Reversal of Heart and Respiratory Failure Following Accidental Exposure to Hydrogen Sulfide: Case Report
Bibliographic record
Abstract
Risks of exposure to toxic gases are well recognized during work in sewers, the principal hazards resulting from hypoxia due to the accumulation of methane, carbon dioxide, or hydrogen sulfide and explosive risk as a result of flammable gases. Hydrogen sulfide ( H 2 S ) is a colourless rotten egg odour gas resulting from organic matter decomposition. The severity of H 2 S intoxication depends on the concentration and duration of exposure and the outcome may be fatal. We report the case of a 59-year-old male patient who was acutely exposed to sewers gases following an accidental leak in a swine facility nearly eighteen hours before. He presented to the emergency room with respiratory complaints and chest pain, and rapidly developed a multi-organ dysfunction syndrome with severe cardio-respiratory failure. No methaemoglobinemia was detected and H 2 S was presumed to be the major implicated toxic substance. Treatment strategy relied mostly on supportive measures with a successful outcome. Approach to victims of exposure to sewers gases should recall the strong possibility of poisoning by H 2 S , a life-threatening condition. Since laboratorial dosing of sulfide compounds is not readily available, the initial approach is based on a high clinical suspicion. H 2 S direct toxicity and cellular hypoxic induction may rapidly lead to multi-organic dysfunction and death. Evidence from case reports suggests that early treatment with nitrites, hyperbaric oxygen therapy and hydroxocobalamin may be beneficial. To the present date, supportive treatment remains the mainstay of care. doi:10.4021/jmc397w
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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) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.008 | 0.005 |
| Insufficient payload (model declined to judge) | 0.002 | 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".