Notice bibliographique
Résumé
PV294 / #139 Case Report Poster Topic: AS19 - Patient-Reported Outcome Measures Introduction Systemic lupus erythematosus (SLE) is a complex disease, often described as the “disease with 1000 faces.” Its impact on the various organs and systems has been thoroughly described, however we believe that it is important to assess the impact it has on patients that are also physicians-on their professional activity, quality of life and relation toward fellow patients. Case Presentation With Investigation My first symptoms, consisting of lower limb rash, fatigue and pancytopenia, appeared around the age of 16. Subsequent investigations suggested an autoimmune disease and although there was no clear diagnosis I received intensive immunosuppression (high-dose oral steroids, IV cyclophosphamide and mycophenolate) which only partially improved the symptoms and caused significant side effects (nausea, vomiting, diarrhea, frequent upper respiratory and urinary infections, menstrual cycle abnormalities), thus leading to educational deficits and isolation from peers. Over the next few years treatment was reassessed, maintaining only low-dose prednisone and hydroxychloroquine (HCQ), which was enough at that point to control the disease and enabling me to start studying medicine. The first 5 years were mostly uneventful, except for the occasional rash, lower limb edema and intense itching from HCQ. Afterwards I started experiencing joint pain (hips, knees, Costo-vertebral, fingers) as well as myalgia and muscle spasms, which lead to extensive use of NSAIDS. Finally in 2012 (the year I graduated) I received the definitive diagnosis of SLE due to positive serology. In addition to steroids and HCQ I was started on azathioprine, which seemed to improve symptoms during the first few months but then was less effective as I started working night shifts as an internal medicine resident. In my second year of residency, I quit these shifts and took part in a study on Belimumab (Benlysta)- being effective both on symptoms and laboratory results. After the study ended, I continued on azathioprine, unfortunately leading to severe neutropenia. For the next 2 years I took only oral vitamin D until a severe flare in 2017 when I was started on sc methotrexate, which lead to anal fissures and a very poor quality of life. Next year (my first as a specialist physician) consisted of extensive joint involvement not controlled by low-dose prednisone. In 2019 Benlysta was finally approved in Romania and I started infusions, finally obtaining remission of symptoms. Unfortunately, my kidney function began deteriorating, biopsy showing class III lupus nephritis. With add-on mycophenolate, HCQ and ACE inhibitor, creatinine and proteinuria decreased, having stable values to the present time. This also determined me to pursue nephrology as a second specialty. Literature Review No relevant information. Discussion Dealing with SLE from both perspectives (patient and doctor) allowed me to better understand all the implications of this disease-on one’s career, family and relationships, self-esteem and overall quality of life, helping me to have a more holistic approach of each case and offer a qualitative care for my patients.
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 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,004 | 0,003 |
| Études des sciences et des technologies | 0,003 | 0,001 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,001 | 0,003 |
| Intégrité de la recherche | 0,006 | 0,005 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,022 | 0,006 |
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 ».