Neonatal and childhood right atrial thrombosis: recognition and a risk-stratified treatment approach
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Pediatric literature and guidelines of treatment options for right atrial thrombosis (RAT) are lacking; thus, this review summarizes the available literature on RAT in infants and children. Medline search identified 35 publications, with 27 prospective or retrospective case series included for data analysis. A total of 122 cases of RAT were identified. The mean age of patients is 3.58 years (n = 86) with a strong predominance in the neonatal and infancy period. Ninety-one percent of cases were found to be associated with central venous catheters, 40.8% are premature neonates, 27.2% are postcardiac surgery patients, and 19.2% have underlying malignancies. Gut failure with total parenteral nutrition given via the central venous catheters occurred in 45.6% of patients. The most frequent presenting symptoms are respiratory distress and arrhythmia, and 56.8% (42 of 74) were asymptomatic. Our study defined high-risk features on echocardiogram as large size, more than 2 cm in any dimension, pedunculated, mobile, or snake-shaped, and mobile. Our result confirmed there is significant difference in the mortality for the high-risk group (16.7%; three of 18) versus the low risk group (0%; n = 32; P = 0.0416). Moreover, none of the asymptomatic patients showed progression in disease or died. Asymptomatic and hemodynamically stable patients with RAT who are at low risk are associated with good prognosis irrespective of treatment. We recommended removal of central venous line if possible, with or without anticoagulation for this group of patients. Systemic anticoagulation therapy should be given to all high-risk or symptomatic RAT patients. Surgical thrombectomy or thrombolytic therapy carries significant risk and should be considered individually.
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Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it