Role of sodium thiosulfate therapy in the treatment of digital necrosis due to <scp>M</scp>önckeberg sclerosis
Bibliographic record
Abstract
Accelerated vascular calcification is a well-described complication of chronic kidney disease often affecting large and small vessels alike through a variety of mechanisms. Accordingly, dysregulation of calcium and phosphate balance, vitamin D metabolism, hyperparathyroidism, and endothelial injury can lead to both macrovascular and microvascular complications. We describe a 56-year-old Hispanic male with a history of end-stage renal disease, diabetes mellitus type 2, and medical noncompliance who developed sequential digital ischemia and necrosis involving both hands as well as right foot as a result of Mönckeberg sclerosis. An extensive metabolic and serologic workup was unrevealing but radiographic studies and histopathology revealed the diagnosis. A multifaceted approach was instituted including wound debridement and amputations along with intensive medical support. In addition to improving hypertensive control and striving for improved calcium and phosphate balance, sodium thiosulfate solution was administered for more than 1 year. This aggressive approach allowed his wounds to heal and has arrested further digital ischemia from occurring.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".