Biomedical-TeMU/CodiEsp_corpus · Datasets at Hugging Face

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• Ultrasound report: "At the level of the superficial lobe of the right parotid gland two hypoechogenic nodular lesions of solid appearance are identified, a more lateral of 32 mm and well-defined edges of the left microechoic lobe and a more superficial contour
1.
• FNAC report:
- FNAC of the left parotid area: negative cytology for malignant cells, compatible with Warthin tumour.
- FNAC of the right parotid area: negative cytology for malignant cells, compatible with Warthin tumour.
(Bilateral).
• Nuclear Magnetic Resonance Report: "There are multiple heterogeneous nodular lesions in both parotid glands.
Some of these lesions present multicystic areas with hyperintense content, in relation to proteinaceous/heated content and all of them present intense enhancement.
Compatible with multicentric and bilateral Warthin's tumor".
1.
The patient is waiting to be operated on by the maxillofacial surgery service of a bilateral multifocal Warthin tumor.
A 79-year-old male presented with obesity, hypertension, type 2 diabetes mellitus, ischemic heart disease, AF, chronic obstructive pulmonary disease (COPD) and sleep apnea syndrome.
She came to the Primary Care clinic for dizziness with sensation of spinning objects, especially when lying down.
cough increased
She had no loss of consciousness, chest pain, vomiting or cold sweating.
Usually, the patient is treated with amyloidosis, repaglinide, nitroglycerin (parches), acenocoumarol, atorvastatin, atenthelinide, acetylcholine, isophanesome,
Physical examination revealed the presence of arrhythmia on cardiac auscultation, with slow, extinguished, and no murmurs.
Radial pulses are present and symmetrical.
Pulmonary auscultation revealed generalized hypoventilation, without excessive sounds.
The neurological examination is rigorously normal.
She had edema with fovea on her knees and signs of chronic venous insufficiency in her lower limbs.
With pulse oximeter we detected a heart rate of 30 beats per minute (lpm) and oxygen saturation of 90 %.
Patient's clinical features (mare with sensation of spinning objects without other added symptoms) and heart rate detected was decided to perform ECG.
1.
After assessing the ECG, and given the patient's personal history (HTN, ischemic heart disease), we compared the recording obtained with a previous ECG, performed three years ago during hospitalization for an episode of exacerbation of COPD.
1.
When comparing both recordings to the hospital electrodes, it was found that bradycardia did not appear and that the QRS complexes now seem rhythmic, but P waves were not observed, so the patient was clinically diagnosed.
With the suspected diagnosis of slow AF, negative chronotrope treatment is withdrawn, without improvement.
Given the lack of response to this measure, admission to Cardiology was decided.
After a complete study, the definitive diagnosis of AF with advanced atrioventricular block and grade III right bundle branch block was reached, which led to the decision of permanent symptomatic implantation.
The patient evolved favorably: the symptoms disappeared and the heart rate was controlled.
This is a 57-year-old patient with a history of ductal carcinoma of the left breast diagnosed in 1999 and ductal carcinoma in situ of the right breast in 2002, with no data of recurrence since then, working as a hospital worker.
The patient has never smoked, but both have a floor of 65 meters square with her husband, a smoker of 30 cigarettes per day also smokers (black age), with whom she has lived for 35 years, her son and daughter,
The child is a smoker of 20 cigarettes a day, with whom he has lived 31 years; and the daughter is a smoker of 10 cigarettes a day, with whom he has lived 25 years.
They all smoked on the floor, none went to the verandah to smoke.
He consulted for frank hematuria related to mechanical low back pain.
The physical examination did not show relevant data, and there was no mass in the renal fossae.
Urocultive examination, ultrasound and laboratory tests were performed.
Blood tests were normal except for proteinuria, and the urine culture was negative.
Ultrasound was reported as "no significant changes except mild ectasia in the upper right quadrant".
We decided that in case of hematuria with positive proteinuria (confirmed in 24-hour urine), we sent him to the Nephrology service to complete study and follow-up.
A second ultrasound was performed, resulting in the same conclusion as the first (performed 6 months apart), as well as an intravenous urography where right foot and ureteral dilation are visualized.
Computed Tomography (CT) showed the same findings, with no obstructive cause justifying this dilation.
In the third ultrasound (months later) echogenic content is visualized in the footlocalization system producing right intrafusal kidney. For this reason a TC was again requested, where an image with a density of the superior renal soft tissues was found.
The lesion captures and is compatible with transitional cell carcinoma in the right collecting system, upper infundibulum and part of the renal pelvis.
Urine cytology was positive.
The patient underwent right laparoscopic nephrectomy and nephrectomy.
1.
Pathology confirmed transitional cell carcinoma of the renal pelvis, with foci of mucinous carcinoma that affects the pelvis, parenchyma and respects ureteral borders, theoretical stage pT3.
Almost two years later, chest CT confirmed space occupying lesions in the liver compatible with liver and bone metastases.
A 7-year-old girl with no history of interest referred from her primary care center because of a painful pruriginous lesion in the right cheek that had not improved after oral treatment with amoxicillin/clavulanic acid for two weeks.
On examination, the right cheek showed a cold, erythematous, violet nodule blaming the tattoo, well-defined 1.5 cm in diameter.
No regional adenomegaly was observed, although there was mild keratosis pilaris on the skin of the cheeks.
1.
Having established the clinical suspicion of IFAG and informed parents about the benignity of the process, they agreed not to perform a skin biopsy and to schedule periodic follow-up, along with metronidazole gel therapy at night.
Two weeks later there was spontaneous drainage of a blood-purulent material from the center of the lesion, with subsequent progressive resolution of the nodule within about 6 weeks.
Cultures for bacteria, mycobacteria from the drainage exudate were negative.
However, after resolution of the nodular lesion, persistent telangiectasias in the affected area have slowly decreased over the 10-month follow-up period.
We advise revisions to the patient until the complete resolution of the process and warn about the need to consult before the appearance of symptoms or clinical signs suggestive of ocular rosacea (dryness, visual acuity or redness).
A 59-year-old patient complained of difficulty sleeping for about a month.
He has weakness and pain in the lower limbs, which improves after stopping, sometimes accompanied by non-irradiated low back pain.
He has noticed changes in voice, which is more dysphonic, related to his work.
In the directed anamnesis, he did not report weakness in the hands or upper extremities.
There is no ocular, sphincter control or sensory disorder.
Emotional lability is not observed, although the patient already had an adaptive disorder after the death of his wife.
Located in twins.
His personal history included hypertension and type 2 diabetes.
Family history: deceased uncle with a diagnosis of amyotrophic lateral sclerosis (ALS).
Neurological examination revealed hypophonic, facial centered speech.
Internal and external ocular mobility was normal.
Lingual fasciculations.
No cervical weakness.
Motor: lower limbs (LLII): paraparesis with proximal predominance 4/5.
Dorsiflexion of both feet 5/5.
No weakness in the upper limbs was observed.
No sensory deficit.
Osteotendinous osteotendinous reflex (OTT) +++/+++ with bilateral positive Hoffmann and indifferent right cutaneous-plantar reflex, preserved left.
Fasciculations in deltoid, pectoral and diffusely in the lower limbs.
Muscular atrophy in both quadriceps.
General anodine.
An ankle-brachial index (ABI) was performed: right 1.18; left 1.29.
Laboratory tests were requested, highlighting CK 232, immunological study and normal serology.
Chest and lumbosacral radiography were normal.
After suspicion of motor neuron disease, the Internal Medicine Department was consulted, requesting electromyography (EMG) / electroneurography (ENG) suggestive of neurogenic pattern with positive right upper limb denervation.
These results led to Neurology.
After evaluation of the patient and diagnosis of probable ALS, according to the revised criteria of El Escorial, and pending completion of the study with cranial-medullary magnetic resonance imaging and new neurolophysiological study Riluzole treatment was initiated 12 hours.
Due to the clinical evolution of the patient with proximal paraparesis in the lower limbs, with significant muscular disorder of both thighs, dysphagia for solids, without involvement in upper limbs (MMSS) and correlated with last possible neurophysiological study.
The EMG suggests myopathy with bulbar and pelvic girdle involvement (myopathy by inclusion bodies), so muscle biopsy was performed, the results of the same being conclusive and secondary changes, discarding the possibility of voiding.
The patient subsequently developed symptoms, progressing weakness in the dorsal flexion of the left foot (4/5).
Early atrophy in the fifth interosseous space of the left hand.
Diffuse fasciculations by different body segments, as well as mild aphonia.
Finally, the diagnosis of probable ALS motor neuron disease is suggested.
Treatment with 50 mg Riluzole was continued. Physical and respiratory home rehabilitation was recommended as soon as possible.
Five months after the definitive diagnosis, the patient developed septic shock of urinary origin and subsequent complications, requiring invasive mechanical ventilation (tracheotomy), percutaneous gastrostomy feeding (PEG) and secondary adaptive disorder, being discharged
Two months later he died.
This is a 46-year-old male patient with no history of interest, who comes to consultation for sudden loss of strength in the lower limbs.
This picture is repeatedly and episodic, self-limiting in a few hours.
It usually affects the lower limbs, but can do so in a generalized way.
She suffered previous episodes that increased in frequency and intensity in the last year.
During the directed interview, the patient reported loss of 20 kilos in the last four months, with no decrease in intake, occasional tremor, irritability and nervousness.

• Ultrasound report: "At the level of the superficial lobe of the right parotid gland two hypoechogenic nodular lesions of solid appearance are identified, a more lateral of 32 mm and well-defined edges of the left microechoic lobe and a more superficial contour

1.

• FNAC report:

- FNAC of the left parotid area: negative cytology for malignant cells, compatible with Warthin tumour.

- FNAC of the right parotid area: negative cytology for malignant cells, compatible with Warthin tumour.

(Bilateral).

• Nuclear Magnetic Resonance Report: "There are multiple heterogeneous nodular lesions in both parotid glands.

Some of these lesions present multicystic areas with hyperintense content, in relation to proteinaceous/heated content and all of them present intense enhancement.

Compatible with multicentric and bilateral Warthin's tumor".

1.

The patient is waiting to be operated on by the maxillofacial surgery service of a bilateral multifocal Warthin tumor.

A 79-year-old male presented with obesity, hypertension, type 2 diabetes mellitus, ischemic heart disease, AF, chronic obstructive pulmonary disease (COPD) and sleep apnea syndrome.

She came to the Primary Care clinic for dizziness with sensation of spinning objects, especially when lying down.

cough increased

She had no loss of consciousness, chest pain, vomiting or cold sweating.

Usually, the patient is treated with amyloidosis, repaglinide, nitroglycerin (parches), acenocoumarol, atorvastatin, atenthelinide, acetylcholine, isophanesome,

Physical examination revealed the presence of arrhythmia on cardiac auscultation, with slow, extinguished, and no murmurs.

Radial pulses are present and symmetrical.

Pulmonary auscultation revealed generalized hypoventilation, without excessive sounds.

The neurological examination is rigorously normal.

She had edema with fovea on her knees and signs of chronic venous insufficiency in her lower limbs.

With pulse oximeter we detected a heart rate of 30 beats per minute (lpm) and oxygen saturation of 90 %.

Patient's clinical features (mare with sensation of spinning objects without other added symptoms) and heart rate detected was decided to perform ECG.

1.

After assessing the ECG, and given the patient's personal history (HTN, ischemic heart disease), we compared the recording obtained with a previous ECG, performed three years ago during hospitalization for an episode of exacerbation of COPD.

1.

When comparing both recordings to the hospital electrodes, it was found that bradycardia did not appear and that the QRS complexes now seem rhythmic, but P waves were not observed, so the patient was clinically diagnosed.

With the suspected diagnosis of slow AF, negative chronotrope treatment is withdrawn, without improvement.

Given the lack of response to this measure, admission to Cardiology was decided.

After a complete study, the definitive diagnosis of AF with advanced atrioventricular block and grade III right bundle branch block was reached, which led to the decision of permanent symptomatic implantation.

The patient evolved favorably: the symptoms disappeared and the heart rate was controlled.

This is a 57-year-old patient with a history of ductal carcinoma of the left breast diagnosed in 1999 and ductal carcinoma in situ of the right breast in 2002, with no data of recurrence since then, working as a hospital worker.

The patient has never smoked, but both have a floor of 65 meters square with her husband, a smoker of 30 cigarettes per day also smokers (black age), with whom she has lived for 35 years, her son and daughter,

The child is a smoker of 20 cigarettes a day, with whom he has lived 31 years; and the daughter is a smoker of 10 cigarettes a day, with whom he has lived 25 years.

They all smoked on the floor, none went to the verandah to smoke.

He consulted for frank hematuria related to mechanical low back pain.

The physical examination did not show relevant data, and there was no mass in the renal fossae.

Urocultive examination, ultrasound and laboratory tests were performed.

Blood tests were normal except for proteinuria, and the urine culture was negative.

Ultrasound was reported as "no significant changes except mild ectasia in the upper right quadrant".

We decided that in case of hematuria with positive proteinuria (confirmed in 24-hour urine), we sent him to the Nephrology service to complete study and follow-up.

A second ultrasound was performed, resulting in the same conclusion as the first (performed 6 months apart), as well as an intravenous urography where right foot and ureteral dilation are visualized.

Computed Tomography (CT) showed the same findings, with no obstructive cause justifying this dilation.

In the third ultrasound (months later) echogenic content is visualized in the footlocalization system producing right intrafusal kidney. For this reason a TC was again requested, where an image with a density of the superior renal soft tissues was found.

The lesion captures and is compatible with transitional cell carcinoma in the right collecting system, upper infundibulum and part of the renal pelvis.

Urine cytology was positive.

The patient underwent right laparoscopic nephrectomy and nephrectomy.

1.

Pathology confirmed transitional cell carcinoma of the renal pelvis, with foci of mucinous carcinoma that affects the pelvis, parenchyma and respects ureteral borders, theoretical stage pT3.

Almost two years later, chest CT confirmed space occupying lesions in the liver compatible with liver and bone metastases.

A 7-year-old girl with no history of interest referred from her primary care center because of a painful pruriginous lesion in the right cheek that had not improved after oral treatment with amoxicillin/clavulanic acid for two weeks.

On examination, the right cheek showed a cold, erythematous, violet nodule blaming the tattoo, well-defined 1.5 cm in diameter.

No regional adenomegaly was observed, although there was mild keratosis pilaris on the skin of the cheeks.

1.

Having established the clinical suspicion of IFAG and informed parents about the benignity of the process, they agreed not to perform a skin biopsy and to schedule periodic follow-up, along with metronidazole gel therapy at night.

Two weeks later there was spontaneous drainage of a blood-purulent material from the center of the lesion, with subsequent progressive resolution of the nodule within about 6 weeks.

Cultures for bacteria, mycobacteria from the drainage exudate were negative.

However, after resolution of the nodular lesion, persistent telangiectasias in the affected area have slowly decreased over the 10-month follow-up period.

We advise revisions to the patient until the complete resolution of the process and warn about the need to consult before the appearance of symptoms or clinical signs suggestive of ocular rosacea (dryness, visual acuity or redness).

A 59-year-old patient complained of difficulty sleeping for about a month.

He has weakness and pain in the lower limbs, which improves after stopping, sometimes accompanied by non-irradiated low back pain.

He has noticed changes in voice, which is more dysphonic, related to his work.

In the directed anamnesis, he did not report weakness in the hands or upper extremities.

There is no ocular, sphincter control or sensory disorder.

Emotional lability is not observed, although the patient already had an adaptive disorder after the death of his wife.

Located in twins.

His personal history included hypertension and type 2 diabetes.

Family history: deceased uncle with a diagnosis of amyotrophic lateral sclerosis (ALS).

Neurological examination revealed hypophonic, facial centered speech.

Internal and external ocular mobility was normal.

Lingual fasciculations.

No cervical weakness.

Motor: lower limbs (LLII): paraparesis with proximal predominance 4/5.

Dorsiflexion of both feet 5/5.

No weakness in the upper limbs was observed.

No sensory deficit.

Osteotendinous osteotendinous reflex (OTT) +++/+++ with bilateral positive Hoffmann and indifferent right cutaneous-plantar reflex, preserved left.

Fasciculations in deltoid, pectoral and diffusely in the lower limbs.

Muscular atrophy in both quadriceps.

General anodine.

An ankle-brachial index (ABI) was performed: right 1.18; left 1.29.

Laboratory tests were requested, highlighting CK 232, immunological study and normal serology.

Chest and lumbosacral radiography were normal.

After suspicion of motor neuron disease, the Internal Medicine Department was consulted, requesting electromyography (EMG) / electroneurography (ENG) suggestive of neurogenic pattern with positive right upper limb denervation.

These results led to Neurology.

After evaluation of the patient and diagnosis of probable ALS, according to the revised criteria of El Escorial, and pending completion of the study with cranial-medullary magnetic resonance imaging and new neurolophysiological study Riluzole treatment was initiated 12 hours.

Due to the clinical evolution of the patient with proximal paraparesis in the lower limbs, with significant muscular disorder of both thighs, dysphagia for solids, without involvement in upper limbs (MMSS) and correlated with last possible neurophysiological study.

The EMG suggests myopathy with bulbar and pelvic girdle involvement (myopathy by inclusion bodies), so muscle biopsy was performed, the results of the same being conclusive and secondary changes, discarding the possibility of voiding.

The patient subsequently developed symptoms, progressing weakness in the dorsal flexion of the left foot (4/5).

Early atrophy in the fifth interosseous space of the left hand.

Diffuse fasciculations by different body segments, as well as mild aphonia.

Finally, the diagnosis of probable ALS motor neuron disease is suggested.

Treatment with 50 mg Riluzole was continued. Physical and respiratory home rehabilitation was recommended as soon as possible.

Five months after the definitive diagnosis, the patient developed septic shock of urinary origin and subsequent complications, requiring invasive mechanical ventilation (tracheotomy), percutaneous gastrostomy feeding (PEG) and secondary adaptive disorder, being discharged

Two months later he died.

This is a 46-year-old male patient with no history of interest, who comes to consultation for sudden loss of strength in the lower limbs.

This picture is repeatedly and episodic, self-limiting in a few hours.

It usually affects the lower limbs, but can do so in a generalized way.

She suffered previous episodes that increased in frequency and intensity in the last year.

During the directed interview, the patient reported loss of 20 kilos in the last four months, with no decrease in intake, occasional tremor, irritability and nervousness.