chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dry eye, Eye ulcer, Full blood count normal, Optic neuropathy, Scar
Clinical narrative: On 02/15/2023 I contacted my Physician for what I thought was Pink Eye. I was told to come into the office for an eye exam and was told that I had an ulcer in both eyes. I was given antibiotic eye drops. However I had an allergic reaction to the antibiotics as I am allergic to CIPRO drugs. I was also diagnosed Neuropathy of the eye. The Ulcers have left scars but are not affecting my vision. I have had dry eyes prior to this episode. My Dr. also suggested that I may have an autoimmune disease that may be affecting my eyes.
Age: 79.0
Sex: F
Vaccine: COVID19
Symptoms: Unevaluable event
Clinical narrative: Reported by patient that vaccine was given by outside source from a pharmacy.
Age: 77.0
Sex: F
Vaccine: COVID19-2
Symptoms: Back pain, Blood test abnormal, Gait disturbance, Inflammatory marker increased, Muscle strain
Clinical narrative: I was cleaning my oven on March 19, 2023, in the morning, around 2:30PM I got up in from my chair and had the worst pain in my back. I made and appointment with my doctor but could not get in to see her until Tuesday March 21, 2023. She ran bloodwork that did show that I had an UTI infection but did prescribe medication. I took the medication, but it did not help at all. By Thursday, March 23, 2023, I went to the emergency to find out if I had a kidney stones. They did an ultrasound and found that I did not have a kidney stone or kidney obstruction. He felt I may have a muscle strain and sent me home. I had to go through the weekend in pain. On Monday I went to my physical therapy appointment. I described what my pain was, they told me it was my SI joint. They were able to put my joint back in place, I woke up on Tuesday able to walk like a new person.
Age: 77.0
Sex: F
Vaccine: COVID19-2
Symptoms: Sacral pain, Ultrasound kidney normal, Urinary tract infection
Clinical narrative: I was cleaning my oven on March 19, 2023, in the morning, around 2:30PM I got up in from my chair and had the worst pain in my back. I made and appointment with my doctor but could not get in to see her until Tuesday March 21, 2023. She ran bloodwork that did show that I had an UTI infection but did prescribe medication. I took the medication, but it did not help at all. By Thursday, March 23, 2023, I went to the emergency to find out if I had a kidney stones. They did an ultrasound and found that I did not have a kidney stone or kidney obstruction. He felt I may have a muscle strain and sent me home. I had to go through the weekend in pain. On Monday I went to my physical therapy appointment. I described what my pain was, they told me it was my SI joint. They were able to put my joint back in place, I woke up on Tuesday able to walk like a new person.
Age: 78.0
Sex: F
Vaccine: VARZOS
Symptoms: Chills, Lethargy, Muscle twitching, Myalgia, Pyrexia
Clinical narrative: Patient reports being lethargic, with chills and a "parkinson's like" shiver that was unrelated to the chills she experienced. She reported having muscle aches for 2 days following vaccination in her back and arms. She also experienced arm 'twitching'. Patient states she had a mild fever but no nasal activity (runny nose, etc.), lungs felt fine, no cough. Patient also reports she hasn't been sick in a while.
Age: 78.0
Sex: F
Vaccine: VARZOS
Symptoms: Rhinorrhoea
Clinical narrative: Patient reports being lethargic, with chills and a "parkinson's like" shiver that was unrelated to the chills she experienced. She reported having muscle aches for 2 days following vaccination in her back and arms. She also experienced arm 'twitching'. Patient states she had a mild fever but no nasal activity (runny nose, etc.), lungs felt fine, no cough. Patient also reports she hasn't been sick in a while.
Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Tinnitus
Clinical narrative: tinnitus, buzzing  in ear, not constant, but frequent After the next booster on 9/12/22, same location, Moderna lot AS71443, intramuscular, left arm. the tinnitus became constant and at times is louder than others, and difficult to ignore
Age: 1.17
Sex: M
Vaccine: DTAPHEPBIP, HIBV, PNC13, RV1
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Adverse administration of a vaccine which was not indicated. Accidentally given a dose of Rotarix despite not indicated at this age.
Age: 90.0
Sex: F
Vaccine: COVID19
Symptoms: Hypothyroidism, Hypoxia, Periarthritis
Clinical narrative: HYPOXIA 1/12/2022 ADHESIVE CAPSULITIS OF RIGHT SHOULDER  HYPOXIA 1/12/2022 HYPOTHYROIDISM
Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Cough, SARS-CoV-2 test positive
Clinical narrative: This is a 79-year-old male who presented from home with weakness and cough; found to be COVID-19 positive. He was placed on remdesivir and Decadron; he fared well during this hospital stay. Will be discharged on Decadron. He will wean off O2 while at SNF; today only requiring 1 L. Was placed on small dose Lantus while on steroid.   Comments/Problems to be Addressed after Discharge Wean off O2 at SNF
Age: 28.0
Sex: F
Vaccine: TDAP
Symptoms: Pain in extremity, Tendonitis
Clinical narrative: patient stated severe arm pain started 4 hours after the vaccine tendonitis feeling patient was seen in followup  app't on March 30, 2023 with Dr.
Age: 62.0
Sex: F
Vaccine: COVID19-2, FLUR4
Symptoms: Biopsy breast, Breast cancer female, Mammogram abnormal
Clinical narrative: I did not have any symptoms but I was made aware of diagnosis of breast cancer following my mammogram.
Age: 11.0
Sex: F
Vaccine: MNQ, TDAP
Symptoms: Dizziness, Fall, Loss of consciousness, Syncope
Clinical narrative: MCV-4 (MenQuadfi) and Tdap were given at 11:30AM. About 5 minutes later she felt dizzy and then fainted and fell. She regained consciousness within one minute. BP checked at 11:36AM showed 77/57 and PR 65. She was awake and no cold sweat. Another BP taken at 11:40AM showed 90/72 and PR 69. She was comfortable then. Another check on 11:56AM showed BP 96/81 and PR 89. She was then discharged home in good condition.
Age: 76.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Brain fog, COVID-19, Chills, Dizziness, Lethargy
Clinical narrative: Had a fever, chills, brain fog and lethargy. Took home COVID-19 test and was positive. Rested and felt better 5 days later. Started having dizzy spells and lasting brain fog.
Age: 76.0
Sex: M
Vaccine: COVID19-2, FLU4
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Had a fever, chills, brain fog and lethargy. Took home COVID-19 test and was positive. Rested and felt better 5 days later. Started having dizzy spells and lasting brain fog.
Age: 59.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Adverse event, Aphonia, Fatigue, Influenza virus test negative, Oropharyngeal pain
Clinical narrative: My adverse event started on 02/14/2023 in the morning. I had sore throat, exhaustion, dry mucus, and I  couldn't sleep. I lost my voice for few hours.  On  the 02/16/2023 I took 2 COVID-19 tests which were negative. I went to my doctor's office  on 02/17/2023 . My doctor gave me all kinds of tests such as RSV, STREP, FLU and COVID-19,  which were all  negative. My doctor said I don't need any medication . She advised me to drink fluids that has glucose and take rest. I recovered from the known virus without medication.
Age: 59.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Respiratory syncytial virus test negative, SARS-CoV-2 test negative, Secretion discharge, Sleep disorder, Streptococcus test negative
Clinical narrative: My adverse event started on 02/14/2023 in the morning. I had sore throat, exhaustion, dry mucus, and I  couldn't sleep. I lost my voice for few hours.  On  the 02/16/2023 I took 2 COVID-19 tests which were negative. I went to my doctor's office  on 02/17/2023 . My doctor gave me all kinds of tests such as RSV, STREP, FLU and COVID-19,  which were all  negative. My doctor said I don't need any medication . She advised me to drink fluids that has glucose and take rest. I recovered from the known virus without medication.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Chronic respiratory failure, Respiratory failure
Clinical narrative: CHRONIC HYPOXEMIC RESPIRATORY FAILURE 9/3/2021  HYPOXIA 7/15/2021  CHRONIC HYPOXEMIC RESPIRATORY FAILURE 9/3/2021  HYPOXIA 7/15/2021
Age: 88.0
Sex: F
Vaccine: COVID19-2
Symptoms: Acute respiratory failure, Asthenia, COVID-19, Chest X-ray normal, Emphysema
Clinical narrative: Patient is a 89 y.o. female patient of, MD with a history of chronic respiratory failure admitted for COVID-19 infection with acute on chronic respiratory failure patient was treated with IV remdesivir and steroids patient's condition improved patient was too weak to return back to her assisted living facility hence patient was discharged to facility for physical therapy.   Discharge Diagnoses: * COVID-19 virus infection Assessment & Plan Patient has constitutional symptoms and requiring more oxygen than usual   Chest x-ray no pneumonia   Inflammatory markers improving   ID consult appreciated patient is on antiviral medication now   Acute on chronic respiratory failure with hypoxia   Assessment & Plan Due to COVID-19 infection and underlying emphysema   Elevated troponin Assessment & Plan Probably type II MI patient has no chest pain.  Delta troponin negative   Panlobular emphysema   Assessment & Plan .   Hypokalemia Assessment & Plan Potassium replacement ordered   Insomnia Assessment & Plan .   History of pulmonary embolism Assessment & Plan On long-term anticoagulation
Age: 88.0
Sex: F
Vaccine: COVID19-2
Symptoms: Hypokalaemia, Inflammatory marker test, Insomnia, Malaise, Respiratory failure
Clinical narrative: Patient is a 89 y.o. female patient of, MD with a history of chronic respiratory failure admitted for COVID-19 infection with acute on chronic respiratory failure patient was treated with IV remdesivir and steroids patient's condition improved patient was too weak to return back to her assisted living facility hence patient was discharged to facility for physical therapy.   Discharge Diagnoses: * COVID-19 virus infection Assessment & Plan Patient has constitutional symptoms and requiring more oxygen than usual   Chest x-ray no pneumonia   Inflammatory markers improving   ID consult appreciated patient is on antiviral medication now   Acute on chronic respiratory failure with hypoxia   Assessment & Plan Due to COVID-19 infection and underlying emphysema   Elevated troponin Assessment & Plan Probably type II MI patient has no chest pain.  Delta troponin negative   Panlobular emphysema   Assessment & Plan .   Hypokalemia Assessment & Plan Potassium replacement ordered   Insomnia Assessment & Plan .   History of pulmonary embolism Assessment & Plan On long-term anticoagulation
Age: 88.0
Sex: F
Vaccine: COVID19-2
Symptoms: Troponin increased
Clinical narrative: Patient is a 89 y.o. female patient of, MD with a history of chronic respiratory failure admitted for COVID-19 infection with acute on chronic respiratory failure patient was treated with IV remdesivir and steroids patient's condition improved patient was too weak to return back to her assisted living facility hence patient was discharged to facility for physical therapy.   Discharge Diagnoses: * COVID-19 virus infection Assessment & Plan Patient has constitutional symptoms and requiring more oxygen than usual   Chest x-ray no pneumonia   Inflammatory markers improving   ID consult appreciated patient is on antiviral medication now   Acute on chronic respiratory failure with hypoxia   Assessment & Plan Due to COVID-19 infection and underlying emphysema   Elevated troponin Assessment & Plan Probably type II MI patient has no chest pain.  Delta troponin negative   Panlobular emphysema   Assessment & Plan .   Hypokalemia Assessment & Plan Potassium replacement ordered   Insomnia Assessment & Plan .   History of pulmonary embolism Assessment & Plan On long-term anticoagulation
Age: 13.0
Sex: M
Vaccine: TDAP
Symptoms: Diarrhoea, Fatigue, Nausea, Pyrexia, Vomiting
Clinical narrative: Nausea, vomiting, diarrhea.  Fever, fatigue.  Twin brother had same vaccine on same day and had same side effects.
Age: 5.0
Sex: F
Vaccine: DTAPIPV, PNC13
Symptoms: Erythema, Localised oedema, Pain
Clinical narrative: localized erythema, edema, pain
Age: 34.0
Sex: F
Vaccine: FLU4
Symptoms: Extra dose administered, Vaccination error
Clinical narrative: Pt received second dose of fluarix vaccine on 3/28/23 in error. Pt had previously received fluarix dose on 10/13/22.
Age: 63.0
Sex: F
Vaccine: VARZOS
Symptoms: Injection site erythema, Injection site rash
Clinical narrative: Redness /rash in a line around injection site- taking benadryl
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Fatigue, Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion
Clinical narrative: On 02/13/2023 I tested positive for COVID-19 and experienced congestion, sore throat and fatigue. I contacted provider and was prescribed Paxlovid. I completed full 5 days of treatment and tested negative for COVID-19 on 02/18/2023. Tested again for COVID-19 on 02/24/2023 and it was negative. I also had a head cold on 03/25/2023 and I ended up in the emergency room on 03/29/2023. Still recovering at the moment.
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive
Clinical narrative: On 02/13/2023 I tested positive for COVID-19 and experienced congestion, sore throat and fatigue. I contacted provider and was prescribed Paxlovid. I completed full 5 days of treatment and tested negative for COVID-19 on 02/18/2023. Tested again for COVID-19 on 02/24/2023 and it was negative. I also had a head cold on 03/25/2023 and I ended up in the emergency room on 03/29/2023. Still recovering at the moment.
Age: 60.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Back pain, COVID-19, Cough, Headache, Nasal congestion
Clinical narrative: Tested positive for COVID-19 on 03/06/23 I had a mild headache, scratchy throat, coughing with nasal congestion and upper back pain. I went into the ER and was given a back xray because of the pain. I was prescribed :Nasal Spray; Prednisone 50 mgs x five days; Solutate; cepacol lozenge and OTC Tylenol for headache and back pain. I was not prescribed Paxlovid.
Age: 60.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: SARS-CoV-2 test positive, Spinal X-ray normal, Throat irritation
Clinical narrative: Tested positive for COVID-19 on 03/06/23 I had a mild headache, scratchy throat, coughing with nasal congestion and upper back pain. I went into the ER and was given a back xray because of the pain. I was prescribed :Nasal Spray; Prednisone 50 mgs x five days; Solutate; cepacol lozenge and OTC Tylenol for headache and back pain. I was not prescribed Paxlovid.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Blood thyroid stimulating hormone, Echocardiogram, Electrocardiogram abnormal, Electrocardiogram ambulatory abnormal, Full blood count
Clinical narrative: Strong heart Palpitations.  PVCs and PACs found later on holster monitor.  Started with only a few waking me at night.  Became more frequent and consistent over time.  Still occurring today all day long now.
Age: 37.0
Sex: F
Vaccine: COVID19
Symptoms: Lipids, Metabolic function test, Palpitations, Supraventricular extrasystoles, Ventricular extrasystoles
Clinical narrative: Strong heart Palpitations.  PVCs and PACs found later on holster monitor.  Started with only a few waking me at night.  Became more frequent and consistent over time.  Still occurring today all day long now.
Age: 11.0
Sex: M
Vaccine: COVID19-2
Symptoms: Incorrect dose administered, No adverse event, Product preparation issue
Clinical narrative: Vaccine Administration Error ONLY  - 5-11yr Bivalent booster administered without diluent in vial - NO adverse effects observed or reported
Age: 68.0
Sex: F
Vaccine: COVID19-2
Symptoms: Blood pressure increased, Dyspnoea, Dyspnoea exertional, Laboratory test normal
Clinical narrative: I have been exercising for a year regularly and recently I started having trouble breathing while working out. I even have problems breathing just walking down the block. When I am doing regular daily activities my blood pressure would go up to 140/80, which is not normal for me. I went to the cardiologist to run some test which were normal. I am going to the doctor for a visit to run test.
Age: 73.0
Sex: M
Vaccine: COVID19-2
Symptoms: Cough, Pyrexia
Clinical narrative: I had a cough and a fever which went up to 101.5 and that was all. I recovered after about 5 days.
Age: 37.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Herpes zoster, Malaise, Rash
Clinical narrative: After my second dose of the Pfizer Covid-19 Vaccine (Lots: ER8736/EW0185) I had an outbreak of what was diagnosed as shingles.  At teh time I was 37 and healthy, but I flew commercially and was feeling run down about 3 months after the second dose.  This was the first time I had been feeling fatigued and this was the first time I had felt ill in about a year or more.  I have never had never had covid.  On Spetember 15 2021 I landed from a commercial flight and had a severe rash on one side of my body.  I went to an urgent care facility and was diagnosed with shingles.  I was prescribed Valacyclovir HCL and this cleared the shingles in about a week.  I have had continued skin outbreaks on my neck and back that are of unknown relation since having shingles.
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: COVID-19, Cough, Fatigue, Headache, Oropharyngeal pain
Clinical narrative: On Friday, I had a sore throat and a bit of a headache. I had an overall felling of being very tired. That night I had a cough and a low grade fever. I then got a terrible cough and congestion. My doctor prescribed me a cough suppressant.
Age: 73.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
Clinical narrative: On Friday, I had a sore throat and a bit of a headache. I had an overall felling of being very tired. That night I had a cough and a low grade fever. I then got a terrible cough and congestion. My doctor prescribed me a cough suppressant.
Age: 76.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Cardiac disorder, Cardiac failure congestive, Chest X-ray abnormal, Chest discomfort, Condition aggravated
Clinical narrative: I have a heart condition and I was starting to feel tightness in my chest and a cough that sounds like a goose. I had gained 12 pounds in 2 days. It was confirmed I was in congestive heart failure. I was given LASIX to reduce fluid. I was released after about 6 hours. Today I had an Echocardiogram.
Age: 76.0
Sex: F
Vaccine: COVID19-2, FLU4
Symptoms: Cough, Echocardiogram, Electrocardiogram, Weight increased
Clinical narrative: I have a heart condition and I was starting to feel tightness in my chest and a cough that sounds like a goose. I had gained 12 pounds in 2 days. It was confirmed I was in congestive heart failure. I was given LASIX to reduce fluid. I was released after about 6 hours. Today I had an Echocardiogram.
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Back pain, Blood creatinine increased, Blood glucose increased
Clinical narrative: 76 y.o. female patient with history of osteoarthritis, sciatica. Presents with acute on chronic lower back pain. Found to be Covid positive on admission. Required NC O2, but likely due to CHF exacerbation and chronic underlying respiratory failure and less so actual covid infection. Required home O2 on discharge.    Acute on Chronic Respiratory Failure Hypercapnic with metabolic acidosis, likely 2/2 chronic respiratory failure contributed to by possible CHF exacerbation from Covid infection given pulmonary edema on CXR  May also have some contribution from possible OHS/OSA  Requiring 1L NC during stay Qualified for home O2 Recommend Sleep study as outpatient Consider PFT's outpatient    Covid Afebrile, VSS otherwise ID consulted - remdesivir and steroids Remdesivir discontinued due to AKI as below Stopped steroid course upon discharge as will only further increase her blood sugar levels    AKI on CKD, improved Cr 2.07 (b/l 2-2.37) on admission 2/2 remdesivir, discontinued   AKI improved upon discharge    Chronic HFpEF  BNP of 4725 on admission  TTE 3/2021 with EF 69%, grade I diastolic dysfunction CXR with pulmonary edema that improved with diuresis during stay  Can continue home lasix on discharge   Acute on chronic back pain Worsening chronic back pain refractory to home regimen- 3/3 Pain well controled Admission CT lumbar spine: multilevel degeneration, central spinal stenosis, no acute fractures or trauma noted  MRI 3/26/21: severe central spinal canal stenosis/narrowing L2-S1 MRI 2/25/23: severe DDD, marked disc bulge L5-S1 with disc protrusion and osteophytes deviated superiorly, thecal sac 7 mm at L5-S1 but only 5.4 mm at L4-L5 Home pain regimen: ASA, gabapentin Pain: tylenol, ASA, flexeril TID prn, lidocaine patches, oxy 5mg PRN q6H C/s neurosurgery, PMR- no acute intervention Consider PMR f/u outpatient    DMT2 Neuropathy  Glucose at goal, last A1c 4.9 Home regimen: lantus 15U daily Held insulin on admission given stable BG However, elevation of BG day of DC due steroid use; 10u lispro given prior to DC Given A1c 4.9 and stopping steroids on discharge, will discontinue home lantus regimen on discharge    Dysphagia Patient reports dysphagia recently when trying to swallow some of her pills, no other related symptoms Passed bedside swallow Monitored    Microcytic Anemia Admission Hgb 8.7 (b/l 8-10), MCV 76.9, Hgb now stable in 7s Likely 2/2 CKD  Fe 28, TIBC 138, ferritin 474 Administered IV iron per KDIGO guidelines Resumed oral iron at discharge   Hypertension Chronic, remains elevated, likely contributed to by pain Home meds: amlodipine continued Home carvedilol 25 mg nightly held briefly for bradycardia Resumed carvedilol at 12.5 mg BID     Lymphedema Chronic, at baseline Continued Home regimen: lasix 20 mg daily  Concern for OSA/OHS Required 1L NC as above  Recommend Sleep Study outpatient
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Blood iron, Blood pressure increased, Bradycardia, Brain natriuretic peptide increased, COVID-19
Clinical narrative: 76 y.o. female patient with history of osteoarthritis, sciatica. Presents with acute on chronic lower back pain. Found to be Covid positive on admission. Required NC O2, but likely due to CHF exacerbation and chronic underlying respiratory failure and less so actual covid infection. Required home O2 on discharge.    Acute on Chronic Respiratory Failure Hypercapnic with metabolic acidosis, likely 2/2 chronic respiratory failure contributed to by possible CHF exacerbation from Covid infection given pulmonary edema on CXR  May also have some contribution from possible OHS/OSA  Requiring 1L NC during stay Qualified for home O2 Recommend Sleep study as outpatient Consider PFT's outpatient    Covid Afebrile, VSS otherwise ID consulted - remdesivir and steroids Remdesivir discontinued due to AKI as below Stopped steroid course upon discharge as will only further increase her blood sugar levels    AKI on CKD, improved Cr 2.07 (b/l 2-2.37) on admission 2/2 remdesivir, discontinued   AKI improved upon discharge    Chronic HFpEF  BNP of 4725 on admission  TTE 3/2021 with EF 69%, grade I diastolic dysfunction CXR with pulmonary edema that improved with diuresis during stay  Can continue home lasix on discharge   Acute on chronic back pain Worsening chronic back pain refractory to home regimen- 3/3 Pain well controled Admission CT lumbar spine: multilevel degeneration, central spinal stenosis, no acute fractures or trauma noted  MRI 3/26/21: severe central spinal canal stenosis/narrowing L2-S1 MRI 2/25/23: severe DDD, marked disc bulge L5-S1 with disc protrusion and osteophytes deviated superiorly, thecal sac 7 mm at L5-S1 but only 5.4 mm at L4-L5 Home pain regimen: ASA, gabapentin Pain: tylenol, ASA, flexeril TID prn, lidocaine patches, oxy 5mg PRN q6H C/s neurosurgery, PMR- no acute intervention Consider PMR f/u outpatient    DMT2 Neuropathy  Glucose at goal, last A1c 4.9 Home regimen: lantus 15U daily Held insulin on admission given stable BG However, elevation of BG day of DC due steroid use; 10u lispro given prior to DC Given A1c 4.9 and stopping steroids on discharge, will discontinue home lantus regimen on discharge    Dysphagia Patient reports dysphagia recently when trying to swallow some of her pills, no other related symptoms Passed bedside swallow Monitored    Microcytic Anemia Admission Hgb 8.7 (b/l 8-10), MCV 76.9, Hgb now stable in 7s Likely 2/2 CKD  Fe 28, TIBC 138, ferritin 474 Administered IV iron per KDIGO guidelines Resumed oral iron at discharge   Hypertension Chronic, remains elevated, likely contributed to by pain Home meds: amlodipine continued Home carvedilol 25 mg nightly held briefly for bradycardia Resumed carvedilol at 12.5 mg BID     Lymphedema Chronic, at baseline Continued Home regimen: lasix 20 mg daily  Concern for OSA/OHS Required 1L NC as above  Recommend Sleep Study outpatient
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac failure, Cardiac failure congestive, Chest X-ray abnormal, Chronic kidney disease, Chronic respiratory failure
Clinical narrative: 76 y.o. female patient with history of osteoarthritis, sciatica. Presents with acute on chronic lower back pain. Found to be Covid positive on admission. Required NC O2, but likely due to CHF exacerbation and chronic underlying respiratory failure and less so actual covid infection. Required home O2 on discharge.    Acute on Chronic Respiratory Failure Hypercapnic with metabolic acidosis, likely 2/2 chronic respiratory failure contributed to by possible CHF exacerbation from Covid infection given pulmonary edema on CXR  May also have some contribution from possible OHS/OSA  Requiring 1L NC during stay Qualified for home O2 Recommend Sleep study as outpatient Consider PFT's outpatient    Covid Afebrile, VSS otherwise ID consulted - remdesivir and steroids Remdesivir discontinued due to AKI as below Stopped steroid course upon discharge as will only further increase her blood sugar levels    AKI on CKD, improved Cr 2.07 (b/l 2-2.37) on admission 2/2 remdesivir, discontinued   AKI improved upon discharge    Chronic HFpEF  BNP of 4725 on admission  TTE 3/2021 with EF 69%, grade I diastolic dysfunction CXR with pulmonary edema that improved with diuresis during stay  Can continue home lasix on discharge   Acute on chronic back pain Worsening chronic back pain refractory to home regimen- 3/3 Pain well controled Admission CT lumbar spine: multilevel degeneration, central spinal stenosis, no acute fractures or trauma noted  MRI 3/26/21: severe central spinal canal stenosis/narrowing L2-S1 MRI 2/25/23: severe DDD, marked disc bulge L5-S1 with disc protrusion and osteophytes deviated superiorly, thecal sac 7 mm at L5-S1 but only 5.4 mm at L4-L5 Home pain regimen: ASA, gabapentin Pain: tylenol, ASA, flexeril TID prn, lidocaine patches, oxy 5mg PRN q6H C/s neurosurgery, PMR- no acute intervention Consider PMR f/u outpatient    DMT2 Neuropathy  Glucose at goal, last A1c 4.9 Home regimen: lantus 15U daily Held insulin on admission given stable BG However, elevation of BG day of DC due steroid use; 10u lispro given prior to DC Given A1c 4.9 and stopping steroids on discharge, will discontinue home lantus regimen on discharge    Dysphagia Patient reports dysphagia recently when trying to swallow some of her pills, no other related symptoms Passed bedside swallow Monitored    Microcytic Anemia Admission Hgb 8.7 (b/l 8-10), MCV 76.9, Hgb now stable in 7s Likely 2/2 CKD  Fe 28, TIBC 138, ferritin 474 Administered IV iron per KDIGO guidelines Resumed oral iron at discharge   Hypertension Chronic, remains elevated, likely contributed to by pain Home meds: amlodipine continued Home carvedilol 25 mg nightly held briefly for bradycardia Resumed carvedilol at 12.5 mg BID     Lymphedema Chronic, at baseline Continued Home regimen: lasix 20 mg daily  Concern for OSA/OHS Required 1L NC as above  Recommend Sleep Study outpatient
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram spine, Condition aggravated, Diuretic therapy, Dysphagia, Glycosylated haemoglobin normal
Clinical narrative: 76 y.o. female patient with history of osteoarthritis, sciatica. Presents with acute on chronic lower back pain. Found to be Covid positive on admission. Required NC O2, but likely due to CHF exacerbation and chronic underlying respiratory failure and less so actual covid infection. Required home O2 on discharge.    Acute on Chronic Respiratory Failure Hypercapnic with metabolic acidosis, likely 2/2 chronic respiratory failure contributed to by possible CHF exacerbation from Covid infection given pulmonary edema on CXR  May also have some contribution from possible OHS/OSA  Requiring 1L NC during stay Qualified for home O2 Recommend Sleep study as outpatient Consider PFT's outpatient    Covid Afebrile, VSS otherwise ID consulted - remdesivir and steroids Remdesivir discontinued due to AKI as below Stopped steroid course upon discharge as will only further increase her blood sugar levels    AKI on CKD, improved Cr 2.07 (b/l 2-2.37) on admission 2/2 remdesivir, discontinued   AKI improved upon discharge    Chronic HFpEF  BNP of 4725 on admission  TTE 3/2021 with EF 69%, grade I diastolic dysfunction CXR with pulmonary edema that improved with diuresis during stay  Can continue home lasix on discharge   Acute on chronic back pain Worsening chronic back pain refractory to home regimen- 3/3 Pain well controled Admission CT lumbar spine: multilevel degeneration, central spinal stenosis, no acute fractures or trauma noted  MRI 3/26/21: severe central spinal canal stenosis/narrowing L2-S1 MRI 2/25/23: severe DDD, marked disc bulge L5-S1 with disc protrusion and osteophytes deviated superiorly, thecal sac 7 mm at L5-S1 but only 5.4 mm at L4-L5 Home pain regimen: ASA, gabapentin Pain: tylenol, ASA, flexeril TID prn, lidocaine patches, oxy 5mg PRN q6H C/s neurosurgery, PMR- no acute intervention Consider PMR f/u outpatient    DMT2 Neuropathy  Glucose at goal, last A1c 4.9 Home regimen: lantus 15U daily Held insulin on admission given stable BG However, elevation of BG day of DC due steroid use; 10u lispro given prior to DC Given A1c 4.9 and stopping steroids on discharge, will discontinue home lantus regimen on discharge    Dysphagia Patient reports dysphagia recently when trying to swallow some of her pills, no other related symptoms Passed bedside swallow Monitored    Microcytic Anemia Admission Hgb 8.7 (b/l 8-10), MCV 76.9, Hgb now stable in 7s Likely 2/2 CKD  Fe 28, TIBC 138, ferritin 474 Administered IV iron per KDIGO guidelines Resumed oral iron at discharge   Hypertension Chronic, remains elevated, likely contributed to by pain Home meds: amlodipine continued Home carvedilol 25 mg nightly held briefly for bradycardia Resumed carvedilol at 12.5 mg BID     Lymphedema Chronic, at baseline Continued Home regimen: lasix 20 mg daily  Concern for OSA/OHS Required 1L NC as above  Recommend Sleep Study outpatient
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Haemoglobin decreased, Hypercapnia, Intervertebral disc degeneration, Intervertebral disc protrusion, Iron binding capacity total
Clinical narrative: 76 y.o. female patient with history of osteoarthritis, sciatica. Presents with acute on chronic lower back pain. Found to be Covid positive on admission. Required NC O2, but likely due to CHF exacerbation and chronic underlying respiratory failure and less so actual covid infection. Required home O2 on discharge.    Acute on Chronic Respiratory Failure Hypercapnic with metabolic acidosis, likely 2/2 chronic respiratory failure contributed to by possible CHF exacerbation from Covid infection given pulmonary edema on CXR  May also have some contribution from possible OHS/OSA  Requiring 1L NC during stay Qualified for home O2 Recommend Sleep study as outpatient Consider PFT's outpatient    Covid Afebrile, VSS otherwise ID consulted - remdesivir and steroids Remdesivir discontinued due to AKI as below Stopped steroid course upon discharge as will only further increase her blood sugar levels    AKI on CKD, improved Cr 2.07 (b/l 2-2.37) on admission 2/2 remdesivir, discontinued   AKI improved upon discharge    Chronic HFpEF  BNP of 4725 on admission  TTE 3/2021 with EF 69%, grade I diastolic dysfunction CXR with pulmonary edema that improved with diuresis during stay  Can continue home lasix on discharge   Acute on chronic back pain Worsening chronic back pain refractory to home regimen- 3/3 Pain well controled Admission CT lumbar spine: multilevel degeneration, central spinal stenosis, no acute fractures or trauma noted  MRI 3/26/21: severe central spinal canal stenosis/narrowing L2-S1 MRI 2/25/23: severe DDD, marked disc bulge L5-S1 with disc protrusion and osteophytes deviated superiorly, thecal sac 7 mm at L5-S1 but only 5.4 mm at L4-L5 Home pain regimen: ASA, gabapentin Pain: tylenol, ASA, flexeril TID prn, lidocaine patches, oxy 5mg PRN q6H C/s neurosurgery, PMR- no acute intervention Consider PMR f/u outpatient    DMT2 Neuropathy  Glucose at goal, last A1c 4.9 Home regimen: lantus 15U daily Held insulin on admission given stable BG However, elevation of BG day of DC due steroid use; 10u lispro given prior to DC Given A1c 4.9 and stopping steroids on discharge, will discontinue home lantus regimen on discharge    Dysphagia Patient reports dysphagia recently when trying to swallow some of her pills, no other related symptoms Passed bedside swallow Monitored    Microcytic Anemia Admission Hgb 8.7 (b/l 8-10), MCV 76.9, Hgb now stable in 7s Likely 2/2 CKD  Fe 28, TIBC 138, ferritin 474 Administered IV iron per KDIGO guidelines Resumed oral iron at discharge   Hypertension Chronic, remains elevated, likely contributed to by pain Home meds: amlodipine continued Home carvedilol 25 mg nightly held briefly for bradycardia Resumed carvedilol at 12.5 mg BID     Lymphedema Chronic, at baseline Continued Home regimen: lasix 20 mg daily  Concern for OSA/OHS Required 1L NC as above  Recommend Sleep Study outpatient
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Lumbar spinal stenosis, Magnetic resonance imaging spinal abnormal, Mean cell volume decreased, Metabolic acidosis, Microcytic anaemia
Clinical narrative: 76 y.o. female patient with history of osteoarthritis, sciatica. Presents with acute on chronic lower back pain. Found to be Covid positive on admission. Required NC O2, but likely due to CHF exacerbation and chronic underlying respiratory failure and less so actual covid infection. Required home O2 on discharge.    Acute on Chronic Respiratory Failure Hypercapnic with metabolic acidosis, likely 2/2 chronic respiratory failure contributed to by possible CHF exacerbation from Covid infection given pulmonary edema on CXR  May also have some contribution from possible OHS/OSA  Requiring 1L NC during stay Qualified for home O2 Recommend Sleep study as outpatient Consider PFT's outpatient    Covid Afebrile, VSS otherwise ID consulted - remdesivir and steroids Remdesivir discontinued due to AKI as below Stopped steroid course upon discharge as will only further increase her blood sugar levels    AKI on CKD, improved Cr 2.07 (b/l 2-2.37) on admission 2/2 remdesivir, discontinued   AKI improved upon discharge    Chronic HFpEF  BNP of 4725 on admission  TTE 3/2021 with EF 69%, grade I diastolic dysfunction CXR with pulmonary edema that improved with diuresis during stay  Can continue home lasix on discharge   Acute on chronic back pain Worsening chronic back pain refractory to home regimen- 3/3 Pain well controled Admission CT lumbar spine: multilevel degeneration, central spinal stenosis, no acute fractures or trauma noted  MRI 3/26/21: severe central spinal canal stenosis/narrowing L2-S1 MRI 2/25/23: severe DDD, marked disc bulge L5-S1 with disc protrusion and osteophytes deviated superiorly, thecal sac 7 mm at L5-S1 but only 5.4 mm at L4-L5 Home pain regimen: ASA, gabapentin Pain: tylenol, ASA, flexeril TID prn, lidocaine patches, oxy 5mg PRN q6H C/s neurosurgery, PMR- no acute intervention Consider PMR f/u outpatient    DMT2 Neuropathy  Glucose at goal, last A1c 4.9 Home regimen: lantus 15U daily Held insulin on admission given stable BG However, elevation of BG day of DC due steroid use; 10u lispro given prior to DC Given A1c 4.9 and stopping steroids on discharge, will discontinue home lantus regimen on discharge    Dysphagia Patient reports dysphagia recently when trying to swallow some of her pills, no other related symptoms Passed bedside swallow Monitored    Microcytic Anemia Admission Hgb 8.7 (b/l 8-10), MCV 76.9, Hgb now stable in 7s Likely 2/2 CKD  Fe 28, TIBC 138, ferritin 474 Administered IV iron per KDIGO guidelines Resumed oral iron at discharge   Hypertension Chronic, remains elevated, likely contributed to by pain Home meds: amlodipine continued Home carvedilol 25 mg nightly held briefly for bradycardia Resumed carvedilol at 12.5 mg BID     Lymphedema Chronic, at baseline Continued Home regimen: lasix 20 mg daily  Concern for OSA/OHS Required 1L NC as above  Recommend Sleep Study outpatient
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pulmonary oedema, SARS-CoV-2 test positive, Serum ferritin increased, Spinal osteoarthritis
Clinical narrative: 76 y.o. female patient with history of osteoarthritis, sciatica. Presents with acute on chronic lower back pain. Found to be Covid positive on admission. Required NC O2, but likely due to CHF exacerbation and chronic underlying respiratory failure and less so actual covid infection. Required home O2 on discharge.    Acute on Chronic Respiratory Failure Hypercapnic with metabolic acidosis, likely 2/2 chronic respiratory failure contributed to by possible CHF exacerbation from Covid infection given pulmonary edema on CXR  May also have some contribution from possible OHS/OSA  Requiring 1L NC during stay Qualified for home O2 Recommend Sleep study as outpatient Consider PFT's outpatient    Covid Afebrile, VSS otherwise ID consulted - remdesivir and steroids Remdesivir discontinued due to AKI as below Stopped steroid course upon discharge as will only further increase her blood sugar levels    AKI on CKD, improved Cr 2.07 (b/l 2-2.37) on admission 2/2 remdesivir, discontinued   AKI improved upon discharge    Chronic HFpEF  BNP of 4725 on admission  TTE 3/2021 with EF 69%, grade I diastolic dysfunction CXR with pulmonary edema that improved with diuresis during stay  Can continue home lasix on discharge   Acute on chronic back pain Worsening chronic back pain refractory to home regimen- 3/3 Pain well controled Admission CT lumbar spine: multilevel degeneration, central spinal stenosis, no acute fractures or trauma noted  MRI 3/26/21: severe central spinal canal stenosis/narrowing L2-S1 MRI 2/25/23: severe DDD, marked disc bulge L5-S1 with disc protrusion and osteophytes deviated superiorly, thecal sac 7 mm at L5-S1 but only 5.4 mm at L4-L5 Home pain regimen: ASA, gabapentin Pain: tylenol, ASA, flexeril TID prn, lidocaine patches, oxy 5mg PRN q6H C/s neurosurgery, PMR- no acute intervention Consider PMR f/u outpatient    DMT2 Neuropathy  Glucose at goal, last A1c 4.9 Home regimen: lantus 15U daily Held insulin on admission given stable BG However, elevation of BG day of DC due steroid use; 10u lispro given prior to DC Given A1c 4.9 and stopping steroids on discharge, will discontinue home lantus regimen on discharge    Dysphagia Patient reports dysphagia recently when trying to swallow some of her pills, no other related symptoms Passed bedside swallow Monitored    Microcytic Anemia Admission Hgb 8.7 (b/l 8-10), MCV 76.9, Hgb now stable in 7s Likely 2/2 CKD  Fe 28, TIBC 138, ferritin 474 Administered IV iron per KDIGO guidelines Resumed oral iron at discharge   Hypertension Chronic, remains elevated, likely contributed to by pain Home meds: amlodipine continued Home carvedilol 25 mg nightly held briefly for bradycardia Resumed carvedilol at 12.5 mg BID     Lymphedema Chronic, at baseline Continued Home regimen: lasix 20 mg daily  Concern for OSA/OHS Required 1L NC as above  Recommend Sleep Study outpatient
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Spinal stenosis, Swallow study, Vertebral osteophyte
Clinical narrative: 76 y.o. female patient with history of osteoarthritis, sciatica. Presents with acute on chronic lower back pain. Found to be Covid positive on admission. Required NC O2, but likely due to CHF exacerbation and chronic underlying respiratory failure and less so actual covid infection. Required home O2 on discharge.    Acute on Chronic Respiratory Failure Hypercapnic with metabolic acidosis, likely 2/2 chronic respiratory failure contributed to by possible CHF exacerbation from Covid infection given pulmonary edema on CXR  May also have some contribution from possible OHS/OSA  Requiring 1L NC during stay Qualified for home O2 Recommend Sleep study as outpatient Consider PFT's outpatient    Covid Afebrile, VSS otherwise ID consulted - remdesivir and steroids Remdesivir discontinued due to AKI as below Stopped steroid course upon discharge as will only further increase her blood sugar levels    AKI on CKD, improved Cr 2.07 (b/l 2-2.37) on admission 2/2 remdesivir, discontinued   AKI improved upon discharge    Chronic HFpEF  BNP of 4725 on admission  TTE 3/2021 with EF 69%, grade I diastolic dysfunction CXR with pulmonary edema that improved with diuresis during stay  Can continue home lasix on discharge   Acute on chronic back pain Worsening chronic back pain refractory to home regimen- 3/3 Pain well controled Admission CT lumbar spine: multilevel degeneration, central spinal stenosis, no acute fractures or trauma noted  MRI 3/26/21: severe central spinal canal stenosis/narrowing L2-S1 MRI 2/25/23: severe DDD, marked disc bulge L5-S1 with disc protrusion and osteophytes deviated superiorly, thecal sac 7 mm at L5-S1 but only 5.4 mm at L4-L5 Home pain regimen: ASA, gabapentin Pain: tylenol, ASA, flexeril TID prn, lidocaine patches, oxy 5mg PRN q6H C/s neurosurgery, PMR- no acute intervention Consider PMR f/u outpatient    DMT2 Neuropathy  Glucose at goal, last A1c 4.9 Home regimen: lantus 15U daily Held insulin on admission given stable BG However, elevation of BG day of DC due steroid use; 10u lispro given prior to DC Given A1c 4.9 and stopping steroids on discharge, will discontinue home lantus regimen on discharge    Dysphagia Patient reports dysphagia recently when trying to swallow some of her pills, no other related symptoms Passed bedside swallow Monitored    Microcytic Anemia Admission Hgb 8.7 (b/l 8-10), MCV 76.9, Hgb now stable in 7s Likely 2/2 CKD  Fe 28, TIBC 138, ferritin 474 Administered IV iron per KDIGO guidelines Resumed oral iron at discharge   Hypertension Chronic, remains elevated, likely contributed to by pain Home meds: amlodipine continued Home carvedilol 25 mg nightly held briefly for bradycardia Resumed carvedilol at 12.5 mg BID     Lymphedema Chronic, at baseline Continued Home regimen: lasix 20 mg daily  Concern for OSA/OHS Required 1L NC as above  Recommend Sleep Study outpatient
Age: 57.0
Sex: M
Vaccine: VARZOS
Symptoms: Erythema, Injection site pain, Injection site swelling, Skin warm
Clinical narrative: Pt called and reported redness, soreness, and swelling of injection area. Pt came in for pharmacist to observe. Gave pt 25mg of Liquid benadryl and compressed ice pack to monitor for 15 minutes. Pt was asked to sit on bench but went shopping and never came back. Instructed pt that if redness spreads and warmness doesn't subside from benadryl and ice pack that to seek medical attention for further treatment. Tried to call pt twice to followup but no answer today 3/31/2023.
Age: 62.0
Sex: F
Vaccine: COVID19-2
Symptoms: Bronchitis, COVID-19, Cough, Malaise, SARS-CoV-2 test positive
Clinical narrative: My COVID-19 symptoms didn't start until after I had bronchitis. I was prescribed azithromycin, albuterol, and prednisone during bronchitis and during COVID-19 as well. My coughing worsened after the COVID-19 diagnosis. The doctor prescribed me an albuterol inhaler which I used four times a day and still use it till this day.
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Arrhythmia, Asthenia, Atrial flutter, Bladder catheter removal
Clinical narrative: Patient is a 87 y.o. male who presented from home on 3/4/2023 after a fall.  He was found to have COVID-19 infection.  Was hypoxemic, initially requiring 5 L of oxygen.  Treated with remdesivir and Decadron.  Oxygen weaned off.  All symptoms of COVID have resolved.  Discharged home.        Assessment and Plan Pneumonia due to COVID-19 -Presented with: cough, sore throat, generalized weakness, confusion -His symptoms started on 3/2/2023 with -He tested positive for COVID-19 on admission on 3/4/2023 -He has been vaccinated and boosted x2 -Initially needed to be placed on 5 L oxygen and then slowly weaned off oxygen.  He has been off oxygen since 3/6 -He was treated with Decadron and remdesivir while in the hospital.  Since he has been off oxygen and doing well, medication stopped on discharge   Acute hypoxemic respiratory failure  -Suspect more related to covid -Initially required 5L NC to maintain sats above 90%, now weaned off oxygen -CXR show moderate bilateral lower lung linear opacities of unclear etiology.     Fall Generalized Weakness -no head trauma or LOC -diffusely weak, likely from above -Seen by PT/OT.  Rehab was recommended but patient wanted to go home.  He refused home health since he says he has helpers who comes every day at home to help.   Arrhythmia -Suspect exac by pneumonia (initial ekg show ?"aflutter", repeat ekg show "sinus rhythm w/PAC's" -He was monitored on telemetry metric which showed PACs.  No evidence of A-fib -EKG repeated again on 3/6 with sinus rhythm and PACs -Has history of SVT status post ablation 1997 -Echo with normal EF -Continue beta-blocker    BPH Urinary retention -BPH noted on outpatient chart review, not on medications -Initially needed placement of Foley catheter which was removed.  Voiding well Hematuria -Suspect due to traumatic foley placement in ER -Now resolved
Age: 86.0
Sex: M
Vaccine: COVID19
Symptoms: Bladder catheterisation, COVID-19, COVID-19 pneumonia, Cardiac telemetry abnormal, Chest X-ray abnormal
Clinical narrative: Patient is a 87 y.o. male who presented from home on 3/4/2023 after a fall.  He was found to have COVID-19 infection.  Was hypoxemic, initially requiring 5 L of oxygen.  Treated with remdesivir and Decadron.  Oxygen weaned off.  All symptoms of COVID have resolved.  Discharged home.        Assessment and Plan Pneumonia due to COVID-19 -Presented with: cough, sore throat, generalized weakness, confusion -His symptoms started on 3/2/2023 with -He tested positive for COVID-19 on admission on 3/4/2023 -He has been vaccinated and boosted x2 -Initially needed to be placed on 5 L oxygen and then slowly weaned off oxygen.  He has been off oxygen since 3/6 -He was treated with Decadron and remdesivir while in the hospital.  Since he has been off oxygen and doing well, medication stopped on discharge   Acute hypoxemic respiratory failure  -Suspect more related to covid -Initially required 5L NC to maintain sats above 90%, now weaned off oxygen -CXR show moderate bilateral lower lung linear opacities of unclear etiology.     Fall Generalized Weakness -no head trauma or LOC -diffusely weak, likely from above -Seen by PT/OT.  Rehab was recommended but patient wanted to go home.  He refused home health since he says he has helpers who comes every day at home to help.   Arrhythmia -Suspect exac by pneumonia (initial ekg show ?"aflutter", repeat ekg show "sinus rhythm w/PAC's" -He was monitored on telemetry metric which showed PACs.  No evidence of A-fib -EKG repeated again on 3/6 with sinus rhythm and PACs -Has history of SVT status post ablation 1997 -Echo with normal EF -Continue beta-blocker    BPH Urinary retention -BPH noted on outpatient chart review, not on medications -Initially needed placement of Foley catheter which was removed.  Voiding well Hematuria -Suspect due to traumatic foley placement in ER -Now resolved