A Case of Diabetic Muscle Infarction
Notice bibliographique
Résumé
While warming up for her first karate class, a 37-year-old woman with a 29-year history of type 1 diabetes mellitus developed a mild pain on the inside of her left thigh.She believed she had pulled a muscle and left the class to rest.In the ensuing days, the pain gradually worsened followed by swelling of the left thigh.Over the next few weeks, a similar pain and swelling developed over the left calf.She was seen at her local hospital emergency room approximately three weeks after onset, and was prescribed antibiotics.However, the pain and swelling continued and within eight weeks she had lost the ability to weightbear secondary to the pain.She was admitted to hospital for further investigations.She was found to be in mild diabetic ketoacidosis.She had no history of fever, and no source of infection could be identified.Her blood work on admission was significant for a mildly elevated white cell count of 14 (N=4-11x10 9 /l), erythrocyte sedimentation rate (ESR) of 84 (N=0-10 mm/hr), C -reactive protein of 151 (N=<6 mg/L), and normal lactate (0.9; N=0.5-2.2 mmol/L) and creatine kinase (100; N=35-250 U/L).She was started on antibiotics for three weeks.All of her blood, urine, and sputum cultures were negative.She was assessed by the neurology service four months after the initial onset of symptoms.At that time, the pain in her left thigh had resolved, although the swelling remained.She continued to have severe pain and swelling of the left calf that prevented her from weightbearing on the left leg.The pain was localized to the calf and associated with calf tenderness.There was no back pain or radicular symptoms.She did not believe there was any significant weakness.Her bowel and bladder function was normal.She had no involvement of other limbs.Her diabetes was complicated by retinopathy, peripheral neuropathy and end-stage renal disease.She had been on haemodialysis for several years prior to presentation.Physical examination revealed mild symmetrical stocking distribution sensory impairment and absent ankle reflexes bilaterally.There was no focal muscle atrophy.Strength was normal in the right leg but difficult to test in the left leg due to pain.However, strength was at least antigravity in all muscle groups in the left leg.Reflexes were present and symmetric at the knees.The remainder of her neurological exam was unremarkable.The left calf was swollen and the medial gastrocnemius muscle was firm and tender to palpation.The medial left thigh was mildly swollen compared with the right thigh.However, the thigh muscles were soft and non-tender.She had flexion contractures at the left knee and ankle.Doppler study of the left leg did not show any sign of venous thrombosis.A bone scan was normal without evidence of osteomyelitis.Findings on the nerve conduction studies were consistent with a mild symmetrical axonal sensorimotor polyneuropathy, presumably secondary to her diabetes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,005 | 0,005 |
| Études des sciences et des technologies | 0,006 | 0,002 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,002 | 0,003 |
| Intégrité de la recherche | 0,009 | 0,006 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».