatment":["immunization"],"problem_indices_start":[97],"problem_indices_end":[106],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[76],"treatment_indices_end":[88]}
{"text":"3. the infant passed a car seat positioning test on 2013-05-11 .","problem":[],"test":["a car seat positioning test"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[21],"test_indices_end":[48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-12-03 10:27 pm wbc - 8.4 rbc - 2.98 * hgb - 9.3 * hct - 26.3 * mcv - 88 mch - 31.1 mchc - 35.3 * rdw - 14.4","problem":[],"test":["rdw","mch","mchc","mcv","hct","rbc","hgb","wbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,30,43,55,68,77,88,102],"test_indices_end":[23,33,46,58,71,80,92,105],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-12-03 10:27 pm glucose - 88 urea n - 12 creat - 1.0 sodium - 138 potassium - 3.3 chloride - 107 total co2 - 25 anion gap - 9","problem":[],"test":["creat","urea n","glucose","chloride","total co2","sodium","potassium","anion gap"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,33,45,57,70,86,101,116],"test_indices_end":[27,39,50,63,79,94,110,125],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no edema , no clubbing","problem":["edema","clubbing"],"test":[],"treatment":[],"problem_indices_start":[3,14],"problem_indices_end":[8,22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rrr s1\/s2 no m","problem":["m"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[14],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"t 97.4 bp 100\/62 p 56 rr 16","problem":[],"test":["rr","p","bp","t"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,7,17,22],"test_indices_end":[1,9,18,24],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"55 year old man with history of metastatic bladder cancer and recurrent dvt s on lovenox admitted with lower gi bleeding .","problem":["metastatic bladder cancer","recurrent dvt s","lower gi bleeding"],"test":[],"treatment":["lovenox"],"problem_indices_start":[32,62,103],"problem_indices_end":[57,77,120],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[81],"treatment_indices_end":[88]}
{"text":"patient recorded as having no known allergies to drugs","problem":["known allergies"],"test":[],"treatment":["drugs"],"problem_indices_start":[30],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[49],"treatment_indices_end":[54]}
{"text":"metastatic bladder ca now in remission s\/p chemo\/xrt s\/p cystectomy and ileal loop urinary diversion and also radical prstatectomy with bilateral pelvic lymph node dissection .","problem":["metastatic bladder ca"],"test":[],"treatment":["bilateral pelvic lymph node dissection","radical prstatectomy","cystectomy","ileal loop urinary diversion","chemo\/xrt"],"problem_indices_start":[0],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[43,57,72,110,136],"treatment_indices_end":[52,67,100,130,174]}
{"text":"on ct scan , a right psoas mass , most consistent with a hematoma , was seen .","problem":["a right psoas mass","a hematoma"],"test":["ct scan"],"treatment":[],"problem_indices_start":[13,55],"problem_indices_end":[31,65],"test_indices_start":[3],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a ct scan of your abdomen showed a right pelvic mass , most likely a hematoma , which had been described previously in 2015-03-28 .","problem":["a right pelvic mass","a hematoma"],"test":["a ct scan of your abdomen"],"treatment":[],"problem_indices_start":[33,67],"problem_indices_end":[52,77],"test_indices_start":[0],"test_indices_end":[25],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pt feeling well , denies abd pain , n\/v , lh , sob , cp .","problem":["lh","cp","sob","abd pain","n\/v"],"test":[],"treatment":[],"problem_indices_start":[25,36,42,47,53],"problem_indices_end":[33,39,44,50,55],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please continue to take your other medications as prescribed .","problem":[],"test":[],"treatment":["your other medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24],"treatment_indices_end":[46]}
{"text":"cbc , creatinine","problem":[],"test":["creatinine","cbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,6],"test_indices_end":[3,16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gib","problem":["gib"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"seen by gi and plan is to continue holding anticoagulation and repeat scope on monday .","problem":[],"test":["repeat scope"],"treatment":["anticoagulation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[63],"test_indices_end":[75],"treatment_indices_start":[43],"treatment_indices_end":[58]}
{"text":"the bleeding has stopped and you have remained hemodynamically stable and your hematocrit is stable , but you are at risk of bleeding from this source again with anticoagulation .","problem":["bleeding","the bleeding"],"test":["your hematocrit"],"treatment":["anticoagulation"],"problem_indices_start":[0,125],"problem_indices_end":[12,133],"test_indices_start":[74],"test_indices_end":[89],"treatment_indices_start":[162],"treatment_indices_end":[177]}
{"text":"55 yo m w\/ h\/o recurrent bladder ca s\/p cystectomy w\/ ileal conduit p\/w brbpr to osh .","problem":["recurrent bladder ca","brbpr"],"test":[],"treatment":["ileal conduit","cystectomy"],"problem_indices_start":[15,72],"problem_indices_end":[35,77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40,54],"treatment_indices_end":[50,67]}
{"text":"h\/o dvt s","problem":["dvt s"],"test":[],"treatment":[],"problem_indices_start":[4],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"b\/l dvt s, most recent seen in ivc to right femoral vein s\/p ivc filter 2015-01-15","problem":["b\/l dvt"],"test":[],"treatment":["ivc filter"],"problem_indices_start":[0],"problem_indices_end":[7],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61],"treatment_indices_end":[71]}
{"text":"attempts to visualize colon by conventional and ct virtual colonoscopy failed because of sigmoid angulation and inadequate preparation , respectively .","problem":["sigmoid angulation"],"test":["conventional and ct virtual colonoscopy"],"treatment":[],"problem_indices_start":[89],"problem_indices_end":[107],"test_indices_start":[31],"test_indices_end":[70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please see a doctor if you feel dizzy , or have blood in your stool again .","problem":["blood in your stool","dizzy"],"test":[],"treatment":[],"problem_indices_start":[32,48],"problem_indices_end":[37,67],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"yellowish urine in rlq","problem":["yellowish urine in rlq"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"please go to dr. colombo office later this week to have your labs drawn and sent to dr. powell .","problem":[],"test":["your labs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[56],"test_indices_end":[65],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"denies fh of bleeding or clotting disorders .","problem":["bleeding","clotting disorders"],"test":[],"treatment":[],"problem_indices_start":[13,25],"problem_indices_end":[21,43],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"also , a repeat outpatient ct colonoscopy with better preparation should be considered .","problem":[],"test":["a repeat outpatient ct colonoscopy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[7],"test_indices_end":[41],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tagged rbc + activity in rlq .","problem":[],"test":["rbc"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[7],"test_indices_end":[10],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lovenox was held until follow-up with primary care doctor .","problem":[],"test":[],"treatment":["lovenox"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"1. pantoprazole 40 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po once a day .","problem":[],"test":[],"treatment":["pantoprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"lovenox 0.6 mg \/ kg sc bid","problem":[],"test":[],"treatment":["lovenox"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[7]}
{"text":"nephrolithiasis .","problem":["nephrolithiasis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"bright red blood per rectum","problem":["bright red blood per rectum"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"since the hematocrit of the patient was stable and outside records from 2015-03-28 mentioned a mass in the right pelvis , the patient was discharged .","problem":["a mass in the right pelvis"],"test":["the hematocrit"],"treatment":[],"problem_indices_start":[93],"problem_indices_end":[119],"test_indices_start":[6],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"anemia - baseline mid 30 s.","problem":["anemia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"soft , +bs , nt , midline surgical scar , nephrostomy bag draining","problem":["midline surgical scar","nt"],"test":[],"treatment":["nephrostomy bag"],"problem_indices_start":[13,18],"problem_indices_end":[15,39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[42],"treatment_indices_end":[57]}
{"text":"we recommend that you do not resume your lovenox until talking to your pcp , dr. jessie .","problem":[],"test":[],"treatment":["your lovenox"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36],"treatment_indices_end":[48]}
{"text":"metastatic , recurrent bladder cancer","problem":["metastatic , recurrent bladder cancer"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"virtual colonoscopy","problem":[],"test":[],"treatment":["virtual colonoscopy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[19]}
{"text":"you likely have a bleeding source in your colon that we have been unable to visualize .","problem":["a bleeding source in your colon"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[47],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"colonoscopy","problem":[],"test":[],"treatment":["colonoscopy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[11]}
{"text":"cscope unable to complete due to blood but tics seen .","problem":["tics","blood"],"test":["cscope"],"treatment":[],"problem_indices_start":[33,43],"problem_indices_end":[38,47],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"right lower quadrant source of bleed on red blood cell scan .","problem":["right lower quadrant source of bleed"],"test":["red blood cell scan"],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[36],"test_indices_start":[40],"test_indices_end":[59],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-12-03 10:27 pm calcium - 8.7 phosphate - 2.4 * magnesium - 1.5 *","problem":[],"test":["phosphate","magnesium","calcium"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,34,52],"test_indices_end":[27,43,61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hct dropped 34 -> 22 .","problem":[],"test":["hct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"transferred to mediplex rehab hospital icu where hct has remained stable .","problem":[],"test":["hct"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[49],"test_indices_end":[52],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"egd normal .","problem":[],"test":["egd"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-12-03 10:27 pm plt count - 164","problem":[],"test":["plt count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-12-03 10:27 pm estgfr - using this","problem":[],"test":["estgfr"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[26],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"supple , no lad","problem":["lad"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2015-12-03 10:27 pm pt - 11.4 ptt - 27.5 inr(pt) - 1.0","problem":[],"test":["pt","ptt","inr(pt)"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20,30,41],"test_indices_end":[22,33,48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"sclera anicteric , mmm","problem":["sclera anicteric"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mid aged man in nad","problem":["nad"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[19],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in general the patient was in no acute distress , afebrile , vital signs stable .","problem":["afebrile","acute distress"],"test":["vital signs"],"treatment":[],"problem_indices_start":[33,50],"problem_indices_end":[47,58],"test_indices_start":[61],"test_indices_end":[72],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. carotid disease .","problem":["carotid disease"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[18],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. lasix 20 mg p.o. q. 12 .","problem":[],"test":[],"treatment":["lasix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"4. plavix 75 mg p.o. q.d. which has been discontinued prior to surgery .","problem":[],"test":[],"treatment":["plavix","surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3,63],"treatment_indices_end":[9,70]}
{"text":"2. potassium 20 meq p.o. q. 12 .","problem":[],"test":[],"treatment":["potassium"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"they requested that he follow up in three to five weeks for endurance training , however then physical therapy followed him a number of times afterward and decided that he was in good condition and did not need further physical therapy .","problem":[],"test":[],"treatment":["physical therapy","endurance training"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[60,219],"treatment_indices_end":[78,235]}
{"text":"carotids were 1+ bilaterally .","problem":[],"test":["carotids"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[8],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. lopressor 12.5 mg p.o. b.i.d.","problem":[],"test":[],"treatment":["lopressor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"abdomen : positive bowel sounds , soft , nontender , nondistended , no masses , no hepatosplenomegaly .","problem":["hepatosplenomegaly","masses","nondistended","nontender"],"test":[],"treatment":[],"problem_indices_start":[41,53,71,83],"problem_indices_end":[50,65,77,101],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left main coronary artery was narrowed 50-60% , left anterior descending coronary artery 70% proximally , right coronary artery dominant diseased up to 90% proximally in the midportion , 70% distally .","problem":["right coronary artery dominant diseased","narrowed"],"test":[],"treatment":[],"problem_indices_start":[30,106],"problem_indices_end":[38,145],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is a 67 - year-old male with a history of high cholesterol who was in his usual state of health until 2016-04-03 .","problem":["high cholesterol"],"test":[],"treatment":[],"problem_indices_start":[47],"problem_indices_end":[63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he may observe regular activity although he should avoid strenuous activity and should not drive while on pain medications .","problem":[],"test":[],"treatment":["pain medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[106],"treatment_indices_end":[122]}
{"text":"1. history of high cholesterol .","problem":["high cholesterol"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[30],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his troponin was 20 and he had ekg changes .","problem":["ekg changes"],"test":["his troponin"],"treatment":[],"problem_indices_start":[31],"problem_indices_end":[42],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. colace 100 mg p.o. b.i.d.","problem":[],"test":[],"treatment":["colace"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[9]}
{"text":"positive for coronary artery disease .","problem":["coronary artery disease"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[36],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his wife gave him mouth-to-mouth resuscitation and he regained consciousness .","problem":[],"test":[],"treatment":["mouth-to-mouth resuscitation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[46]}
{"text":"5. percocet 1-2 tablets p.o. q. 4 p.r.n. pain .","problem":["pain"],"test":[],"treatment":["percocet"],"problem_indices_start":[41],"problem_indices_end":[45],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"heent : normocephalic , atraumatic .","problem":["atraumatic"],"test":[],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"extremities : without cyanosis , clubbing or edema .","problem":["cyanosis","clubbing","edema"],"test":[],"treatment":[],"problem_indices_start":[22,33,45],"problem_indices_end":[30,41,50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. aspirin 325 mg p.o. q.d.","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"neck : supple with full range of motion , no lymphadenopathy nor thyromegaly .","problem":["lymphadenopathy","thyromegaly"],"test":[],"treatment":[],"problem_indices_start":[45,65],"problem_indices_end":[60,76],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. lopressor 25 mg p.o. b.i.d.","problem":[],"test":[],"treatment":["lopressor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"pulses were 2+ bilaterally throughout .","problem":[],"test":["pulses"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. aspirin 325 mg p.o. q.d.","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"2. hemorrhoidectomy .","problem":[],"test":[],"treatment":["hemorrhoidectomy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[19]}
{"text":"1. lipitor 20 mg p.o. q.d.","problem":[],"test":[],"treatment":["lipitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"the patient was admitted to the hospital and on 2016-04-06 the patient underwent coronary artery bypass grafting x 4 with left internal mammary artery to the left anterior descending coronary artery , saphenous vein graft to the diagonal , saphenous vein graft to obtuse marginal , saphenous vein graft to right coronary artery , posterior descending coronary artery .","problem":[],"test":[],"treatment":["coronary artery bypass grafting","saphenous vein graft to obtuse marginal","saphenous vein graft to the diagonal","saphenous vein graft to right coronary artery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[81,201,240,282],"treatment_indices_end":[112,237,279,327]}
{"text":"he presented to an outside hospital with an acute inferior myocardial infarction and was treated with thrombolytic therapy .","problem":["an acute inferior myocardial infarction"],"test":[],"treatment":["thrombolytic therapy"],"problem_indices_start":[41],"problem_indices_end":[80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[102],"treatment_indices_end":[122]}
{"text":"he underwent catheterization on 2016-04-05 which revealed a left ventricular ejection fraction of 50% , no mitral regurgitation , insufficiency or hypokinesis .","problem":["mitral regurgitation","insufficiency","hypokinesis"],"test":["a left ventricular ejection fraction","catheterization"],"treatment":[],"problem_indices_start":[107,130,147],"problem_indices_end":[127,143,158],"test_indices_start":[13,58],"test_indices_end":[28,94],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiovascular : regular rate and rhythm , no murmurs .","problem":["murmurs"],"test":[],"treatment":[],"problem_indices_start":[46],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"lungs : clear to auscultation bilaterally .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17],"test_indices_end":[29],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was raking leaves on 04-02 and then developed episodes of mid chest pain and burning which radiated to the left arm .","problem":["mid chest pain","burning"],"test":[],"treatment":[],"problem_indices_start":[61,80],"problem_indices_end":[75,87],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"positive right carotid bruits .","problem":["right carotid bruits"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[29],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"that night he reportedly stopped breathing and was unresponsive .","problem":["unresponsive","breathing"],"test":[],"treatment":[],"problem_indices_start":[33,51],"problem_indices_end":[42,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient appeared to have tolerated the procedure and was transferred to the cardiac intensive care unit for postoperative management .","problem":[],"test":[],"treatment":["postoperative management","the procedure"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39,112],"treatment_indices_end":[52,136]}
{"text":"he was started on beta blockers .","problem":[],"test":[],"treatment":["beta blockers"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18],"treatment_indices_end":[31]}
{"text":"the patient had pacing wires and chest tubes in place , both of which over the course of his stay were removed successfully .","problem":[],"test":[],"treatment":["chest tubes","pacing wires"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16,33],"treatment_indices_end":[28,44]}
{"text":"cardiothoracic surgery","problem":[],"test":[],"treatment":["cardiothoracic surgery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[22]}
{"text":"lungs were clear to auscultation and equal .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[20],"test_indices_end":[32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hepatitis b surface antigen negative , rubella immune .","problem":[],"test":["hepatitis b surface antigen","rubella"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,39],"test_indices_end":[27,46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"medications are tri-vi-michael 1 cc by mouth each day .","problem":[],"test":[],"treatment":["tri-vi-michael","medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,16],"treatment_indices_end":[11,30]}
{"text":"a blood culture was obtained upon admission and ampicillin and gentamicin were given for 48 hours with blood cultures remaining sterile .","problem":[],"test":["blood cultures","a blood culture"],"treatment":["ampicillin","gentamicin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,103],"test_indices_end":[15,117],"treatment_indices_start":[48,63],"treatment_indices_end":[58,73]}
{"text":"he was fed with a bottle occasionally by his dad and had a vigorous suck and was noted to have some discoordination of his suck while breathing at the initial onset of feeding time .","problem":["some discoordination of his suck"],"test":[],"treatment":[],"problem_indices_start":[95],"problem_indices_end":[127],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this was minimized with limitation of volume at each feed with frequent feeding .","problem":[],"test":[],"treatment":["frequent feeding","limitation of volume at each feed"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[24,63],"treatment_indices_end":[57,79]}
{"text":"infant was circumcised in the newborn nursery which was healing well .","problem":[],"test":[],"treatment":["circumcised"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[11],"treatment_indices_end":[22]}
{"text":"rupture of membranes at time of delivery .","problem":["rupture of membranes"],"test":[],"treatment":["delivery"],"problem_indices_start":[0],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32],"treatment_indices_end":[40]}
{"text":"there were no blood products received during hospitalization .","problem":[],"test":[],"treatment":["blood products"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[28]}
{"text":"his neck was supple without masses or bruits .","problem":["masses","bruits"],"test":[],"treatment":[],"problem_indices_start":[28,38],"problem_indices_end":[34,44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"baby was noted to have frequent spitting episodes .","problem":["frequent spitting episodes"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"head circumference was 34.5 cm , 75th percentile , and length was 50.7 cm , also the 75th percentile .","problem":[],"test":["length","head circumference"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,55],"test_indices_end":[18,61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no electrographic evidence of seizure activity noted .","problem":["seizure activity"],"test":["electrographic evidence"],"treatment":[],"problem_indices_start":[40],"problem_indices_end":[56],"test_indices_start":[13],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"serologies include blood type o negative , antibody negative , rpr nonreactive .","problem":[],"test":["serologies","blood type","rpr","antibody"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,19,43,63],"test_indices_end":[10,29,51,66],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"regular rate and rhythm , no murmur .","problem":["murmur"],"test":[],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"mother 's blood type is o negative .","problem":[],"test":["mother 's blood type"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was noted to have an episode of desaturation related to feeding with desaturations in the 70 percent .","problem":["desaturation","desaturations"],"test":[],"treatment":[],"problem_indices_start":[35,72],"problem_indices_end":[47,85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no maternal fever .","problem":["maternal fever"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in addition a complete blood count was obtained on admission with a white count of 10.1 with 43 polys and 0 bands .","problem":[],"test":["a white count","polys","a complete blood count","bands ."],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12,66,96,108],"test_indices_end":[34,79,101,115],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the infant was placed on a cardiopulmonary monitor upon admission to the newborn intensive care unit with pulse oximetry .","problem":[],"test":["a cardiopulmonary monitor","pulse oximetry"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[25,106],"test_indices_end":[50,120],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the eeg showed transient sharp waves in the left front , left occipital and right parietal regions .","problem":["transient sharp waves in the left front"],"test":["the eeg"],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[54],"test_indices_start":[0],"test_indices_end":[7],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"an eeg was performed .","problem":[],"test":["an eeg"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"neurology was consulted due to the concern for seizures in the setting of dusky episodes .","problem":["dusky episodes","seizures"],"test":[],"treatment":[],"problem_indices_start":[47,74],"problem_indices_end":[55,88],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"full term male infant with cyanosis episodes .","problem":["cyanosis episodes"],"test":[],"treatment":[],"problem_indices_start":[27],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"birth weight was 3.29 kilograms in the 75th percentile .","problem":[],"test":["birth weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"full term well appearing infant with some facial jaundice , overall pink , warm and well perfused , alert and responsive .","problem":["some facial jaundice"],"test":[],"treatment":[],"problem_indices_start":[37],"problem_indices_end":[57],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"immunizations received are hepatitis b vaccine given on 09-26 .","problem":[],"test":[],"treatment":["immunizations","hepatitis b vaccine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,27],"treatment_indices_end":[13,46]}
{"text":"hematocrit was noted to 47.5 with platelets of 257,000 .","problem":[],"test":["platelets","hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,34],"test_indices_end":[10,43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a second episode occurred where the baby turned pale .","problem":["pale","a second episode"],"test":[],"treatment":[],"problem_indices_start":[0,48],"problem_indices_end":[16,52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"breast feeding was limited to four to five minutes on each side per recommendation of neurology after their evaluation to try and minimize incidence of gastroesophageal reflux .","problem":["gastroesophageal reflux"],"test":["their evaluation"],"treatment":[],"problem_indices_start":[152],"problem_indices_end":[175],"test_indices_start":[102],"test_indices_end":[118],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there were no sepsis risk factors .","problem":["sepsis risk factors"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"infant 's blood type was o positive and coombs was noted to be negative .","problem":[],"test":["coombs","infant 's blood type"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,40],"test_indices_end":[20,46],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pregnancy was also complicated by maternal history of depression for which mother received zoloft .","problem":["depression"],"test":[],"treatment":["zoloft"],"problem_indices_start":[54],"problem_indices_end":[64],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[91],"treatment_indices_end":[97]}
{"text":"ophthalmology was consulted due to the presence of a coloboma into the left cmed .","problem":["a coloboma"],"test":[],"treatment":[],"problem_indices_start":[51],"problem_indices_end":[61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ophthalmology noted that this left martha coloboma was likely an isolated anomaly in the absence of other pathology .","problem":["other pathology","an isolated anomaly","this left martha coloboma"],"test":[],"treatment":[],"problem_indices_start":[25,62,100],"problem_indices_end":[50,81,115],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"delivery was by repeat cesarean section and apgars of 8 and 9 were given at one and five minutes respectively .","problem":[],"test":["apgars"],"treatment":["delivery","repeat cesarean section"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[44],"test_indices_end":[50],"treatment_indices_start":[0,16],"treatment_indices_end":[8,39]}
{"text":"jule remained in room air without any evidence of respiratory distress and was without any further dusky spells or pale episodes in the 48 hours prior to discharge .","problem":["respiratory distress","any further dusky spells","pale episodes"],"test":[],"treatment":[],"problem_indices_start":[50,87,115],"problem_indices_end":[70,111,128],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"on the newborn nursery the mother called the nurse for concern of baby turning dusky while feeding .","problem":["dusky"],"test":[],"treatment":[],"problem_indices_start":[79],"problem_indices_end":[84],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"baby appeared well and went to the newborn nursery and was breast feeding and undergoing routine newborn care .","problem":[],"test":[],"treatment":["routine newborn care"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[89],"treatment_indices_end":[109]}
{"text":"red reflexes noted bilaterally .","problem":[],"test":["red reflexes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[12],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the baby demonstrated mild physiologic jaundice with a serum bilirubin obtained on day of life three which was 6.7 with a direct of 0.2 .","problem":["mild physiologic jaundice"],"test":["a serum bilirubin"],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[47],"test_indices_start":[53],"test_indices_end":[70],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hearing screening was performed with automated auditory brain stem responses .","problem":[],"test":["hearing screening"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had a left pupil that was in unequal in size with a keyhole appearance consistent with a coloboma .","problem":["a keyhole appearance","a coloboma","unequal in size"],"test":[],"treatment":[],"problem_indices_start":[32,53,90],"problem_indices_end":[47,73,100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this episode was also accompanied by gagging motions noted of the infant .","problem":["this episode","gagging motions"],"test":[],"treatment":[],"problem_indices_start":[0,37],"problem_indices_end":[12,52],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"newborn state screen was sent on day of life three .","problem":[],"test":["newborn state screen"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gbs negative .","problem":[],"test":["gbs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pregnancy was uncomplicated until an occurrence of hsv outbreak occurred on 2017-09-13 approximately one week prior to delivery .","problem":["hsv outbreak","uncomplicated"],"test":[],"treatment":["delivery"],"problem_indices_start":[14,51],"problem_indices_end":[27,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[119],"treatment_indices_end":[127]}
{"text":"on day of delivery mother presented in spontaneous labor .","problem":["spontaneous labor"],"test":[],"treatment":["delivery"],"problem_indices_start":[39],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10],"treatment_indices_end":[18]}
{"text":"peggy hammock is a full term baby boy born at 38 1\/7 weeks by repeat cesarean section to a 34 year old gravida iii , now para ii mother .","problem":[],"test":[],"treatment":["repeat cesarean section"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[62],"treatment_indices_end":[85]}
{"text":"rule out sepsis .","problem":["sepsis"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"group b strep screening was negative .","problem":[],"test":["group b strep screening"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2 plus femoral pulses were noted .","problem":[],"test":["femoral pulses"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[7],"test_indices_end":[21],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"weight at time of discharge is 3.13 kilograms .","problem":[],"test":["weight"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[6],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood pressure 84\/43 with a mean of 59 .","problem":[],"test":["blood pressure","a mean"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,26],"test_indices_end":[14,32],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"antibiotics were discontinued on day of life three and infant has remained clinically well off antibiotics .","problem":[],"test":[],"treatment":["antibiotics","antibiotics"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,95],"treatment_indices_end":[11,106]}
{"text":"the neonatal intensive care unit was notified and the baby was transferred to the newborn intensive care unit for further evaluation .","problem":[],"test":["further evaluation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[114],"test_indices_end":[132],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the baby did not turn blue at that time .","problem":["blue"],"test":[],"treatment":[],"problem_indices_start":[22],"problem_indices_end":[26],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"left coloboma .","problem":["left coloboma"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[13],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"renee remained cardiovascularly stable with ap s noted to be 120 to 130 s.","problem":[],"test":["ap s"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[44],"test_indices_end":[48],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"tone was appropriate for gestational age with equal strength , symmetric reflexes .","problem":[],"test":["tone","reflexes","strength"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,52,73],"test_indices_end":[4,60,81],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rule out seizures .","problem":["seizures"],"test":[],"treatment":[],"problem_indices_start":[9],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he received a normal saline bolus of 2 liters of good blood pressure response .","problem":[],"test":[],"treatment":["a normal saline bolus"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[33]}
{"text":"liver function tests : alt 38 , ast 34 , alk phos is 107 , albumin is 3.2 , peak bili is 0.3 , amylase 31 , and lipase is 32 .","problem":[],"test":["liver function tests","ast","alk phos is","peak bili is","albumin","amylase","alt","lipase"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,23,32,41,59,76,95,112],"test_indices_end":[20,26,35,52,66,88,102,118],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"positive bowel sounds , nontender and nondistended .","problem":["nontender","nondistended"],"test":[],"treatment":[],"problem_indices_start":[24,38],"problem_indices_end":[33,50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"serum osmolality was 38397 , calculated osmolality gap was 21 .","problem":[],"test":["serum osmolality","calculated osmolality gap"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,29],"test_indices_end":[16,54],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient denies any chest pain , shortness of breath , dysuria , diarrhea , bright red blood per rectum .","problem":["dysuria","diarrhea","shortness of breath","bright red blood per rectum","any chest pain"],"test":[],"treatment":[],"problem_indices_start":[19,36,58,68,79],"problem_indices_end":[33,55,65,76,106],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in the past , he has been very depressed and has seen a counselor at greenfield community college community health .","problem":["very depressed"],"test":[],"treatment":["a counselor"],"problem_indices_start":[26],"problem_indices_end":[40],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[54],"treatment_indices_end":[65]}
{"text":"mr. pohl is a 53 - year-old male with history of alcohol use and hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[65],"problem_indices_end":[77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chem-7 : sodium 145 , potassium 3.4 , chloride 116 , bicarb 21 , bun 12 , creatinine 0.6 , glucose 96 , calcium 7.2 , phos 3.6 , magnesium 1.7 .","problem":[],"test":["chloride","bun","calcium","phos","chem-7","creatinine","sodium","magnesium","potassium","bicarb","glucose"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,9,22,38,53,65,74,91,104,118,129],"test_indices_end":[6,15,31,46,59,68,84,98,111,122,138],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"we decided to discontinue telemetry and held all hypertension medications including lisinopril , mavik , hydrochlorothiazide .","problem":[],"test":["telemetry"],"treatment":["hydrochlorothiazide","all hypertension medications","mavik","lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[26],"test_indices_end":[35],"treatment_indices_start":[45,84,97,105],"treatment_indices_end":[73,94,102,124]}
{"text":"mr. pohl is a 53 - year-old male with a history of etoh , hypertension who presented int he emergency room with increased agitation , like secondary to etoh intoxication and developed subsequent hypotension , systolic blood pressures in the 80 's, status post ativan and haldol , but was responsive","problem":["hypertension","subsequent hypotension","etoh intoxication","increased agitation"],"test":["systolic blood pressures"],"treatment":["ativan","haldol"],"problem_indices_start":[58,112,152,184],"problem_indices_end":[70,131,169,206],"test_indices_start":[209],"test_indices_end":[233],"treatment_indices_start":[260,271],"treatment_indices_end":[266,277]}
{"text":"cbc : white blood cell count is 8.8 , hematocrit 35.5 platelets 266 , pt 13 , pt-t 23.3 , inr was 1.1 .","problem":[],"test":["inr","pt-t","hematocrit","cbc","platelets","pt","white blood cell count"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,6,38,54,70,78,90],"test_indices_end":[3,28,48,63,72,82,93],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"systolic blood pressure in the 120 's to 130 's.","problem":[],"test":["systolic blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. history of colonic polyps times 3 , benign in 2007 , repeat colonoscopy due to in 2010 .","problem":["colonic polyps"],"test":["repeat colonoscopy"],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[28],"test_indices_start":[56],"test_indices_end":[74],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no murmurs , rubs or gallops .","problem":["gallops","murmurs","rubs"],"test":[],"treatment":[],"problem_indices_start":[3,13,21],"problem_indices_end":[10,17,28],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ciwa scale over night was 1 for tremor and the patient did not require any valium for alcohol withdrawal .","problem":["tremor","alcohol withdrawal"],"test":["ciwa scale"],"treatment":["valium"],"problem_indices_start":[32,86],"problem_indices_end":[38,104],"test_indices_start":[0],"test_indices_end":[10],"treatment_indices_start":[75],"treatment_indices_end":[81]}
{"text":"there was bran atrophy and right temporal encephalomalacia .","problem":["bran atrophy","right temporal encephalomalacia"],"test":[],"treatment":[],"problem_indices_start":[10,27],"problem_indices_end":[22,58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was asymptomatic without chest pain , shortness of breath and no mental status changes .","problem":["asymptomatic","chest pain","mental status changes","shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[16,37,50,77],"problem_indices_end":[28,47,69,98],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rare crackles on the right base , otherwise clear to auscultation bilaterally .","problem":["rare crackles on the right base"],"test":["auscultation bilaterally"],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[31],"test_indices_start":[53],"test_indices_end":[77],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he by emergency room report , was found in his apartment lobby agitated .","problem":["agitated"],"test":[],"treatment":[],"problem_indices_start":[63],"problem_indices_end":[71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"pulse in the 60 's to 70 's.","problem":[],"test":["pulse"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[5],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was a thin well-appearing man who was visibly restless in bed .","problem":["visibly restless"],"test":[],"treatment":[],"problem_indices_start":[50],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"agitated in emergency room requiring 4 leather restraints , received 5 mg of haldol , 2 mg of ativan .","problem":["agitated"],"test":[],"treatment":["4 leather restraints","ativan","haldol"],"problem_indices_start":[0],"problem_indices_end":[8],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[37,77,94],"treatment_indices_end":[57,83,100]}
{"text":"3. history of colonic polyp times 3 , benign in 2007 , repeat colonoscopy due in 2010 .","problem":["colonic polyp"],"test":["repeat colonoscopy"],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[27],"test_indices_start":[55],"test_indices_end":[73],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"calcium carbonate 500 mg p.o. t.i.d. , mag oxide 400 mg p.o. times one dose , potassium chloride repleted 40 meq times one dose .","problem":[],"test":[],"treatment":["potassium chloride","mag oxide","calcium carbonate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,39,78],"treatment_indices_end":[17,48,96]}
{"text":"1. etoh intoxication .","problem":["etoh intoxication"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient responded well to fluid resuscitation .","problem":[],"test":[],"treatment":["fluid resuscitation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30],"treatment_indices_end":[49]}
{"text":"1. blood pressure :","problem":[],"test":["blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[3],"test_indices_end":[17],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient became notably less anxious throughout hospital stay .","problem":["notably less anxious"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"serum tox was positive for etoh at 383 , otherwise negative .","problem":[],"test":["etoh","serum tox"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,27],"test_indices_end":[9,31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient on ranitidine 150 mg p.o. b.i.d. for gastrointestinal prophylaxis .","problem":[],"test":[],"treatment":["ranitidine","gastrointestinal prophylaxis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[15,49],"treatment_indices_end":[25,77]}
{"text":"head , ears , eyes , nose and throat : atraumatic and normocephalic .","problem":["atraumatic"],"test":["head , ears , eyes , nose and throat"],"treatment":[],"problem_indices_start":[39],"problem_indices_end":[49],"test_indices_start":[0],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"we will given valium 5 mg p.o. q. 3 hours for withdrawal .","problem":["withdrawal"],"test":[],"treatment":["valium"],"problem_indices_start":[46],"problem_indices_end":[56],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[20]}
{"text":"we will consider psychiatry consult in the future to assess for underlying anxiety disorder or depression .","problem":["depression","underlying anxiety disorder"],"test":[],"treatment":[],"problem_indices_start":[64,95],"problem_indices_end":[91,105],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient 's blood pressure remained stable on hospital day #2 through hospital day #3 status post iv hydration with systolic blood pressures in the 120 's to 130 's.","problem":[],"test":["the patient 's blood pressure","systolic blood pressures"],"treatment":["iv hydration"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,119],"test_indices_end":[29,143],"treatment_indices_start":[101],"treatment_indices_end":[113]}
{"text":"2. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"return to home medications :","problem":[],"test":[],"treatment":["home medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10],"treatment_indices_end":[26]}
{"text":"mag was 1.7 , repleted with magnesium oxide with 400 mg p.o. times one dose .","problem":[],"test":["mag"],"treatment":["magnesium oxide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[3],"treatment_indices_start":[28],"treatment_indices_end":[43]}
{"text":"2. thiamine 100 mg q.d.","problem":[],"test":[],"treatment":["thiamine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[11]}
{"text":"plan for patient regarding cardiac , unlike hypotension of cardiac origin .","problem":["hypotension of cardiac origin"],"test":[],"treatment":[],"problem_indices_start":[44],"problem_indices_end":[73],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chest x-ray from 02-07 had linear atelectasis in right lower lobe with no evidence of a band-like opacity in the left lower lobe which was evident on the chest x-ray on 02-06 .","problem":["a band-like opacity in the left lower lobe","linear atelectasis in right lower lobe"],"test":["the chest x-ray","chest x-ray"],"treatment":[],"problem_indices_start":[27,86],"problem_indices_end":[65,128],"test_indices_start":[0,150],"test_indices_end":[11,165],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. mavik question of dosage .","problem":[],"test":[],"treatment":["mavik"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"vital signs were stable .","problem":[],"test":["vital signs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no hepatosplenomegaly .","problem":["hepatosplenomegaly"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[21],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his brother is mentally handicapped and might be sent away from his instate institution .","problem":["mentally handicapped"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had atelectasis in the right lower lobe by chest x-ray .","problem":["atelectasis in the right lower lobe"],"test":["chest x-ray"],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[42],"test_indices_start":[46],"test_indices_end":[57],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no stigmata of iv drug use .","problem":["stigmata"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[11],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"to fluid resuscitation at 4 liters and was admitted to the cmed ccu for hemodynamic monitoring .","problem":[],"test":["hemodynamic monitoring"],"treatment":["fluid resuscitation"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[72],"test_indices_end":[94],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"3. history of right inguinal hernia in 2002 .","problem":["right inguinal hernia"],"test":[],"treatment":[],"problem_indices_start":[14],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had dorsalis pedis in radial pulses , hands and feet notably tremulous without asterixis .","problem":["asterixis","hands and feet notably tremulous"],"test":["dorsalis pedis","radial pulses"],"treatment":[],"problem_indices_start":[41,82],"problem_indices_end":[73,91],"test_indices_start":[7,25],"test_indices_end":[21,38],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was alert and oriented times 3 and with slightly pressured speech .","problem":["slightly pressured speech"],"test":[],"treatment":[],"problem_indices_start":[43],"problem_indices_end":[68],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"k was 3.4 , repleted , potassium chloride 40 meq times 1 dose p.o.","problem":[],"test":["k"],"treatment":["potassium chloride"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[1],"treatment_indices_start":[23],"treatment_indices_end":[41]}
{"text":"he does complain of cold symptoms times one week .","problem":["cold symptoms"],"test":[],"treatment":[],"problem_indices_start":[20],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"calcium with 7.2 corrected to less than 8.0, completed calcium carbonate at 500 mg blood pressure.o. t.i.d. while in the hospital .","problem":[],"test":["calcium","blood pressure.o."],"treatment":["calcium carbonate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,83],"test_indices_end":[7,100],"treatment_indices_start":[55],"treatment_indices_end":[72]}
{"text":"we will monitor for signs of alcohol withdrawal according to the ciwa scale .","problem":["alcohol withdrawal"],"test":["the ciwa scale","monitor"],"treatment":[],"problem_indices_start":[29],"problem_indices_end":[47],"test_indices_start":[8,61],"test_indices_end":[15,75],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient may be discharge harry 02-08 pending observations for delirium tremens after discussion with primary care physician , dr. blue who knows the patient well .","problem":["delirium tremens"],"test":["observations"],"treatment":[],"problem_indices_start":[66],"problem_indices_end":[82],"test_indices_start":[49],"test_indices_end":[61],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he uses condoms consistently .","problem":[],"test":[],"treatment":["condoms"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[8],"treatment_indices_end":[15]}
{"text":"the patient seemed notably anxious and depressed .","problem":["notably anxious","depressed"],"test":[],"treatment":[],"problem_indices_start":[19,39],"problem_indices_end":[34,48],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he became hypotensive in the emergency room with a systolic blood pressure in the 80 's and had decreased respiratory rate .","problem":["hypotensive","decreased respiratory rate"],"test":["a systolic blood pressure"],"treatment":[],"problem_indices_start":[10,96],"problem_indices_end":[21,122],"test_indices_start":[49],"test_indices_end":[74],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"elevated ck on 02-07 is likely secondary to mild rhabdomyolysis .","problem":["elevated ck","mild rhabdomyolysis"],"test":[],"treatment":[],"problem_indices_start":[0,44],"problem_indices_end":[11,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ct of the head on 02-06 was negative for hemorrhage .","problem":["hemorrhage"],"test":["ct of the head"],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[51],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. lisinopril 5 mg p.o.q.d.","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"sclerae were anicteric .","problem":["anicteric"],"test":[],"treatment":[],"problem_indices_start":[13],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. lisinopril 5 mg p.o. q.d.","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"major stressors in his life include unstable job , brother is mentally handicapped , war .","problem":["mentally handicapped"],"test":[],"treatment":[],"problem_indices_start":[62],"problem_indices_end":[82],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. mavik unknown dosage .","problem":[],"test":[],"treatment":["mavik"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[8]}
{"text":"it is possible that the patient is self medicating for underlying psychiatric disorder .","problem":["underlying psychiatric disorder"],"test":[],"treatment":[],"problem_indices_start":[55],"problem_indices_end":[86],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient states in the past that he has participated in several alcohol treatment programs , most recently star which is similar alcoholics anonymous .","problem":[],"test":[],"treatment":["alcohol treatment programs"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[67],"treatment_indices_end":[93]}
{"text":"cranial nerves ii-xii are grossly intact , 5\/5 strength in all extremities , sensation is intact in all extremities .","problem":[],"test":["strength in all extremities","sensation","cranial nerves ii-xii"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,47,77],"test_indices_end":[21,74,86],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was urinating without difficulty .","problem":["difficulty"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"positive tobacco , 10 pack year history , quit for 8 years in his 40 's and now no cigarettes for one week using no pharmacal therapy .","problem":[],"test":[],"treatment":["pharmacal therapy"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[116],"treatment_indices_end":[133]}
{"text":"ua was negative .","problem":[],"test":["ua"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[2],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient has only male sexual partners and in the last six months has two regular partners who reportedly are human immunodeficiency virus negative and no iv drug use .","problem":["human immunodeficiency virus"],"test":[],"treatment":[],"problem_indices_start":[113],"problem_indices_end":[141],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. for pulmonary , the patient had a good o2 saturations on room air .","problem":[],"test":["o2 saturations"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[42],"test_indices_end":[56],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"we continued iv fluids at 100 cc per hour for one liter secondary to a concern for rhabdomyolysis plus kidney protective effects .","problem":["rhabdomyolysis"],"test":[],"treatment":["kidney protective effects","iv fluids"],"problem_indices_start":[83],"problem_indices_end":[97],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13,103],"treatment_indices_end":[22,128]}
{"text":"vitals on admission : please refer to addendum .","problem":[],"test":["vitals on admission"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood alcohol level was 383 .","problem":[],"test":["blood alcohol level"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[19],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was found in his apartment lobby \" shouting \" and very agitated .","problem":["very agitated"],"test":[],"treatment":[],"problem_indices_start":[53],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"urine tox was negative .","problem":[],"test":["urine tox"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[9],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"we continued to hold the patient 's home blood pressure medications .","problem":[],"test":[],"treatment":["home blood pressure medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[36],"treatment_indices_end":[67]}
{"text":"4. multivitamin","problem":[],"test":[],"treatment":["multivitamin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"the patient was then admitted to the medical intensive care unit for observation of his blood pressure and then transferred to our service on medicine when the blood pressures remained stable overnight .","problem":[],"test":["the blood pressures","his blood pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[84,156],"test_indices_end":[102,175],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. folic acid 1 mg q. d.","problem":[],"test":[],"treatment":["folic acid"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"he denies auditory , visual or tactile hallucinations .","problem":["auditory , visual or tactile hallucinations"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"oropharynx was benign without exudate .","problem":["exudate"],"test":[],"treatment":[],"problem_indices_start":[30],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. hydrochlorothiazide question of dosage .","problem":[],"test":[],"treatment":["hydrochlorothiazide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"1. ranitidine 150 mg b.i.d.","problem":[],"test":[],"treatment":["ranitidine"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"4. history of right inguinal hernia in 2002 .","problem":["history of right inguinal hernia"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he states that mood is depressed .","problem":["depressed"],"test":[],"treatment":[],"problem_indices_start":[23],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. urology : foley was discontinued in the cmed ccu at 12 p.m.","problem":[],"test":[],"treatment":["foley"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[13],"treatment_indices_end":[18]}
{"text":"3. hydrochlorothiazide unknown dosage .","problem":[],"test":[],"treatment":["hydrochlorothiazide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[22]}
{"text":"on hospital day #2 through hospital day #3 , the patient had mild tremor on hands , but improved over hospital course .","problem":["mild tremor on hands"],"test":[],"treatment":[],"problem_indices_start":[61],"problem_indices_end":[81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"allergies : no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[15],"problem_indices_end":[35],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is an 82 - year-old male with a history of prior tobacco use , hypertension , chronic renal insufficiency , copd , gastritis , and tia who initially presented to braintree with a non-st elevation mi and guaiac positive stools , transferred to st. margaret's center for women & infants for cardiac catheterization with ptca to mid lad lesion complicated by hypotension and bradycardia requiring atropine , iv fluids and transient dopamine possibly secondary to vagal reaction , subsequently transferred to ccu for close monitoring , hemodynamically stable at the time of admission to the ccu .","problem":["a non-st elevation mi","gastritis","vagal reaction","hypotension","bradycardia","tia","guaiac positive stools","mid lad lesion","copd","chronic renal insufficiency","hypertension"],"test":["close monitoring","cardiac catheterization"],"treatment":["transient dopamine","iv fluids","atropine","ptca"],"problem_indices_start":[68,83,113,120,136,182,208,331,361,377,465],"problem_indices_end":[80,110,117,129,139,203,230,345,372,388,479],"test_indices_start":[294,518],"test_indices_end":[317,534],"treatment_indices_start":[323,399,410,424],"treatment_indices_end":[327,407,419,442]}
{"text":"he had 2+ dorsalis pedis and posterior tibial pulses bilaterally .","problem":[],"test":["posterior tibial pulses","dorsalis pedis"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[10,29],"test_indices_end":[24,52],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the symptoms were associated with diaphoresis and shortness of breath but no nausea or vomiting .","problem":["diaphoresis","nausea","shortness of breath","the symptoms","vomiting"],"test":[],"treatment":[],"problem_indices_start":[0,34,50,77,87],"problem_indices_end":[12,45,69,83,95],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"heart rate 91 , regular , blood pressure 169\/81 from a right groin a line , respirations 12 , oxygen saturation of 97 percent on 2 liters nasal cannula .","problem":[],"test":["heart rate","blood pressure","respirations","oxygen saturation"],"treatment":["a right groin a line","2 liters nasal cannula"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,26,76,94],"test_indices_end":[10,40,88,111],"treatment_indices_start":[53,129],"treatment_indices_end":[73,151]}
{"text":"he had no evident edema .","problem":["evident edema"],"test":[],"treatment":[],"problem_indices_start":[10],"problem_indices_end":[23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his ace inhibitor post mi was initially held due to his creatinine .","problem":["mi"],"test":["his creatinine"],"treatment":["his ace inhibitor"],"problem_indices_start":[23],"problem_indices_end":[25],"test_indices_start":[52],"test_indices_end":[66],"treatment_indices_start":[0],"treatment_indices_end":[17]}
{"text":"he was initially continued on aspirin , plavix , beta blocker , statin , and ace inhibitor .","problem":[],"test":[],"treatment":["statin","aspirin","ace inhibitor","beta blocker","plavix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30,40,49,64,77],"treatment_indices_end":[37,46,61,70,90]}
{"text":"he was continued on his mdi and was at his baseline 02 requirement throughout admission .","problem":["his baseline 02 requirement"],"test":[],"treatment":["his mdi"],"problem_indices_start":[39],"problem_indices_end":[66],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[27]}
{"text":"at the time of transfer , he was initially admitted to the cmi service after undergoing cardiac catheterization which revealed a long lad lesion that was angioplastied without stent placement , and a total occlusion of the rca with collaterals .","problem":["a long lad lesion","a total occlusion of the rca"],"test":["cardiac catheterization"],"treatment":["stent placement"],"problem_indices_start":[127,198],"problem_indices_end":[144,226],"test_indices_start":[88],"test_indices_end":[111],"treatment_indices_start":[176],"treatment_indices_end":[191]}
{"text":"he had a history of copd for which he is on baseline 2 liters of 02 by nasal cannula at home and albuterol and atrovent mdi s p.r.n. at home .","problem":["copd"],"test":[],"treatment":["nasal cannula","02","atrovent mdi","albuterol"],"problem_indices_start":[20],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[65,71,97,111],"treatment_indices_end":[67,84,106,123]}
{"text":"there was a right groin a line and a left groin venous sheath with a swan .","problem":[],"test":[],"treatment":["a right groin a line","a swan","a left groin venous sheath"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[10,35,67],"treatment_indices_end":[30,61,73]}
{"text":"he had a transthoracic echocardiogram the day after admission showing an ejection fraction of greater than 60 percent .","problem":[],"test":["an ejection fraction","a transthoracic echocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[7,70],"test_indices_end":[37,90],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was felt most appropriate for him to have an outpatient gi workup , and his pcp was contacted and will arrange for outpatient colonoscopy .","problem":[],"test":["outpatient colonoscopy","an outpatient gi workup"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[45,118],"test_indices_end":[68,140],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had a bedside transthoracic echocardiogram done in the cardiac catheterization laboratory without evidence of an effusion .","problem":["an effusion"],"test":["a bedside transthoracic echocardiogram"],"treatment":[],"problem_indices_start":[113],"problem_indices_end":[124],"test_indices_start":[7],"test_indices_end":[45],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"gastritis .","problem":["gastritis"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[9],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. aspirin 325 mg q.d.","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"serum chemistries revealed a sodium of 135, potassium 4.0 , chloride 102 , bicarbonate 26 , bun 29 , creatinine 1.6 , and glucose of 111 .","problem":[],"test":["bun","a sodium","creatinine","bicarbonate","glucose","serum chemistries","potassium","chloride"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,27,44,60,75,92,101,122],"test_indices_end":[17,35,53,68,86,95,111,129],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"vital signs :","problem":[],"test":["vital signs"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he subsequently became hypotensive and bradycardiac in the catheterization laboratory which responded to iv fluids , dopamine , atropine , and he was then transferred to the ccu for further monitoring .","problem":["hypotensive","bradycardiac"],"test":["further monitoring"],"treatment":["atropine","dopamine","iv fluids"],"problem_indices_start":[23,39],"problem_indices_end":[34,51],"test_indices_start":[182],"test_indices_end":[200],"treatment_indices_start":[105,117,128],"treatment_indices_end":[114,125,136]}
{"text":"by the time he was admitted , he was off pressors and hemodynamically stable and pain-free .","problem":["pain-free"],"test":[],"treatment":["pressors"],"problem_indices_start":[81],"problem_indices_end":[90],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[41],"treatment_indices_end":[49]}
{"text":"at the time of discharge , the patient 's vital signs were stable and he was without complaints .","problem":["complaints"],"test":["the patient 's vital signs"],"treatment":[],"problem_indices_start":[85],"problem_indices_end":[95],"test_indices_start":[27],"test_indices_end":[53],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"as summarized above , the patient had a non-st elevation mi with evidence of an 80 percent mid lad lesion for which he underwent angioplasty without stent placement .","problem":["an 80 percent mid lad lesion","a non-st elevation mi"],"test":[],"treatment":["angioplasty","stent placement"],"problem_indices_start":[38,77],"problem_indices_end":[59,105],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[129,149],"treatment_indices_end":[140,164]}
{"text":"no focal wall motion abnormalities .","problem":["focal wall motion abnormalities"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the ekg was prior to catheterization and the one post ptca was no different .","problem":[],"test":["catheterization","the ekg"],"treatment":["ptca"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,21],"test_indices_end":[7,36],"treatment_indices_start":[54],"treatment_indices_end":[58]}
{"text":"however , this responded to iv fluids and his ace inhibitor was restarted at the time of discharge .","problem":[],"test":[],"treatment":["iv fluids","his ace inhibitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[28,42],"treatment_indices_end":[37,59]}
{"text":"his stools were noted to be guaiac positive at the outside hospital and there was still concern for possible gi bleed given continued guaiac positive stools during this admission and a slight drop in his hematocrit from 39 to 33 .","problem":["gi bleed","guaiac positive stools","a slight drop in his hematocrit","guaiac positive"],"test":[],"treatment":[],"problem_indices_start":[28,109,134,183],"problem_indices_end":[43,117,156,214],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he also had a widened qrs of 153 milliseconds , an old right bundle branch block , and no acute st or t wave changes .","problem":["an old right bundle branch block","acute st or t wave changes","a widened qrs"],"test":[],"treatment":[],"problem_indices_start":[12,48,90],"problem_indices_end":[25,80,116],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the right heart catheterization revealed pulmonary capillary wedge pressure of 4 , cardiac output of 8 , and cardiac index of 3.8 , he had an ra pressure of 10 , rv pressure of 43\/4 , pa pressure of 37\/10 .","problem":[],"test":["cardiac index","the right heart catheterization","an ra pressure","cardiac output","rv pressure","pa pressure","pulmonary capillary wedge pressure"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,41,83,109,139,162,184],"test_indices_end":[31,75,97,122,153,173,195],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there were no stents deployed at all throughout the catheterization .","problem":[],"test":["the catheterization"],"treatment":["stents"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[48],"test_indices_end":[67],"treatment_indices_start":[14],"treatment_indices_end":[20]}
{"text":"his plavix was held at the time of discharge due to a question of gi bleed and in the setting of not having a stent placed at the time of catheterization .","problem":["gi bleed"],"test":["catheterization"],"treatment":["a stent","his plavix"],"problem_indices_start":[66],"problem_indices_end":[74],"test_indices_start":[138],"test_indices_end":[153],"treatment_indices_start":[0,108],"treatment_indices_end":[10,115]}
{"text":"5. heparin drip on transfer .","problem":[],"test":[],"treatment":["heparin drip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"1. lipitor 10 mg q.d.","problem":[],"test":[],"treatment":["lipitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"the patient was subsequently transferred to youville hospital for cardiac catheterization .","problem":[],"test":["cardiac catheterization"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[66],"test_indices_end":[89],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"4. mdi p.r.n.","problem":[],"test":[],"treatment":["mdi"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[6]}
{"text":"at the time of discharge , his plavix was held due to guaiac positive stools and hematocrit drop throughout admission .","problem":["guaiac positive stools","hematocrit drop"],"test":[],"treatment":["his plavix"],"problem_indices_start":[54,81],"problem_indices_end":[76,96],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[27],"treatment_indices_end":[37]}
{"text":"the patient has no known drug allergies .","problem":["known drug allergies"],"test":[],"treatment":[],"problem_indices_start":[19],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was started on nitrates there as well as heparin and integrelin and remained pain-free .","problem":["pain-free"],"test":[],"treatment":["heparin","nitrates","integrelin"],"problem_indices_start":[80],"problem_indices_end":[89],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[18,44,56],"treatment_indices_end":[26,51,66]}
{"text":"the initial ekg showed normal sinus rhythm at a rate of 71 with a normal axis and evidence of first-degree av block with prolonged pr interval of 238 milliseconds .","problem":["prolonged pr interval","first-degree av block"],"test":["sinus rhythm","a rate","axis","the initial ekg"],"treatment":[],"problem_indices_start":[94,121],"problem_indices_end":[115,142],"test_indices_start":[0,30,46,73],"test_indices_end":[15,42,52,77],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chronic renal insufficiency .","problem":["chronic renal insufficiency"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a swan was also placed .","problem":[],"test":[],"treatment":["a swan"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[6]}
{"text":"he had normoactive bowel sounds .","problem":[],"test":["bowel sounds"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[19],"test_indices_end":[31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. flovent 110 micrograms aerosol two puffs b.i.d.","problem":[],"test":[],"treatment":["flovent"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"after approximately one hour , he presented to the bristol county tuberculosis hospital dana-farber cancer institute campus where he ruled in for a non-st elevation mi with a ck of 438 with a peak ck mb of 19.8 and troponin that peaked at 10.2 .","problem":["a non-st elevation mi"],"test":["a ck","troponin","a peak ck mb"],"treatment":[],"problem_indices_start":[146],"problem_indices_end":[167],"test_indices_start":[173,190,215],"test_indices_end":[177,202,223],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had no recurrent chest pain or shortness of breath throughout admission .","problem":["shortness of breath","recurrent chest pain"],"test":[],"treatment":[],"problem_indices_start":[10,34],"problem_indices_end":[30,53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"cardiac catheterization revealed a totally occluded rca with collaterals , an 80 percent lad lesion extending distally which was angioplastied but no stent was placed .","problem":["an 80 percent lad lesion","a totally occluded rca"],"test":["cardiac catheterization"],"treatment":["stent"],"problem_indices_start":[33,75],"problem_indices_end":[55,99],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[150],"treatment_indices_end":[155]}
{"text":"tia in 1998 .","problem":["tia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he also had bilateral arm numbness .","problem":["bilateral arm numbness"],"test":[],"treatment":[],"problem_indices_start":[12],"problem_indices_end":[34],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient is an 82 - year-old male with a history of hypertension , remote tobacco abuse , chronic renal insufficiency , and a history of a tia who was in his usual state of health until five nights prior to admission when he awoke at midnight with severe epigastric pain radiating to both arms .","problem":["severe epigastric pain","chronic renal insufficiency","a tia","hypertension"],"test":[],"treatment":[],"problem_indices_start":[55,93,140,251],"problem_indices_end":[67,120,145,273],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his lungs were clear to auscultation bilaterally anteriorly and laterally .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"coronary artery disease , status post non-st elevation myocardial infarction with 80 percent mid lad lesion , now status post angioplasty .","problem":["80 percent mid lad lesion","non-st elevation myocardial infarction","coronary artery disease"],"test":[],"treatment":["angioplasty"],"problem_indices_start":[0,38,82],"problem_indices_end":[23,76,107],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[126],"treatment_indices_end":[137]}
{"text":"he had a bedside echocardiogram done in the catheterization laboratory which showed normal lv wall thickness and normal lv cavity size .","problem":[],"test":["a bedside echocardiogram"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[7],"test_indices_end":[31],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"5. combivent mdi p.r.n.","problem":[],"test":[],"treatment":["combivent"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"on admission , the cbc revealed a white count of 7.4 , hematocrit 39.7 , and platelets of 217,000 .","problem":[],"test":["hematocrit","the cbc","a white count","platelets"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[15,32,55,77],"test_indices_end":[22,45,65,86],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"in regards to his rhythm , he has an underlying right bundle branch block and first-degree av block which were stable throughout this admission .","problem":["first-degree av block","an underlying right bundle branch block"],"test":[],"treatment":[],"problem_indices_start":[34,78],"problem_indices_end":[73,99],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he denied any history of similar symptoms in the past and has had no prior history of angina or myocardial infarction .","problem":["myocardial infarction","similar symptoms","angina"],"test":[],"treatment":[],"problem_indices_start":[25,86,96],"problem_indices_end":[41,92,117],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2. metoprolol 50 mg b.i.d.","problem":[],"test":[],"treatment":["metoprolol"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"he was continued on his aspirin , however .","problem":[],"test":[],"treatment":["his aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[31]}
{"text":"he will need close monitoring of his creatinine post discharge in the setting of reinstitution of his ace inhibitor .","problem":[],"test":["close monitoring","his creatinine"],"treatment":["his ace inhibitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[13,33],"test_indices_end":[29,47],"treatment_indices_start":[98],"treatment_indices_end":[115]}
{"text":"crusting around the right eyelid but the pupils were equal , round , and reactive to light .","problem":["crusting around the right eyelid"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[32],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had no murmurs , rubs , or gallops .","problem":["murmurs","gallops","rubs"],"test":[],"treatment":[],"problem_indices_start":[10,20,30],"problem_indices_end":[17,24,37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he uses a cane p.r.n. for walking .","problem":[],"test":[],"treatment":["a cane"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[8],"treatment_indices_end":[14]}
{"text":"4. aspirin 325 mg q.d.","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"he was edentulous .","problem":["edentulous"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he has a history of chronic renal insufficiency likely secondary to hypertension and was admitted with a creatinine of 1.6 .","problem":["hypertension","chronic renal insufficiency"],"test":["a creatinine"],"treatment":[],"problem_indices_start":[20,68],"problem_indices_end":[47,80],"test_indices_start":[103],"test_indices_end":[115],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"asthma .","problem":["asthma"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"there was no evidence of effusion .","problem":["effusion"],"test":[],"treatment":[],"problem_indices_start":[25],"problem_indices_end":[33],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"it was discussed with him the need to schedule follow-up for colonoscopy with his pcp as well .","problem":[],"test":["colonoscopy"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[61],"test_indices_end":[72],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"3. lipitor 10 mg q.d.","problem":[],"test":[],"treatment":["lipitor"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[10]}
{"text":"bph .","problem":["bph"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[3],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he is also on flovent mdi at home as well .","problem":[],"test":[],"treatment":["flovent mdi"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14],"treatment_indices_end":[25]}
{"text":"2. lisinopril 2.5 mg q.d.","problem":[],"test":[],"treatment":["lisinopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[13]}
{"text":"copd with 2 liters dependence of home 02 .","problem":["copd"],"test":[],"treatment":["home 02"],"problem_indices_start":[0],"problem_indices_end":[4],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[33],"treatment_indices_end":[40]}
{"text":"soft , obese , nontender , nondistended .","problem":["nontender","obese","nondistended"],"test":[],"treatment":[],"problem_indices_start":[7,15,27],"problem_indices_end":[12,24,39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the neck was supple without lymphadenopathy or thyromegaly .","problem":["lymphadenopathy","thyromegaly"],"test":[],"treatment":[],"problem_indices_start":[28,47],"problem_indices_end":[43,58],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. integrelin drip on transfer .","problem":[],"test":[],"treatment":["integrelin drip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[18]}
{"text":"chronic obstructive pulmonary disease .","problem":["chronic obstructive pulmonary disease"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"chronic renal insufficiency .","problem":["chronic renal insufficiency"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[27],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"anemia .","problem":["anemia"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[6],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"6. toprol xl 100 mg q.d.","problem":[],"test":[],"treatment":["toprol xl"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"guaiac positive stools .","problem":["guaiac positive stools"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[22],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was a well appearing male in no acute distress .","problem":["acute distress"],"test":[],"treatment":[],"problem_indices_start":[35],"problem_indices_end":[49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"upon discharge the patient was changed to a bid protonix regimen .","problem":[],"test":[],"treatment":["a bid protonix regimen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[42],"treatment_indices_end":[64]}
{"text":"her hct dropped from hct 38.9 before fluids to 35.5 s\/p 1.5l ns and was thought to be dilutional .","problem":[],"test":["hct","her hct"],"treatment":["fluids","ns"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,21],"test_indices_end":[7,24],"treatment_indices_start":[37,61],"treatment_indices_end":[43,63]}
{"text":"she will need outpatient follow up for her guiac pos stools with endoscopy vs egd +\/- h.pylori serologies .","problem":["her guiac pos stools"],"test":["endoscopy","h.pylori serologies","egd"],"treatment":[],"problem_indices_start":[39],"problem_indices_end":[59],"test_indices_start":[65,78,86],"test_indices_end":[74,81,105],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"7. tiotropium bromide 18 mcg capsule , w\/ inhalation device sig : one ( 1 ) cap inhalation daily ( daily ).","problem":[],"test":[],"treatment":["tiotropium bromide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[21]}
{"text":"4. guiac pos stool : given the patient 's sx of gerd , current po steroid regimen , and asa for her stents , the ddx for her guiac positive stools would include gastritis \/ gastric ulcer in addition to lower gi pathology .","problem":["guiac pos stool","her guiac positive stools","gastritis","gastric ulcer","lower gi pathology","gerd"],"test":[],"treatment":["po steroid regimen","her stents","asa"],"problem_indices_start":[3,48,121,161,173,202],"problem_indices_end":[18,52,146,170,186,220],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[63,88,96],"treatment_indices_end":[81,91,106]}
{"text":"13. oxygen continue 02 at 1l\/min continuous to keep sats in 90 's.","problem":[],"test":["sats"],"treatment":["oxygen","02"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[52],"test_indices_end":[56],"treatment_indices_start":[4,20],"treatment_indices_end":[10,22]}
{"text":"she also has no gross blood per rectum and her hct is stable .","problem":["gross blood per rectum"],"test":["her hct"],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[38],"test_indices_start":[43],"test_indices_end":[50],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"infection \/ sepsis was not likely given she was afebrile and had no localizing sx with an improving lung exam and 02 requirement .","problem":["afebrile","02 requirement","sepsis","infection","localizing sx"],"test":["lung exam"],"treatment":[],"problem_indices_start":[0,12,48,68,114],"problem_indices_end":[9,18,56,81,128],"test_indices_start":[100],"test_indices_end":[109],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"9. albuterol sulfate 0.083 % solution sig : one ( 1 ) puff inhalation q6h ( every 6 hours ) as needed for shortness of breath or wheezing .","problem":["wheezing","shortness of breath"],"test":[],"treatment":["albuterol sulfate"],"problem_indices_start":[106,129],"problem_indices_end":[125,137],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[20]}
{"text":"therefore , the cause of her mild diarrhea ( few loose bm \/ liquid stool \/ night ) may be either viral or secondary to resolving abdominal hematoma with resultant irritation of gi system .","problem":["irritation of gi system","viral","resolving abdominal hematoma","liquid stool","her mild diarrhea","few loose bm"],"test":[],"treatment":[],"problem_indices_start":[25,45,60,97,119,163],"problem_indices_end":[42,57,72,102,147,186],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"stool for c.diff toxin was sent x 1 and was negative .","problem":[],"test":["stool for c.diff toxin"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[22],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"all of this occurred in the setting of aggressive bp management with metoprolol 25 bid , hctz \/ triampterene ( as a replacment for lasix due to recurrent hypokalemia ), benicar 20 mg qd , and imdur 30 mg qd .","problem":["recurrent hypokalemia"],"test":[],"treatment":["metoprolol","lasix","imdur","benicar","hctz","aggressive bp management","triampterene"],"problem_indices_start":[144],"problem_indices_end":[165],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[39,69,89,96,131,169,192],"treatment_indices_end":[63,79,93,108,136,176,197]}
{"text":"her bowel regimen is prn .","problem":[],"test":[],"treatment":["her bowel regimen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[17]}
{"text":"2. thrush : this is likely secondary to her steroid inhalers and po prednisone for copd exacerbation .","problem":["copd exacerbation","thrush"],"test":[],"treatment":["po prednisone","her steroid inhalers"],"problem_indices_start":[3,83],"problem_indices_end":[9,100],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[40,65],"treatment_indices_end":[60,78]}
{"text":"she was asymptomatic .","problem":["asymptomatic"],"test":[],"treatment":[],"problem_indices_start":[8],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was encouraged to take po liquids to prevent volume depletion .","problem":["volume depletion"],"test":[],"treatment":["take po liquids"],"problem_indices_start":[57],"problem_indices_end":[73],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30],"treatment_indices_end":[45]}
{"text":"you must take your aspirin and plavix every day to prevent failure of these stents which could be life threatening .","problem":["failure of these stents"],"test":[],"treatment":["plavix","your aspirin"],"problem_indices_start":[59],"problem_indices_end":[82],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[14,31],"treatment_indices_end":[26,37]}
{"text":"3. diarrhea : the patient has been having loose stools at night and was guiac pos x 2 .","problem":["loose stools","diarrhea","guiac pos"],"test":[],"treatment":[],"problem_indices_start":[3,42,72],"problem_indices_end":[11,54,81],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she will need follow up with her pcp within b week after discharge from the extended care facility for further bp titration and monitoring of her electrolytes .","problem":[],"test":["monitoring of her electrolytes"],"treatment":["further bp titration"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[128],"test_indices_end":[158],"treatment_indices_start":[103],"treatment_indices_end":[123]}
{"text":"the hypotension was likely due to volume depletion caused by her diarrhea \/ loose stools in addition to decreased po intake secondary to her gerd and thrush .","problem":["loose stools","the hypotension","volume depletion","her diarrhea","decreased po intake","her gerd","thrush"],"test":[],"treatment":[],"problem_indices_start":[0,34,61,76,104,137,150],"problem_indices_end":[15,50,73,88,123,145,156],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"she was also placed on on low dose spironolactone as a k sparing diuretic and for bp control in addition to toprol xl 25 mg qd for her coronary disease .","problem":["her coronary disease"],"test":[],"treatment":["bp control","low dose spironolactone","a k sparing diuretic","toprol xl"],"problem_indices_start":[131],"problem_indices_end":[151],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[26,53,82,108],"treatment_indices_end":[49,73,92,117]}
{"text":"4. oxycodone 5 mg tablet sig : one ( 1 ) tablet po q4h ( every 4 hours ) as needed for pain .","problem":["pain"],"test":[],"treatment":["oxycodone"],"problem_indices_start":[87],"problem_indices_end":[91],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[12]}
{"text":"the patient was kept an additional two days to follow her hcts and titrate her bp meds .","problem":[],"test":["her hcts"],"treatment":["her bp meds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[54],"test_indices_end":[62],"treatment_indices_start":[75],"treatment_indices_end":[86]}
{"text":"as volume depletion was thought to be the cause of her low bp , only the bblocker was restarted .","problem":["her low bp","volume depletion"],"test":[],"treatment":["the bblocker"],"problem_indices_start":[3,51],"problem_indices_end":[19,61],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[69],"treatment_indices_end":[81]}
{"text":"just prior to discharge on 11-14 , pt 's bp was found to be 70\/40 p70 s just after receiving her am bp meds .","problem":[],"test":["pt 's bp"],"treatment":["her am bp meds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[35],"test_indices_end":[43],"treatment_indices_start":[93],"treatment_indices_end":[107]}
{"text":"sulfa ( sulfonamides ) \/ penicillins \/ macrodantin \/ ivp dye , iodine containing","problem":[],"test":[],"treatment":["iodine containing","penicillins","macrodantin","ivp dye","sulfa ( sulfonamides"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,25,39,53,63],"treatment_indices_end":[20,36,50,60,80]}
{"text":"however , she has no vomiting and only mild nausea with medications .","problem":["vomiting","only mild nausea"],"test":[],"treatment":["medications"],"problem_indices_start":[21,34],"problem_indices_end":[29,50],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[56],"treatment_indices_end":[67]}
{"text":"gastroenteritis is possible but she has no vomiting and only occ nausea with meds .","problem":["vomiting","occ nausea","gastroenteritis"],"test":[],"treatment":["meds"],"problem_indices_start":[0,43,61],"problem_indices_end":[15,51,71],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[77],"treatment_indices_end":[81]}
{"text":"2. pantoprazole 40 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po twice a day .","problem":[],"test":[],"treatment":["pantoprazole"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"she tolerated these meds with sbp s in the high 90 s to 100 s and was therefore discharged on this regimen .","problem":[],"test":["sbp s"],"treatment":["this regimen","these meds"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[30],"test_indices_end":[35],"treatment_indices_start":[14,94],"treatment_indices_end":[24,106]}
{"text":"16. nystatin 100,000 unit \/ ml suspension sig : ten ( 10 ) ml po qid ( 4 times a day ) for 7 days .","problem":[],"test":[],"treatment":["nystatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[12]}
{"text":"17. aspirin 325 mg tablet , delayed release ( e.c. ) sig : one ( 1 ) tablet , delayed release ( e.c. ) po daily ( daily ).","problem":[],"test":[],"treatment":["aspirin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[11]}
{"text":"given the patient 's recent rp bleed , there was concern for a recurrent bleed .","problem":["the patient 's recent rp bleed","a recurrent bleed"],"test":[],"treatment":[],"problem_indices_start":[6,61],"problem_indices_end":[36,78],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"we have advised a brat diet .","problem":[],"test":[],"treatment":["a brat diet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[16],"treatment_indices_end":[27]}
{"text":"if you experience cp , sob , dizzyness , or any other symptoms that concern you please call your pcp or return to the er .","problem":["cp","dizzyness","sob","any other symptoms"],"test":[],"treatment":[],"problem_indices_start":[18,23,29,44],"problem_indices_end":[20,26,38,62],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"2) retroperitoneal bleed","problem":["retroperitoneal bleed"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. hypotension : the patient 'd pm bp meds were held 11-14 and she was administered 1.5l ns over the course of the day with subsequent sbp s in the high 90 s, low 100 s,.","problem":["hypotension"],"test":["sbp s"],"treatment":["ns","the patient 'd pm bp meds"],"problem_indices_start":[3],"problem_indices_end":[14],"test_indices_start":[135],"test_indices_end":[140],"treatment_indices_start":[17,89],"treatment_indices_end":[42,91]}
{"text":"15. metoprolol succinate 25 mg tablet sustained release 24hr sig : one ( 1 ) tablet sustained release 24hr po daily ( daily ).","problem":[],"test":[],"treatment":["metoprolol succinate"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[24]}
{"text":"6. fluticasone 110 mcg \/ actuation aerosol sig : two ( 2 ) puff inhalation bid ( 2 times a day ).","problem":[],"test":[],"treatment":["fluticasone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"10. aluminum - magnesium hydroxide 225-200 mg \/ 5 ml suspension sig : 15-30 ml s po prn ( as needed ).","problem":[],"test":[],"treatment":["aluminum - magnesium hydroxide"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[34]}
{"text":"14. spironolactone 25 mg tablet sig : 0.5 tablet po daily ( daily ).","problem":[],"test":[],"treatment":["spironolactone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[18]}
{"text":"1) rapid atrial fibrillation with demand ischemia","problem":["demand ischemia","rapid atrial fibrillation"],"test":[],"treatment":[],"problem_indices_start":[3,34],"problem_indices_end":[28,49],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"repeat hcts were stable .","problem":[],"test":["repeat hcts"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[11],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"11. senna 8.6 mg tablet sig : one ( 1 ) tablet po bid ( 2 times a day ) as needed .","problem":[],"test":[],"treatment":["senna"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[9]}
{"text":"8. clopidogrel 75 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["clopidogrel"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"12. prednisone 10 mg tablet sig : 1-2 tablets po daily ( daily ) for 4 days : please take two pills for one day starting 11-17 , then take one pill for three days .","problem":[],"test":[],"treatment":["prednisone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[4],"treatment_indices_end":[14]}
{"text":"there is no evidence of obstruction on axr .","problem":["obstruction"],"test":["axr"],"treatment":[],"problem_indices_start":[24],"problem_indices_end":[35],"test_indices_start":[39],"test_indices_end":[42],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. atorvastatin 10 mg tablet sig : one ( 1 ) tablet po daily ( daily ).","problem":[],"test":[],"treatment":["atorvastatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[15]}
{"text":"she was started on nystatin swish and swallow qid .","problem":[],"test":[],"treatment":["nystatin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[19],"treatment_indices_end":[27]}
{"text":"please take all medications as prescribed .","problem":[],"test":[],"treatment":["all medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[12],"treatment_indices_end":[27]}
{"text":"3. acetaminophen 500 mg tablet sig : two ( 2 ) tablet po q6h ( every 6 hours ).","problem":[],"test":[],"treatment":["acetaminophen"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[16]}
{"text":"5. fluticasone 50 mcg \/ actuation aerosol , spray sig : two ( 2 ) spray nasal daily ( daily ).","problem":[],"test":[],"treatment":["fluticasone"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[3],"treatment_indices_end":[14]}
{"text":"her groin exam was unchanged .","problem":[],"test":["her groin exam"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[14],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"note : you have had a cardiac stent placed during this admission .","problem":[],"test":[],"treatment":["a cardiac stent"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[20],"treatment_indices_end":[35]}
{"text":"2) you are scheduled to have your staples removed on 2013-11-20 3:00 with provider : leah , paula g. wilson surgery ( nhb )","problem":[],"test":[],"treatment":["your staples"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[29],"treatment_indices_end":[41]}
{"text":"ekg s were followed for normalization .","problem":[],"test":["ekg s"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[5],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"at baseline the patient denies any previous chest pain , pressure , dyspnea on exertion , orthopnea , pnd or palpitations .","problem":["palpitations","dyspnea","orthopnea","pressure","previous chest pain","pnd"],"test":[],"treatment":[],"problem_indices_start":[35,57,68,90,102,109],"problem_indices_end":[54,65,75,99,105,121],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient had an echocardiogram on day two of admission , which revealed a mildly dilated left atrium , mild symmetric lvh , normal lv cavity size , mild region lv systolic dysfunction , arresting regional wall motion abnormality including focal apical hypokinesis , a normal right ventricular chamber size and free wall motion , a moderately dilated aortic root , a mildly dilated ascending aorta , normal aortic valve leaflet , normal mitral valve leaflet and no pericardial effusions .","problem":["arresting regional wall motion abnormality","focal apical hypokinesis","a mildly dilated left atrium","mild symmetric lvh","mild region lv systolic dysfunction","a moderately dilated aortic root","a mildly dilated ascending aorta","pericardial effusions"],"test":["an echocardiogram"],"treatment":[],"problem_indices_start":[75,106,151,189,242,332,367,467],"problem_indices_end":[103,124,186,231,266,364,399,488],"test_indices_start":[16],"test_indices_end":[33],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was transferred to the cc for monitoring and he denied having further pain , shortness of breath , nausea or vomiting .","problem":["shortness of breath","nausea","further pain","vomiting"],"test":["monitoring"],"treatment":[],"problem_indices_start":[65,80,102,112],"problem_indices_end":[77,99,108,120],"test_indices_start":[33],"test_indices_end":[43],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the chest pain persisted afterwards and a relook catheterization was performed that revealed no occlusions .","problem":["occlusions","the chest pain"],"test":["a relook catheterization"],"treatment":[],"problem_indices_start":[0,96],"problem_indices_end":[14,106],"test_indices_start":[40],"test_indices_end":[64],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the right heart catheterization revealed a cardiac output index of 4.11 and 2.15 respectively .","problem":[],"test":["the right heart catheterization","a cardiac output index"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,41],"test_indices_end":[31,63],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"captopril 6.2 3 x a day and titrated up .","problem":[],"test":[],"treatment":["captopril"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[9]}
{"text":"skin was strong build and was in no apparent distress .","problem":["apparent distress"],"test":[],"treatment":[],"problem_indices_start":[36],"problem_indices_end":[53],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"blood pressure 156\/67 , pulse 80 and respiratory rate 14 .","problem":[],"test":["blood pressure","respiratory rate","pulse"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,24,37],"test_indices_end":[14,29,53],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"ra pressure was 13 , rv pressure 45\/7 , wedge 27 and pa pressures of 42\/21 .","problem":[],"test":["pa pressures","ra pressure","rv pressure","wedge"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,21,40,53],"test_indices_end":[11,32,45,65],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"a hepacoat stent was placed with no residuals but good flow after nitroglycerin and diltiazem .","problem":[],"test":["residuals"],"treatment":["a hepacoat stent","diltiazem","nitroglycerin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[36],"test_indices_end":[45],"treatment_indices_start":[0,66,84],"treatment_indices_end":[16,79,93]}
{"text":"there were no lifts or heaves on examination .","problem":["lifts","heaves"],"test":["examination"],"treatment":[],"problem_indices_start":[14,23],"problem_indices_end":[19,29],"test_indices_start":[33],"test_indices_end":[44],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was told to return to the emergency department if he had any chest pain , pressure , difficulty breathing , nausea , light-headiness or dizziness .","problem":["dizziness","nausea","any chest pain","difficulty breathing","pressure","light-headiness"],"test":[],"treatment":[],"problem_indices_start":[60,77,88,111,120,139],"problem_indices_end":[74,85,108,117,135,148],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his pmi was two finger breath width in the fifth intercostal space lateral to the midclavicular line .","problem":[],"test":["his pmi","finger breath width"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,16],"test_indices_end":[7,35],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient did not have any carotid bruits , abdominal bruits or femoral bruits .","problem":["femoral bruits","abdominal bruits","any carotid bruits"],"test":[],"treatment":[],"problem_indices_start":[25,46,66],"problem_indices_end":[43,62,80],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"hypertension was managed with beta blocker and ace inhibitor and integrilin was continued post mi for 18 hours .","problem":["hypertension","mi"],"test":[],"treatment":["beta blocker","integrilin","ace inhibitor"],"problem_indices_start":[0,95],"problem_indices_end":[12,97],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30,47,65],"treatment_indices_end":[42,60,75]}
{"text":"heparin and nitroglycerin drip were started with 10 mg of iv retavase half dose .","problem":[],"test":[],"treatment":["heparin","iv retavase","nitroglycerin drip"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,12,58],"treatment_indices_end":[7,30,69]}
{"text":"his heart was regular with no murmurs , rubs or gallops and his radial and dp pulses were both 2+ bilaterally and equal .","problem":["murmurs","rubs","gallops"],"test":["his radial and dp pulses"],"treatment":[],"problem_indices_start":[30,40,48],"problem_indices_end":[37,44,55],"test_indices_start":[60],"test_indices_end":[84],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his abdomen was scaphoid , nondistended , nontender with positive bowel sounds .","problem":["nondistended","scaphoid","nontender"],"test":[],"treatment":[],"problem_indices_start":[16,27,42],"problem_indices_end":[24,39,51],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"antihypertensive medications that the patient could not identify .","problem":[],"test":[],"treatment":["antihypertensive medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0],"treatment_indices_end":[28]}
{"text":"serial ck s were followed with a ck peak of 433 .","problem":[],"test":["serial ck s","a ck peak"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,31],"test_indices_end":[11,40],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was transferred to the north adams regional hospital for catheterization .","problem":[],"test":["catheterization"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[60],"test_indices_end":[75],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"aspirin 325 mg q.d. , plavix 75 mg q.d. , lipitor 20 mg q.d. , nitroglycerin 0.3 mg sublingually p.r.n. chest pain or pressure or shortness of breath , lisinopril hydrochlorothiazide 20 \/ 12.5 mg q.d. , atenolol 25 mg q.d.","problem":["chest pain","pressure","shortness of breath"],"test":[],"treatment":["aspirin","atenolol","nitroglycerin","plavix","lisinopril","lipitor","hydrochlorothiazide"],"problem_indices_start":[104,118,130],"problem_indices_end":[114,126,149],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,22,42,63,152,163,203],"treatment_indices_end":[7,28,49,76,162,182,211]}
{"text":"plavix was started at 75 mg a day , lipitor 20 mg per day , metoprolol 25 mg twice a day to be titrated up as tolerated and on day two of admission an ace inhibitor was started .","problem":[],"test":[],"treatment":["an ace inhibitor","lipitor","metoprolol","plavix"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[0,36,60,148],"treatment_indices_end":[6,43,70,164]}
{"text":"on day two of admission , the patient ambulated with pt and was moved to the regular floor .","problem":[],"test":[],"treatment":["pt"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[53],"treatment_indices_end":[55]}
{"text":"a lipid panel was checked and found to be within normal limits , although it was noted this was in the post mi setting and the lipid panel could be falsely low .","problem":[],"test":["the lipid panel","a lipid panel"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0,123],"test_indices_end":[13,138],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was given a low fat \/ low cholesterol diet .","problem":[],"test":[],"treatment":["a low fat \/ low cholesterol diet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[22],"treatment_indices_end":[54]}
{"text":"the right calf site had minimal ooze and no hematomas or bruits .","problem":["bruits","hematomas","minimal ooze"],"test":[],"treatment":[],"problem_indices_start":[24,44,57],"problem_indices_end":[36,53,63],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is a 54 - year-old man with significant coronary artery disease risk factors , positive family history , smoking history , hypertension and gender who presented with an st elevation mi status post lad stent , complicated by no residuals requiring nitroglycerin and diltiazem for good flow .","problem":["significant coronary artery disease risk factors","an st elevation mi","residuals","hypertension"],"test":[],"treatment":["diltiazem","lad stent","nitroglycerin"],"problem_indices_start":[33,128,171,232],"problem_indices_end":[81,140,189,241],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[202,252,270],"treatment_indices_end":[211,265,279]}
{"text":"cardiac catheterization and stent placement in the mid left anterior descending artery .","problem":[],"test":["cardiac catheterization"],"treatment":["stent placement in the mid left anterior descending artery"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[23],"treatment_indices_start":[28],"treatment_indices_end":[86]}
{"text":"the patient was afebrile .","problem":["afebrile"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[24],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was told repeatedly that he needed to stop smoking and was given a nicotine patch and his primary care provider was called to discuss outpatient plans to help the patient stop smoking .","problem":[],"test":[],"treatment":["a nicotine patch"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[77],"treatment_indices_end":[93]}
{"text":"for renal , his creatinine was monitored and the dye load and the catheterization .","problem":[],"test":["the dye load","his creatinine","the catheterization"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[12,45,62],"test_indices_end":[26,57,81],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was advised to have a low fat \/ low cholesterol diet , was cleared by pt and advised to do cardiac rehabilitation .","problem":[],"test":[],"treatment":["cardiac rehabilitation","a low fat \/ low cholesterol diet"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[32,103],"treatment_indices_end":[64,125]}
{"text":"once at hahnemann general hospital he received heparin and integrilin .","problem":[],"test":[],"treatment":["integrilin","heparin"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[47,59],"treatment_indices_end":[54,69]}
{"text":"the patient was normal volume and displayed no evidence chf signs or symptoms .","problem":["chf signs or symptoms"],"test":[],"treatment":[],"problem_indices_start":[56],"problem_indices_end":[77],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was told he could return to work after two weeks of rest , given that his work required a high level of exertion and the patient was also given a prescription for a transdermal nicotine patch 14 mg the be used for up to 2 weeks until cravings remitted .","problem":["cravings"],"test":[],"treatment":["a transdermal nicotine patch","rest"],"problem_indices_start":[246],"problem_indices_end":[254],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[64,175],"treatment_indices_end":[68,203]}
{"text":"he denied ever having any chest pain , chest pressure , shortness of breath , dyspnea on exertion and he was discharged to home .","problem":["chest pressure","shortness of breath","any chest pain","dyspnea"],"test":[],"treatment":[],"problem_indices_start":[22,39,56,78],"problem_indices_end":[36,53,75,85],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"they were normal and did not change and the patient received pneumatic boots for dvt prophylaxis .","problem":[],"test":[],"treatment":["dvt prophylaxis","pneumatic boots"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[61,81],"treatment_indices_end":[76,96]}
{"text":"significant for a brother who had an mi at age 61 .","problem":["an mi"],"test":[],"treatment":[],"problem_indices_start":[34],"problem_indices_end":[39],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was advised the importance of each of his and compliance with each of these medications and was told he needed close followup with a cardiologist .","problem":[],"test":[],"treatment":["these medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[73],"treatment_indices_end":[90]}
{"text":"each episode lasted approximately 15 minutes in duration and resolved on their own .","problem":["each episode"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[12],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he had normal bowel movements and had gi prophylaxis throughout his stay .","problem":[],"test":[],"treatment":["gi prophylaxis"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[38],"treatment_indices_end":[52]}
{"text":"2. hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[15],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient was pain free and doing well .","problem":["pain"],"test":[],"treatment":[],"problem_indices_start":[16],"problem_indices_end":[20],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the risk factors were addressed .","problem":["the risk factors"],"test":[],"treatment":[],"problem_indices_start":[0],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"for his coronary artery disease , aspirin was started at 325 .","problem":["his coronary artery disease"],"test":[],"treatment":["aspirin"],"problem_indices_start":[4],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[34],"treatment_indices_end":[41]}
{"text":"coronary angiography revealed left main , left circumflex and rca normal and left lad with 99% midstenosis .","problem":["left lad with 99% midstenosis"],"test":["coronary angiography"],"treatment":[],"problem_indices_start":[77],"problem_indices_end":[106],"test_indices_start":[0],"test_indices_end":[20],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was advised to take all of his medications .","problem":[],"test":[],"treatment":["his medications"],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[30],"treatment_indices_end":[45]}
{"text":"only hypertension .","problem":["hypertension"],"test":[],"treatment":[],"problem_indices_start":[5],"problem_indices_end":[17],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"1. st elevation myocardial infarction .","problem":["st elevation myocardial infarction"],"test":[],"treatment":[],"problem_indices_start":[3],"problem_indices_end":[37],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was anicteric with moist mucous membranes .","problem":["anicteric"],"test":[],"treatment":[],"problem_indices_start":[7],"problem_indices_end":[16],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this morning while landscaping the patient had unremitting 12-05 pain with shortness of breath and diaphoresis .","problem":["diaphoresis","unremitting 12-05 pain","shortness of breath"],"test":[],"treatment":[],"problem_indices_start":[47,75,99],"problem_indices_end":[69,94,110],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"rhythm was maintained at normal sinus , monitored on telemetry without ectopy .","problem":["ectopy"],"test":["telemetry"],"treatment":[],"problem_indices_start":[71],"problem_indices_end":[77],"test_indices_start":[53],"test_indices_end":[62],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"for hematology , the patient 's hematocrit and platelets were monitored after the catheterization .","problem":[],"test":["the catheterization","platelets","the patient 's hematocrit"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[17,47,78],"test_indices_end":[42,56,97],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"no jvd or increased jvp was appreciated at 0 degrees .","problem":["jvd","increased jvp"],"test":[],"treatment":[],"problem_indices_start":[3,10],"problem_indices_end":[6,23],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"the patient denies having any drug allergies .","problem":["any drug allergies"],"test":[],"treatment":[],"problem_indices_start":[26],"problem_indices_end":[44],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"this is a 55 - year-old caucasian speaking male who is a smoker and has a family history of coronary artery disease , as well as a personal history of hypertension , who experienced multiple episodes of 10\/10 substernal chest pain radiating down his left arm last night with his daily activities .","problem":["coronary artery disease","10\/10 substernal chest pain","hypertension"],"test":[],"treatment":[],"problem_indices_start":[92,151,203],"problem_indices_end":[115,163,230],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his extremities were warm , pink with no edema .","problem":["edema"],"test":[],"treatment":[],"problem_indices_start":[41],"problem_indices_end":[46],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he presented to deaconess-nashoba hospital hospital and the first ekg was found to have st elevations in v1-v3 of 1-2 mm with t wave inversions in v4-6 , i and l , which progressed to 3-0167 w. seventh ave. elevations within 20 minutes .","problem":["t wave inversions","st elevations in v1-v3"],"test":["the first ekg"],"treatment":[],"problem_indices_start":[88,126],"problem_indices_end":[110,143],"test_indices_start":[56],"test_indices_end":[69],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"he was laying flat , very tense .","problem":["very tense"],"test":[],"treatment":[],"problem_indices_start":[21],"problem_indices_end":[31],"test_indices_start":[],"test_indices_end":[],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his electrolytes were monitored and repleted carefully .","problem":[],"test":["his electrolytes"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[0],"test_indices_end":[16],"treatment_indices_start":[],"treatment_indices_end":[]}
{"text":"his lungs were clear to auscultation .","problem":[],"test":["auscultation"],"treatment":[],"problem_indices_start":[],"problem_indices_end":[],"test_indices_start":[24],"test_indices_end":[36],"treatment_indices_start":[],"treatment_indices_end":[]}