chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 2.25
Sex: M
Vaccine: COVID19, UNK, UNK
Symptoms: Conjunctivitis, Cough, Ear infection, Pyrexia, Respiratory tract congestion
Clinical narrative: Starting on 9/3/22, 10 days after receiving the second dose of the pfizer covid vaccine, patient had conjunctivitis, congestion and slight cough.Also, there was a pontential covid exposure on 9/1/22 and a at home test was performed results were negative. Due to the holiday weekend of labor day we took patient in to be seen by his primary Doctor on 9/6/22. He was diagnosis with a double ear infection. His doctor prescibed a course of antibotic, augment. On 9/7/22 he developed a fever of 101, we have treated with tylenol. Unsure if this is a true adverse reaction to the vaccine, or simply a child who got sick.
Age: 2.25
Sex: M
Vaccine: COVID19, UNK, UNK
Symptoms: SARS-CoV-2 test negative
Clinical narrative: Starting on 9/3/22, 10 days after receiving the second dose of the pfizer covid vaccine, patient had conjunctivitis, congestion and slight cough.Also, there was a pontential covid exposure on 9/1/22 and a at home test was performed results were negative. Due to the holiday weekend of labor day we took patient in to be seen by his primary Doctor on 9/6/22. He was diagnosis with a double ear infection. His doctor prescibed a course of antibotic, augment. On 9/7/22 he developed a fever of 101, we have treated with tylenol. Unsure if this is a true adverse reaction to the vaccine, or simply a child who got sick.
Age: 15.0
Sex: M
Vaccine: MMR, VARCEL
Symptoms: Incorrect route of product administration
Clinical narrative: Vaccinations prescribed to be given sq were given IM .  Both MMR and Varicella.  MD notified and ordered for monitoring for fever and arm soreness.
Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, No adverse event
Clinical narrative: This dose was administered as dose #5 (3rd booster). #3 booster was not authorized at the time administration.  I called the patient on 8/6/22. no side effects/symptoms to report.
Age: 32.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Urticaria
Clinical narrative: unsuccessful wheal to left arm. readminister another dose to right arm with wheal
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, Product administered to patient of inappropriate age
Clinical narrative: A 0.5 mL dose of Moderna 6M-5Y was given to 67 year of age patient
Age: 38.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Vaccination error
Clinical narrative: unsuccessful wheal first administration on left arm, re-administered on left arm with wheal
Age: 67.0
Sex: F
Vaccine: COVID19-2
Symptoms: Palpitations
Clinical narrative: pt called  and stated that she was having heart palpitations- normal 70 and hers was 90. I suggested she try to relax if she felt bad she could call her dr or go to the er.
Age: 14.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect dose administered, No adverse event, Product administered to patient of inappropriate age
Clinical narrative: No adverse effects, but booster was given to 14 year old accidentally on 12/21/2021. Booster was not approved for <18 by FDA until January 2022. Patient's mom was informed (who brought in the child originally).
Age: 63.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: Invasive ductal breast carcinoma, Mammogram abnormal, Ultrasound breast abnormal
Clinical narrative: Diagnosed with stage 1 ductal invasive carcinoma in right breast
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Abdominal pain upper, Biopsy intestine abnormal, Blood test abnormal, Change of bowel habit
Clinical narrative: I started to get intermittent stomach pains in September with no change in bowl habits. There seemed to also be no known reason for the pain to come and go. Just pressure pain on my whole abdomen. Around December my bowel habits changed. I was not having a bowel movement every morning at 7am, it was now every few days.  I went to the doctor February 2022, they gave me medication for  an ulcer with no tests. I didnt take the meds since I didnt think it was an ulcer, and told them it didnt work and I was still in pain. They had me test my gall bladder in June  which came back fine.  Between May June and July Ive had to call out of work several times due to horrible stomach pain. On august 24, I had an EGD, saw I had no ulcer as I suspected, and they took a biopsy of my duodenum, and they saw I had short blunt villa. I went in for blood work on the 31st, and it became known  that I have celiacs disease.  I had no issues before my second vaccine on September 3rd.
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Coeliac disease, Discomfort, Impaired work ability, Laboratory test normal, Oesophagogastroduodenoscopy normal
Clinical narrative: I started to get intermittent stomach pains in September with no change in bowl habits. There seemed to also be no known reason for the pain to come and go. Just pressure pain on my whole abdomen. Around December my bowel habits changed. I was not having a bowel movement every morning at 7am, it was now every few days.  I went to the doctor February 2022, they gave me medication for  an ulcer with no tests. I didnt take the meds since I didnt think it was an ulcer, and told them it didnt work and I was still in pain. They had me test my gall bladder in June  which came back fine.  Between May June and July Ive had to call out of work several times due to horrible stomach pain. On august 24, I had an EGD, saw I had no ulcer as I suspected, and they took a biopsy of my duodenum, and they saw I had short blunt villa. I went in for blood work on the 31st, and it became known  that I have celiacs disease.  I had no issues before my second vaccine on September 3rd.
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Scan
Clinical narrative: I started to get intermittent stomach pains in September with no change in bowl habits. There seemed to also be no known reason for the pain to come and go. Just pressure pain on my whole abdomen. Around December my bowel habits changed. I was not having a bowel movement every morning at 7am, it was now every few days.  I went to the doctor February 2022, they gave me medication for  an ulcer with no tests. I didnt take the meds since I didnt think it was an ulcer, and told them it didnt work and I was still in pain. They had me test my gall bladder in June  which came back fine.  Between May June and July Ive had to call out of work several times due to horrible stomach pain. On august 24, I had an EGD, saw I had no ulcer as I suspected, and they took a biopsy of my duodenum, and they saw I had short blunt villa. I went in for blood work on the 31st, and it became known  that I have celiacs disease.  I had no issues before my second vaccine on September 3rd.
Age: 9.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, Product administered to patient of inappropriate age
Clinical narrative: Patient reported feeling fine when leaving the pharmacy after monitoring for 20 mins. However the 9 year old patient received an adult dose of the Pfizer biotech vaccine.
Age: 27.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Extra dose administered, Wrong technique in product usage process
Clinical narrative: 1st attempted not successful with wheal to left arm. re-administered another dose to right arm
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Fall, Fatigue, Mobility decreased, Pyrexia
Clinical narrative: I had fever up to 101.5 despite Tylenol. I got so weak that I fell twice trying to get out of bed to go to the bathroom, and I couldn't get up by myself. I notified the research staff but since the usual questions were just the degree of fever, not whether it was before or after an anti-pyretic. And the questionnaire asked about fatigue that interfered with normal activities, but didn't capture the degree of weakness I felt. I'm concerned that if the FDA accepts this vaccine at this dose without a warning that someone living alone could be in big trouble. I'm not normally a weak person. I walk daily and do Pilates 3x/week. I had fever and weakness after COVID vaccine but not this bad. I'm a retired PH physician.
Age: 4.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: Child was given the Pfizer COVID 19 vaccine 10mcg/0.2ml approved for ages 5 yrs and above. He was not 5 yrs old at the time
Age: 52.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Ascites, Diuretic therapy, Hepatic encephalopathy, Hepatic failure, Paracentesis
Clinical narrative: Admitted to hospital.
Age: 52.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Renal failure, Transfusion
Clinical narrative: Admitted to hospital.
Age: 52.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Unevaluable event
Clinical narrative: Admitted to hospital.
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, Cardiac failure congestive, Condition aggravated
Clinical narrative: Hospitalization: ADMITTED 8/19/22 - DISCHARGED 8/28/22. Presentation to the ED: hypoxia and shortness of breath.  COVID-19 + date: 8/27/22. Treatment: Remdesivir & Decadron.  Discharge to: SNF.
Age: 87.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, Dyspnoea, Hypoxia, SARS-CoV-2 test positive
Clinical narrative: Hospitalization: ADMITTED 8/19/22 - DISCHARGED 8/28/22. Presentation to the ED: hypoxia and shortness of breath.  COVID-19 + date: 8/27/22. Treatment: Remdesivir & Decadron.  Discharge to: SNF.
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Alcoholism, Asymptomatic COVID-19, Blood sodium decreased, Computerised tomogram thorax, Condition aggravated
Clinical narrative: Admitted to hospital
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Essential hypertension, Hyponatraemia, Mental status changes, Metabolic encephalopathy, Procalcitonin increased
Clinical narrative: Admitted to hospital
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: SARS-CoV-2 test positive, Systemic inflammatory response syndrome, Type 2 diabetes mellitus
Clinical narrative: Admitted to hospital
Age: 76.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Unevaluable event
Clinical narrative: Admitted to hospital
Age: 11.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Expired product administered
Clinical narrative: Error: Expired Product Administered-
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Antinuclear antibody negative, Blood copper normal, Blood glucose normal, Blood test, Bone pain
Clinical narrative: WHOLE BODY ITCHES, HAS PAIN FEEL LIKE NEEDLES STABBING INTO THE BONES, FEEL EXHAUSTED, COULDN'T LEAVE HIS ROOM FOR FEW MONTHS, AND RIGHT NOW THE LEFT LEG IS STILL TOO WEAK TO WALK, GOTTA  USE A  WALKER.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Electrophoresis protein, Fatigue, Full blood count normal, Gait inability, Mobility decreased
Clinical narrative: WHOLE BODY ITCHES, HAS PAIN FEEL LIKE NEEDLES STABBING INTO THE BONES, FEEL EXHAUSTED, COULDN'T LEAVE HIS ROOM FOR FEW MONTHS, AND RIGHT NOW THE LEFT LEG IS STILL TOO WEAK TO WALK, GOTTA  USE A  WALKER.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Muscular weakness, Pain, Renal function test normal, Thyroid function test normal, Vitamin B12 normal
Clinical narrative: WHOLE BODY ITCHES, HAS PAIN FEEL LIKE NEEDLES STABBING INTO THE BONES, FEEL EXHAUSTED, COULDN'T LEAVE HIS ROOM FOR FEW MONTHS, AND RIGHT NOW THE LEFT LEG IS STILL TOO WEAK TO WALK, GOTTA  USE A  WALKER.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Walking aid user
Clinical narrative: WHOLE BODY ITCHES, HAS PAIN FEEL LIKE NEEDLES STABBING INTO THE BONES, FEEL EXHAUSTED, COULDN'T LEAVE HIS ROOM FOR FEW MONTHS, AND RIGHT NOW THE LEFT LEG IS STILL TOO WEAK TO WALK, GOTTA  USE A  WALKER.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Bone pain, Fatigue, Gait disturbance, Hemiparesis, Mobility decreased
Clinical narrative: WHOLE BODY ITCHES, HAS PAIN FEEL LIKE NEEDLES STABBING INTO THE BONES, FEEL EXHAUSTED, COULDN'T LEAVE HIS ROOM FOR FEW MONTHS, AND RIGHT NOW THE LEFT LEG IS STILL TOO WEAK TO WALK, GOTTA  USE A  WALKER.
Age: 64.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Muscular weakness, Paraesthesia, Pruritus, Walking aid user
Clinical narrative: WHOLE BODY ITCHES, HAS PAIN FEEL LIKE NEEDLES STABBING INTO THE BONES, FEEL EXHAUSTED, COULDN'T LEAVE HIS ROOM FOR FEW MONTHS, AND RIGHT NOW THE LEFT LEG IS STILL TOO WEAK TO WALK, GOTTA  USE A  WALKER.
Age: 26.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dysstasia, Pain, Syncope, Vertigo, Vomiting
Clinical narrative: i was expecting body aches, as I've had rough reactions to previous doses, but was thrown off by vasovagal syncope and wanted to report that. I don't know if it's cause of my eds or what, but figured that's a relevant thing to report! Basically i lost ability to stand and room went spinning and i had to stay on the kitchen floor for a while. Happened about 12 hours post administration, accompanied with vomiting.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Acute respiratory failure, Appendicectomy, Appendicitis, COVID-19, COVID-19 pneumonia
Clinical narrative: MD  Last attending ? Treatment team Acute hypoxemic respiratory failure due to COVID-19  Principal problem   Discharge Summary MD (Physician) ? ? Hospitalist Physician Discharge Summary   Patient ID: MRN:  Name: Patient Age: 34 y.o. Birthday:   Admit Date: 8/13/2022 10:24 AM Discharge Date: 8/16/2022 Unit: 3A126/3A126A Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Acute hypoxemic respiratory failure due to COVID-19       HPI: "Patient is a 34 y.o. male with a history below admitted for Acute respiratory failure with hypoxia. Pt came in with complaints of sob, started at the same time he had developed appendicitis, had recent appendectomy 8/11 at hosptial. States he continued to have sob after procedure, but was temporarily better when sent home. Has le swelling and hand swelling. O2 dropped further. Denies cp. No wheezing. Denies cough, fever. Discussed with er and will admit ".   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.      * Acute hypoxemic respiratory failure due to COVID-19 o Pneumonia due to Covid 19 virus with acute respiratory failure with hypoxia. Improved on current treatment. Declined IV Remdesivir following admission as he reported feeling better. He is improving on IV Decadron, transitioned to PO. Nebs and inhalers as ordered. Continue to follow up daily inflammatory markers and d-dimer. Patient's hypoxia resolved. Weaned off oxygen to room air from Ventimask on admission. Continue nebs and inhalers. Encourage incentive spirometry use and pronating. Continue supportive/symptomatic treatment and supplements as ordered per COVID protocol. Followed up daily lab which remained stable. Transitioned antibiotics to by mouth. DC home today and follow up outpatient.       Physical Exam on the Date of Discharge: Stable and improved.      Consults:   IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:    labs, microbiology, radiology, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Dyspnoea, Fibrin D dimer, Inflammatory marker test, Peripheral swelling
Clinical narrative: MD  Last attending ? Treatment team Acute hypoxemic respiratory failure due to COVID-19  Principal problem   Discharge Summary MD (Physician) ? ? Hospitalist Physician Discharge Summary   Patient ID: MRN:  Name: Patient Age: 34 y.o. Birthday:   Admit Date: 8/13/2022 10:24 AM Discharge Date: 8/16/2022 Unit: 3A126/3A126A Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Acute hypoxemic respiratory failure due to COVID-19       HPI: "Patient is a 34 y.o. male with a history below admitted for Acute respiratory failure with hypoxia. Pt came in with complaints of sob, started at the same time he had developed appendicitis, had recent appendectomy 8/11 at hosptial. States he continued to have sob after procedure, but was temporarily better when sent home. Has le swelling and hand swelling. O2 dropped further. Denies cp. No wheezing. Denies cough, fever. Discussed with er and will admit ".   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.      * Acute hypoxemic respiratory failure due to COVID-19 o Pneumonia due to Covid 19 virus with acute respiratory failure with hypoxia. Improved on current treatment. Declined IV Remdesivir following admission as he reported feeling better. He is improving on IV Decadron, transitioned to PO. Nebs and inhalers as ordered. Continue to follow up daily inflammatory markers and d-dimer. Patient's hypoxia resolved. Weaned off oxygen to room air from Ventimask on admission. Continue nebs and inhalers. Encourage incentive spirometry use and pronating. Continue supportive/symptomatic treatment and supplements as ordered per COVID protocol. Followed up daily lab which remained stable. Transitioned antibiotics to by mouth. DC home today and follow up outpatient.       Physical Exam on the Date of Discharge: Stable and improved.      Consults:   IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:    labs, microbiology, radiology, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Blood creatinine increased, Cardiac telemetry, Chest X-ray, Computerised tomogram head normal, Dehydration
Clinical narrative: Patient ID: MRN:  Name:  Age: 67 y.o. Birthday:   Admit Date: 8/13/2022  1:16 PM Discharge Date:  8/15/2022 Unit:  Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Syncope Active Problems:   COVID-19 virus infection   AKI (acute kidney injury)   B12 deficiency       HPI: "The patient is a 67 y.o. female with a history below admitted for Syncope. Pt came in with complaints of sudden loss of consciousness. States was sitting, 'felt woozy', then suddenly became unresponsive. Family there. Lasted 3 minutes or so. Nothing made better / worse. Was grey in color, diaphoretic, eyes glazed over. When pt came to, she states she had no confusion after. Has some headache now but otherwise no focal deficits. Eats little at baseline, and although has not had any resp symptoms, may have become dehydrated from poor po intake. Smokes daily. Does not want nicotine patch. No hx of stroke for her, but family hx present. Discussed cxr finding. Discussed with er and will admit ".   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.    The patient was admitted to Hospital telemetry which remained essentially unremarkable. Patient appears dehydrated with a serum creatinine on admission up to 1.4. Was treated with IV fluid hydration and creatinine trended down to 1.1. She was feeling markedly better. She remains off all her blood pressure medications and blood pressure remained on the low side but significantly improved. Patient appetite improved as well along with her by mouth fluid intake. CT of the head showed no acute findings and MRI showed no acute changes. Carotid duplex showed mild plaque but no stenosis and echocardiogram was done Showing no cardiac source of emboli noted. Was found to have B12 deficiency and started on replacement treatment. For discharge per neurology to follow up outpatient.   Physical Exam on the Date of Discharge: Stable and improved.      Consults:   IP CONSULT TO STROKE NURSE NAVIGATOR IP CONSULT TO NEUROLOGY IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:    labs, radiology, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Echocardiogram normal, Glassy eyes, Headache, Hyperhidrosis
Clinical narrative: Patient ID: MRN:  Name:  Age: 67 y.o. Birthday:   Admit Date: 8/13/2022  1:16 PM Discharge Date:  8/15/2022 Unit:  Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Syncope Active Problems:   COVID-19 virus infection   AKI (acute kidney injury)   B12 deficiency       HPI: "The patient is a 67 y.o. female with a history below admitted for Syncope. Pt came in with complaints of sudden loss of consciousness. States was sitting, 'felt woozy', then suddenly became unresponsive. Family there. Lasted 3 minutes or so. Nothing made better / worse. Was grey in color, diaphoretic, eyes glazed over. When pt came to, she states she had no confusion after. Has some headache now but otherwise no focal deficits. Eats little at baseline, and although has not had any resp symptoms, may have become dehydrated from poor po intake. Smokes daily. Does not want nicotine patch. No hx of stroke for her, but family hx present. Discussed cxr finding. Discussed with er and will admit ".   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.    The patient was admitted to Hospital telemetry which remained essentially unremarkable. Patient appears dehydrated with a serum creatinine on admission up to 1.4. Was treated with IV fluid hydration and creatinine trended down to 1.1. She was feeling markedly better. She remains off all her blood pressure medications and blood pressure remained on the low side but significantly improved. Patient appetite improved as well along with her by mouth fluid intake. CT of the head showed no acute findings and MRI showed no acute changes. Carotid duplex showed mild plaque but no stenosis and echocardiogram was done Showing no cardiac source of emboli noted. Was found to have B12 deficiency and started on replacement treatment. For discharge per neurology to follow up outpatient.   Physical Exam on the Date of Discharge: Stable and improved.      Consults:   IP CONSULT TO STROKE NURSE NAVIGATOR IP CONSULT TO NEUROLOGY IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:    labs, radiology, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Hypophagia, Hypotension, Loss of consciousness, Magnetic resonance imaging head normal, Skin discolouration
Clinical narrative: Patient ID: MRN:  Name:  Age: 67 y.o. Birthday:   Admit Date: 8/13/2022  1:16 PM Discharge Date:  8/15/2022 Unit:  Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Syncope Active Problems:   COVID-19 virus infection   AKI (acute kidney injury)   B12 deficiency       HPI: "The patient is a 67 y.o. female with a history below admitted for Syncope. Pt came in with complaints of sudden loss of consciousness. States was sitting, 'felt woozy', then suddenly became unresponsive. Family there. Lasted 3 minutes or so. Nothing made better / worse. Was grey in color, diaphoretic, eyes glazed over. When pt came to, she states she had no confusion after. Has some headache now but otherwise no focal deficits. Eats little at baseline, and although has not had any resp symptoms, may have become dehydrated from poor po intake. Smokes daily. Does not want nicotine patch. No hx of stroke for her, but family hx present. Discussed cxr finding. Discussed with er and will admit ".   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.    The patient was admitted to Hospital telemetry which remained essentially unremarkable. Patient appears dehydrated with a serum creatinine on admission up to 1.4. Was treated with IV fluid hydration and creatinine trended down to 1.1. She was feeling markedly better. She remains off all her blood pressure medications and blood pressure remained on the low side but significantly improved. Patient appetite improved as well along with her by mouth fluid intake. CT of the head showed no acute findings and MRI showed no acute changes. Carotid duplex showed mild plaque but no stenosis and echocardiogram was done Showing no cardiac source of emboli noted. Was found to have B12 deficiency and started on replacement treatment. For discharge per neurology to follow up outpatient.   Physical Exam on the Date of Discharge: Stable and improved.      Consults:   IP CONSULT TO STROKE NURSE NAVIGATOR IP CONSULT TO NEUROLOGY IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:    labs, radiology, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Syncope, Tobacco user, Ultrasound Doppler, Unresponsive to stimuli, Vitamin B12 deficiency
Clinical narrative: Patient ID: MRN:  Name:  Age: 67 y.o. Birthday:   Admit Date: 8/13/2022  1:16 PM Discharge Date:  8/15/2022 Unit:  Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Syncope Active Problems:   COVID-19 virus infection   AKI (acute kidney injury)   B12 deficiency       HPI: "The patient is a 67 y.o. female with a history below admitted for Syncope. Pt came in with complaints of sudden loss of consciousness. States was sitting, 'felt woozy', then suddenly became unresponsive. Family there. Lasted 3 minutes or so. Nothing made better / worse. Was grey in color, diaphoretic, eyes glazed over. When pt came to, she states she had no confusion after. Has some headache now but otherwise no focal deficits. Eats little at baseline, and although has not had any resp symptoms, may have become dehydrated from poor po intake. Smokes daily. Does not want nicotine patch. No hx of stroke for her, but family hx present. Discussed cxr finding. Discussed with er and will admit ".   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.    The patient was admitted to Hospital telemetry which remained essentially unremarkable. Patient appears dehydrated with a serum creatinine on admission up to 1.4. Was treated with IV fluid hydration and creatinine trended down to 1.1. She was feeling markedly better. She remains off all her blood pressure medications and blood pressure remained on the low side but significantly improved. Patient appetite improved as well along with her by mouth fluid intake. CT of the head showed no acute findings and MRI showed no acute changes. Carotid duplex showed mild plaque but no stenosis and echocardiogram was done Showing no cardiac source of emboli noted. Was found to have B12 deficiency and started on replacement treatment. For discharge per neurology to follow up outpatient.   Physical Exam on the Date of Discharge: Stable and improved.      Consults:   IP CONSULT TO STROKE NURSE NAVIGATOR IP CONSULT TO NEUROLOGY IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:    labs, radiology, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Acute kidney injury, Blood creatinine increased, COVID-19, Chronic kidney disease, Condition aggravated
Clinical narrative: Patient ID: Age: 32 y.o. Admit Date: 8/13/2022  2:56 PM Discharge Date:  8/16/2022 Admitting Physician:  Discharge Physician:   Discharge Diagnosis: Principal Problem:   Acute renal failure with acute tubular necrosis superimposed on stage 3b chronic kidney disease Active Problems:   Type 1 diabetes mellitus with diabetic polyneuropathy   HTN (hypertension)   COVID-19 virus infection   Elevated d-dimer       HPI: "Patient is a 32 y.o. female who came to the ER due to persistent upper respiratory symptoms from Covid-19 infection. She tested (+) a week ago. She had been vaccinated. She has CKD 3b, HTN, DM. She is found to be in AKI with Cr 3.6. She has been admitted for that"   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.      * Acute renal failure with acute tubular necrosis superimposed on stage 3b chronic kidney disease o Acute on chronic renal failure. Serum creatinine remains elevated at 3.0 today but trending down closer to baseline near 2.0. Treated initially with IV fluids. Serum creatinine remained elevated and IV fluids held by nephrology. Improved as discussed above. Nephrology cleared for discharge to follow up outpatient.  o COVID-19 virus infection. Remains asymptomatic from respiratory standpoint. Not on any Remdesivir. Continue to monitor closely. o Diabetes mellitus type 1. Poorly controlled with a hemoglobin A1c of 10.2. Continue same treatment. Diabetic diet ordered. Insulin sliding scale. o Elevated d-dimer. Bumped from normal up to 1544. VQ scan was ordered. repeat d-dimer came back much lower at 346. V/Q scan resulted as low probability. Patient remains on room air with no respiratory symptoms. PE and DVT are unlikely. o Hypertension. Controlled. Continue same treatment. Follow up daily labs.      Physical Exam on the Date of Discharge: Stable and improved.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Diabetes mellitus inadequate control, Diabetic neuropathy, Fibrin D dimer increased, Glycosylated haemoglobin increased, Hypertension
Clinical narrative: Patient ID: Age: 32 y.o. Admit Date: 8/13/2022  2:56 PM Discharge Date:  8/16/2022 Admitting Physician:  Discharge Physician:   Discharge Diagnosis: Principal Problem:   Acute renal failure with acute tubular necrosis superimposed on stage 3b chronic kidney disease Active Problems:   Type 1 diabetes mellitus with diabetic polyneuropathy   HTN (hypertension)   COVID-19 virus infection   Elevated d-dimer       HPI: "Patient is a 32 y.o. female who came to the ER due to persistent upper respiratory symptoms from Covid-19 infection. She tested (+) a week ago. She had been vaccinated. She has CKD 3b, HTN, DM. She is found to be in AKI with Cr 3.6. She has been admitted for that"   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.      * Acute renal failure with acute tubular necrosis superimposed on stage 3b chronic kidney disease o Acute on chronic renal failure. Serum creatinine remains elevated at 3.0 today but trending down closer to baseline near 2.0. Treated initially with IV fluids. Serum creatinine remained elevated and IV fluids held by nephrology. Improved as discussed above. Nephrology cleared for discharge to follow up outpatient.  o COVID-19 virus infection. Remains asymptomatic from respiratory standpoint. Not on any Remdesivir. Continue to monitor closely. o Diabetes mellitus type 1. Poorly controlled with a hemoglobin A1c of 10.2. Continue same treatment. Diabetic diet ordered. Insulin sliding scale. o Elevated d-dimer. Bumped from normal up to 1544. VQ scan was ordered. repeat d-dimer came back much lower at 346. V/Q scan resulted as low probability. Patient remains on room air with no respiratory symptoms. PE and DVT are unlikely. o Hypertension. Controlled. Continue same treatment. Follow up daily labs.      Physical Exam on the Date of Discharge: Stable and improved.
Age: 32.0
Sex: F
Vaccine: COVID19
Symptoms: Renal tubular necrosis, Respiratory symptom, SARS-CoV-2 test positive, Type 1 diabetes mellitus, Ventilation/perfusion scan
Clinical narrative: Patient ID: Age: 32 y.o. Admit Date: 8/13/2022  2:56 PM Discharge Date:  8/16/2022 Admitting Physician:  Discharge Physician:   Discharge Diagnosis: Principal Problem:   Acute renal failure with acute tubular necrosis superimposed on stage 3b chronic kidney disease Active Problems:   Type 1 diabetes mellitus with diabetic polyneuropathy   HTN (hypertension)   COVID-19 virus infection   Elevated d-dimer       HPI: "Patient is a 32 y.o. female who came to the ER due to persistent upper respiratory symptoms from Covid-19 infection. She tested (+) a week ago. She had been vaccinated. She has CKD 3b, HTN, DM. She is found to be in AKI with Cr 3.6. She has been admitted for that"   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.      * Acute renal failure with acute tubular necrosis superimposed on stage 3b chronic kidney disease o Acute on chronic renal failure. Serum creatinine remains elevated at 3.0 today but trending down closer to baseline near 2.0. Treated initially with IV fluids. Serum creatinine remained elevated and IV fluids held by nephrology. Improved as discussed above. Nephrology cleared for discharge to follow up outpatient.  o COVID-19 virus infection. Remains asymptomatic from respiratory standpoint. Not on any Remdesivir. Continue to monitor closely. o Diabetes mellitus type 1. Poorly controlled with a hemoglobin A1c of 10.2. Continue same treatment. Diabetic diet ordered. Insulin sliding scale. o Elevated d-dimer. Bumped from normal up to 1544. VQ scan was ordered. repeat d-dimer came back much lower at 346. V/Q scan resulted as low probability. Patient remains on room air with no respiratory symptoms. PE and DVT are unlikely. o Hypertension. Controlled. Continue same treatment. Follow up daily labs.      Physical Exam on the Date of Discharge: Stable and improved.
Age: 71.0
Sex: M
Vaccine: UNK
Symptoms: Erythema
Clinical narrative: I received the Jynneos Injection for Monkey pox. Two mornings later, a large number of circular flat red circles up to the size of a quarter appeared on my right leg below my knee. There are also a couple on my upper right leg and a couple on my bottom left leg
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Agitation, Ammonia increased, Ascites, Asthenia, Asymptomatic COVID-19
Clinical narrative: Patient ID: MRN:   Name:   Age: 53 y.o. Birthday:    Admit Date: 8/14/2022 11:32 PM Discharge Date: 8/18/2022 Unit:   Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Acute hepatic encephalopathy Active Problems:   Hyperammonemia   Metabolic encephalopathy   IVDU (intravenous drug user)   COVID-19   Hep C w/o coma, chronic       HPI: "Patient is a 53 y.o. male with a history of liver disease and recurrent admits for hepatic encephalopathy. To ED with confusion that started over past day presumably from elevated ammonia. Nothing noted to make this better or worse. No vomiting or fever reported. Patient agitated some on admit and has been medicated."   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.      * Acute hepatic encephalopathy Description of the Problem/Progression:  Plan:  o Acute hepatic encephalopathy. Hyperammonemia with serum ammonia level at 133 on admission down to 69 then 91. Status post lactulose enema. By mouth lactulose ordered and patient is tolerating by mouth intake. Dose was increased to 4 times a day. Continue to monitor closely. Patient reported feeling markedly better and back to his baseline and requested discharge home. He was discharged accordingly to follow up outpatient with primary care provider and GI. o Liver cirrhosis with ascites. Known history of hepatitis C infection. On empirical IV Rocephin. Interventional radiology consulted and paracentesis done with up to 6.6 L of fluid retrieved. Fluid cultures show no growth so far. Follow-up on patient. o COVID-19 virus infection. Remains asymptomatic from a respiratory standpoint. No IV remdesivir ordered. Continue to monitor closely. o Chronic kidney disease stage IIIa. Remains at baseline. Monitor closely with daily lab. o Pancytopenia due to cirrhosis. Continue to monitor closely with daily labs.  o Debility. PT/OT ordered. Social work consulted.        Physical Exam on the Date of Discharge: Stable and improved.        Consults:   IP CONSULT TO INTERVENTIONAL RADIOLOGY IP CONSULT TO GASTROENTEROLOGY IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:    labs, microbiology, radiology, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Confusional state, Culture negative, Enema administration, Hepatic cirrhosis, Hepatic encephalopathy
Clinical narrative: Patient ID: MRN:   Name:   Age: 53 y.o. Birthday:    Admit Date: 8/14/2022 11:32 PM Discharge Date: 8/18/2022 Unit:   Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Acute hepatic encephalopathy Active Problems:   Hyperammonemia   Metabolic encephalopathy   IVDU (intravenous drug user)   COVID-19   Hep C w/o coma, chronic       HPI: "Patient is a 53 y.o. male with a history of liver disease and recurrent admits for hepatic encephalopathy. To ED with confusion that started over past day presumably from elevated ammonia. Nothing noted to make this better or worse. No vomiting or fever reported. Patient agitated some on admit and has been medicated."   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.      * Acute hepatic encephalopathy Description of the Problem/Progression:  Plan:  o Acute hepatic encephalopathy. Hyperammonemia with serum ammonia level at 133 on admission down to 69 then 91. Status post lactulose enema. By mouth lactulose ordered and patient is tolerating by mouth intake. Dose was increased to 4 times a day. Continue to monitor closely. Patient reported feeling markedly better and back to his baseline and requested discharge home. He was discharged accordingly to follow up outpatient with primary care provider and GI. o Liver cirrhosis with ascites. Known history of hepatitis C infection. On empirical IV Rocephin. Interventional radiology consulted and paracentesis done with up to 6.6 L of fluid retrieved. Fluid cultures show no growth so far. Follow-up on patient. o COVID-19 virus infection. Remains asymptomatic from a respiratory standpoint. No IV remdesivir ordered. Continue to monitor closely. o Chronic kidney disease stage IIIa. Remains at baseline. Monitor closely with daily lab. o Pancytopenia due to cirrhosis. Continue to monitor closely with daily labs.  o Debility. PT/OT ordered. Social work consulted.        Physical Exam on the Date of Discharge: Stable and improved.        Consults:   IP CONSULT TO INTERVENTIONAL RADIOLOGY IP CONSULT TO GASTROENTEROLOGY IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:    labs, microbiology, radiology, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Pancytopenia, Paracentesis
Clinical narrative: Patient ID: MRN:   Name:   Age: 53 y.o. Birthday:    Admit Date: 8/14/2022 11:32 PM Discharge Date: 8/18/2022 Unit:   Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Acute hepatic encephalopathy Active Problems:   Hyperammonemia   Metabolic encephalopathy   IVDU (intravenous drug user)   COVID-19   Hep C w/o coma, chronic       HPI: "Patient is a 53 y.o. male with a history of liver disease and recurrent admits for hepatic encephalopathy. To ED with confusion that started over past day presumably from elevated ammonia. Nothing noted to make this better or worse. No vomiting or fever reported. Patient agitated some on admit and has been medicated."   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.      * Acute hepatic encephalopathy Description of the Problem/Progression:  Plan:  o Acute hepatic encephalopathy. Hyperammonemia with serum ammonia level at 133 on admission down to 69 then 91. Status post lactulose enema. By mouth lactulose ordered and patient is tolerating by mouth intake. Dose was increased to 4 times a day. Continue to monitor closely. Patient reported feeling markedly better and back to his baseline and requested discharge home. He was discharged accordingly to follow up outpatient with primary care provider and GI. o Liver cirrhosis with ascites. Known history of hepatitis C infection. On empirical IV Rocephin. Interventional radiology consulted and paracentesis done with up to 6.6 L of fluid retrieved. Fluid cultures show no growth so far. Follow-up on patient. o COVID-19 virus infection. Remains asymptomatic from a respiratory standpoint. No IV remdesivir ordered. Continue to monitor closely. o Chronic kidney disease stage IIIa. Remains at baseline. Monitor closely with daily lab. o Pancytopenia due to cirrhosis. Continue to monitor closely with daily labs.  o Debility. PT/OT ordered. Social work consulted.        Physical Exam on the Date of Discharge: Stable and improved.        Consults:   IP CONSULT TO INTERVENTIONAL RADIOLOGY IP CONSULT TO GASTROENTEROLOGY IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:    labs, microbiology, radiology, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Unevaluable event
Clinical narrative: Patient ID: MRN:   Name:   Age: 53 y.o. Birthday:    Admit Date: 8/14/2022 11:32 PM Discharge Date: 8/18/2022 Unit:   Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Acute hepatic encephalopathy Active Problems:   Hyperammonemia   Metabolic encephalopathy   IVDU (intravenous drug user)   COVID-19   Hep C w/o coma, chronic       HPI: "Patient is a 53 y.o. male with a history of liver disease and recurrent admits for hepatic encephalopathy. To ED with confusion that started over past day presumably from elevated ammonia. Nothing noted to make this better or worse. No vomiting or fever reported. Patient agitated some on admit and has been medicated."   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.      * Acute hepatic encephalopathy Description of the Problem/Progression:  Plan:  o Acute hepatic encephalopathy. Hyperammonemia with serum ammonia level at 133 on admission down to 69 then 91. Status post lactulose enema. By mouth lactulose ordered and patient is tolerating by mouth intake. Dose was increased to 4 times a day. Continue to monitor closely. Patient reported feeling markedly better and back to his baseline and requested discharge home. He was discharged accordingly to follow up outpatient with primary care provider and GI. o Liver cirrhosis with ascites. Known history of hepatitis C infection. On empirical IV Rocephin. Interventional radiology consulted and paracentesis done with up to 6.6 L of fluid retrieved. Fluid cultures show no growth so far. Follow-up on patient. o COVID-19 virus infection. Remains asymptomatic from a respiratory standpoint. No IV remdesivir ordered. Continue to monitor closely. o Chronic kidney disease stage IIIa. Remains at baseline. Monitor closely with daily lab. o Pancytopenia due to cirrhosis. Continue to monitor closely with daily labs.  o Debility. PT/OT ordered. Social work consulted.        Physical Exam on the Date of Discharge: Stable and improved.        Consults:   IP CONSULT TO INTERVENTIONAL RADIOLOGY IP CONSULT TO GASTROENTEROLOGY IP CONSULT TO SOCIAL WORK   Significant Diagnostic Studies:    labs, microbiology, radiology, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, Blood bilirubin increased, COVID-19, Chest X-ray normal, Cholecystectomy
Clinical narrative: Discharge Summary MD (Physician) ? ? Hospitalist Physician Discharge Summary   Patient ID: MRN:  Name: Patient Age: 70 y.o. Birthday:  Admit Date: 8/14/2022  1:08 PM Discharge Date:  8/17/2022 Unit: 3A116/3A116A Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Idiopathic acute pancreatitis Active Problems:   COVID-19   Essential hypertension   Hypokalemia       HPI: "The patient is a 70 y.o. female, presented on 8/14/2022 with the above. . The symptoms/labs were thought to be marked in severity and unstable. Onset several days ago. Associated symptoms include abdominal pain . Alleviated by none. The patient was diagnosed with COVID 19 on the 8th of this month. She was given steroid and paxlovid as she was not severly symptomatic. 3 days ago she began to have abdominal pain nausea and vomting. She was not able to take her paxlovid due to the vomiting. She comes in today with the above. She was found to have a lipase 100. CT of the abdomen and pelvis showed Acute pancreatitis. She has never had pancreatitis before. She denies frequent alcohol use. She is post cholecystectomy. She has been admitted for further management. "   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.      * Idiopathic acute pancreatitis Description of the Problem/Progression:  Plan:  o Acute pancreatitis. Patient reports feeling much better. However lab showed initially bilirubin and LFTs trending up as well as serum lipase. Continued IV fluid hydration. Patient denies any history of alcohol intake. Lipid profile is unremarkable. Lipase trended down back to normal and T Bili normalized with near normal LFT's. Patient tolerated clearly a diet and was advanced to low-fat. She continued to tolerate her diet. Consulted GI and advised MRCP initially. Patient was unable to tolerate due to Claustrophobia. With her improving GI advised no further plans for endoscopy or imaging. Patient was cleared for discharge to follow up outpatient. o COVID-19 virus infection. Remains on room air. Chest x-ray shows no focal consolidation. Started on IV Remdesivir on admission due to elevated risk. Finished course day 3 / 3. o Hypokalemia. Treated in the emergency room. Continue to monitor lab closely and treat as needed with IV/oral K replacement until normalized. o Hypertension. Controlled. Continue same treatment. Follow up daily labs.        Physical Exam on the Date of Discharge: Stable and improved.      Consults:   IP CONSULT TO SOCIAL WORK IP CONSULT TO GASTROENTEROLOGY   Significant Diagnostic Studies:    labs, radiology, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram abdomen normal, Hypertension, Hypokalaemia, Lipase normal, Liver function test abnormal
Clinical narrative: Discharge Summary MD (Physician) ? ? Hospitalist Physician Discharge Summary   Patient ID: MRN:  Name: Patient Age: 70 y.o. Birthday:  Admit Date: 8/14/2022  1:08 PM Discharge Date:  8/17/2022 Unit: 3A116/3A116A Admitting Physician:  Discharge Physician: M.D.   Discharge Diagnosis: Principal Problem:   Idiopathic acute pancreatitis Active Problems:   COVID-19   Essential hypertension   Hypokalemia       HPI: "The patient is a 70 y.o. female, presented on 8/14/2022 with the above. . The symptoms/labs were thought to be marked in severity and unstable. Onset several days ago. Associated symptoms include abdominal pain . Alleviated by none. The patient was diagnosed with COVID 19 on the 8th of this month. She was given steroid and paxlovid as she was not severly symptomatic. 3 days ago she began to have abdominal pain nausea and vomting. She was not able to take her paxlovid due to the vomiting. She comes in today with the above. She was found to have a lipase 100. CT of the abdomen and pelvis showed Acute pancreatitis. She has never had pancreatitis before. She denies frequent alcohol use. She is post cholecystectomy. She has been admitted for further management. "   Hospital Course:  The patient was admitted to the hospital and was evaluated and treated per below.      * Idiopathic acute pancreatitis Description of the Problem/Progression:  Plan:  o Acute pancreatitis. Patient reports feeling much better. However lab showed initially bilirubin and LFTs trending up as well as serum lipase. Continued IV fluid hydration. Patient denies any history of alcohol intake. Lipid profile is unremarkable. Lipase trended down back to normal and T Bili normalized with near normal LFT's. Patient tolerated clearly a diet and was advanced to low-fat. She continued to tolerate her diet. Consulted GI and advised MRCP initially. Patient was unable to tolerate due to Claustrophobia. With her improving GI advised no further plans for endoscopy or imaging. Patient was cleared for discharge to follow up outpatient. o COVID-19 virus infection. Remains on room air. Chest x-ray shows no focal consolidation. Started on IV Remdesivir on admission due to elevated risk. Finished course day 3 / 3. o Hypokalemia. Treated in the emergency room. Continue to monitor lab closely and treat as needed with IV/oral K replacement until normalized. o Hypertension. Controlled. Continue same treatment. Follow up daily labs.        Physical Exam on the Date of Discharge: Stable and improved.      Consults:   IP CONSULT TO SOCIAL WORK IP CONSULT TO GASTROENTEROLOGY   Significant Diagnostic Studies:    labs, radiology, and cardiac graphics: per chart.     Disposition:  home   Discharge Condition:  good