The prophylactic use of C1 esterase inhibitor in HAE patients undergoing invasive procedures
Bibliographic record
Abstract
For a patient with Hereditary Angioedema (HAE), physiological and/or psychological stress can cause insufficient control of local inflammatory pathways. This leads to complement and contact system activation and excess bradykinin resulting in angioedema. Therefore, an invasive procedure or surgery can trigger an HAE attack; this in turn can cause further medical complications and pose an added danger to the post-procedure patient. C1 inhibitor, Berinert®, was approved in the US and Canada in 2009 and 2010, respectively, for the treatment of acute attacks. In April 2013, Berinert® was approved in Europe for short-term prophylaxis prior to medical, dental, or surgical procedures to prevent HAE attacks. Currently, Berinert® is not approved in Canada or the US for prophylaxis. We aim to demonstrate the effectiveness of C1 esterase inhibitor, Berinert®, as a prophylactic treatment for HAE patients undergoing invasive procedures. A retrospective chart review from our Canadian Tertiary Care Allergy and Asthma Clinic of our entire database of HAE patients was performed. Between 1997 and June 2014, C1 esterase inhibitor for prophylactic use was administered prior to invasive procedures. There were a total of 28 procedures, performed on 15 patients. The 28 procedures breakdown as follows: 9 dental surgeries, 3 open heart surgeries, 8 other surgical procedures, 3 child birth, 5 invasive procedures In all 28 procedures, there was no incidence of post-procedure HAE attacks after prophylactic administration of C1 esterase inhibitor. We found that C1 esterase inhibitor decreased the incidence of post-procedure HAE attacks and was an effective prophylactic treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".