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PROFOUND WEAKNESS AFTER AN ARCTIC EXPEDITION

2001· article· en· W2004957163 on OpenAlexaboutno aff
Kathleen M. Sheehan, Peter Frykman, M. A. Sharp

Bibliographic record

VenueMedicine & Science in Sports & Exercise · 2001
Typearticle
Languageen
FieldMedicine
TopicAlcoholism and Thiamine Deficiency
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineIngestionRhabdomyolysisInternal medicine

Abstract

fetched live from OpenAlex

HISTORY - 29 y/o previously healthy Norwegian male presented with profound weakness and palpitations 36 hours after he and a fellow expeditioner successfully completed the first unsupported Arctic ski trek. The expedition consisted of a 109-day mission traversing 1,914 km from Russia through the North Pole to Canada. On the ice, he consumed a high fat, high calorie daily ration of 6,000 kcal/d. Some food ingested during the final 19 days of the trek may have been contaminated by fuel, which spilled onto the limited rations. Only pre-packed food rations were ingested during the trek. No significant alcohol or drug history was noted. PHYSICAL EXAM- Ht- 188 cm, wt- 89.1kg (down 25.4 kg from pre-expedition wt of 114.5 kg), BP- 155/70 supine, 126/70 standing, pulse- 52 supine, 55 standing, normothermic, General- emaciated white male in mild distress, alert and oriented, Lungs- clear, CV- occasional premature beats, no murmurs or gallops, Abdomentender hepatomegaly with liver edge 2 cm below right costal margin, no splenomegaly, masses, or ascites, GU/Rectal-normal, Extremities-no edema or frostbite injury, decreased sensation to pinprick over fingers and toes, hands pale appearing, Neurologic- normal, gait slowed with difficulty walking up a 5% grade, muscle strength 4/5 throughout, no muscle tenderness or fasciculations, reflexes normal. DIFFERENTIAL DIAGNOSIS - Hepatic- 1) hepatitis- viral 2) toxic hepatic necrosis from hydrocarbon fuel ingestion 3) acute fatty liver secondary to high fat diet Neurologic-peripheral neuropathy: 1) toxicity from hydrocarbon ingestion 2) cold-induced 3) thiamine deficiency Metabolic- protein- calorie malnutrition TESTS AND RESULTS- Chemistries normal except for potassium-3.4 (nl 3.5–5.3), chloride-107 (nl 98–106), total protein-5.4 (nl 6.2–8.0), albumin-2.8 (nl 3.5–5.0), AST-142 (nl 15–37), ALT-149 (nl 30–65), LDH- 232 (nl 100–200). Cardiac enzymes, CBC, PT/PTT, hepatitis panel, blood cultures, monospot, and TFT-all normal, drug screen- negative, EKG- normal sinus rhythm, diffuse non-specific T wave abnormalities, CXR- normal, CT Scan of Abdomen- mild to moderate hepatomegaly with increased liver density, DEXA - 5.9% body fat FINAL/WORKING DIAGNOSIS- Acute hepatitis secondary to inadvertent fuel ingestion Peripheral neuropathy- hydrocarbon toxicity vs. cold-induced vs. nutritional Protein-calorie malnutrition with hypoalbuminemia TREATMENT - Phone consultation with Denver Poison Control Center, no antidote available this late after hydrocarbon ingestion. Refeeding, thiamine, folate, and vitamin repletion. I.V. hydration and electrolyte replacement begun. Supportive care given. Follow-up care requested with gastroenterologist and neurologist upon return to Norway for resolution of liver function abnormalities and neuropathy.

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 distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.031
Threshold uncertainty score0.999

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0010.002
Science and technology studies0.0000.002
Scholarly communication0.0000.001
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

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.

Opus teacher head0.021
GPT teacher head0.307
Teacher spread0.286 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2001
Admission routes1
Has abstractyes

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