Acute renal failure in a young woman with endometriosis
Bibliographic record
Abstract
(Section Editor: M. G. Zeier) A 27‐year‐old woman was known to have a solitary left kidney since the age of 17. In her early 20s she was investigated for recurrent lower abdominal pain related to her menstrual periods. At the age of 25 (1997), pain in the right inguinal area was explored surgically, and endometriosis in the proximity of the round ligament was found and excised. Cyclic pelvic pain was investigated further and a laparoscopy showed endometriosis in the Douglas pouch. The patient was also known to have a bicornuate uterus, which was considered to be a risk factor for endometriosis. While waiting for definitive surgery of pelvic endometriosis (December 1997), she presented recurrent episodes of fever, anorexia, nausea and fatigue accompanied by pelvic pain beginning in the middle of her menstrual periods and lasting for a few days afterwards. She noted progressive polyuria and nocturia. She came to medical attention in April 1998, during a more severe cyclic episode with vomiting and headache. She was found to be severely hypertensive (blood pressure 200/120) with an elevated serum creatinine at 201 μmol/l (baseline value of 89 μmol/l in 1989). An ultrasound showed hydronephrosis of the solitary left kidney with hydroureter. A retrograde pyelogram demonstrated severe obstruction of the distal ureter of the solitary kidney (Figure 1). A double J catheter was advanced with difficulty into the left ureter through the tight distal stenosis. Her clinical symptoms corrected readily together with improvement in serum creatinine.
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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 | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.006 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".