Dysphagia and Eosinophilic Infiltration of the Esophageal Muscular Layer: A Case Report
Bibliographic record
Abstract
Eosinophilic gastrointestinal diseases are a group of pathological entities characterized by an eosinophilic infiltration of the gastrointestinal tract without known cause. Eosinophilic esophagitis (EE) is one of these conditions, which has three diagnostic criteria: symptoms of esophageal dysfunction, mucosal infiltration of 15 eosinophils per high-power field (HPF) microscope and no response to high-dose proton pump inhibitors (PPIs). A 51-year-old patient attended to the emergency department claiming to suffer from heartburn, dysphagia, regurgitation and chest pain. He was treated with high doses of PPIs without success and the condition progressed to food impaction. An esophagogram, which showed esophageal motor dysfunction in the middle and lower part of the esophagus, was performed, and pathologic examination of an esophageal biopsy taken by endoscopy revealed histopathological changes suggestive of gastroesophageal reflux disease. An esophageal manometry was carried out and it reported diffuse esophageal spasms and a hypertensive inferior esophageal sphincter with incomplete relaxation. A Heller cardiomyotomy was performed and the biopsy specimen revealed fibrosis and eosinophilic infiltration of the muscular layer. Symptoms ceased for 6 months after which symptoms reappeared. The patient was diagnosed with EE and treated with budesonide orally 12 mg/day with complete remission of all symptoms. In this peculiar case, the eosinophilic infiltration was in the muscular layer of the esophagus, not in the mucosa; therefore, it did not meet the diagnostic criteria of EE nor its differential diagnoses. Nevertheless, treatment with oral steroids was in fact effective. J Med Cases. 2014;5(12):621-626 doi: http://dx.doi.org/10.14740/jmc1942w
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.004 | 0.003 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.004 | 0.003 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.010 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
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".