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Record W2060694545 · doi:10.1159/000076540

No More Intravenous Procaine for Pancreatitis Pain?

2004· letter· en· W2060694545 on OpenAlexaboutno aff
Markus M. Lerch

Bibliographic record

VenueDigestion · 2004
Typeletter
Languageen
FieldMedicine
TopicPancreatitis Pathology and Treatment
Canadian institutionsnot available
Fundersnot available
KeywordsProcainePancreatitisMedicineAnesthesiaDiseaseIntractable painGeneral surgerySurgeryInternal medicine

Abstract

fetched live from OpenAlex

Having been trained in the German-speaking world ofpancreatology, I was taught that the pain of patients withpancreatitis is special – special in that it responds well tointravenous procaine, a drug then commonly used as ei-ther a local anaesthetic or a cure for ventricular arrhyth-mias. Special also in that drugs generally used for a pain inother diseases were ‘verboten’ in pancreatitis because theywould make the disease worse. Since hands-on experi-mental work had taught me that pancreatitis is, indeed, avery special disease, I followed the rules for medical resi-dents and pancreatitis patients in pain received their24-hour infusions of procaine.First doubts about this approach arose when manypatients treated in this way remained in pain, requiredhigh doses of additional analgesics, or developed ECGchanges. Due to repeated exposure to the Anglo-Saxonworld of pancreatology, my belief was further shakenwhen British or Canadian pancreatitis patients with painwere not regarded as special at all: they received morphinefor severe pain just like cardiac or tumour patients, itrelieved their symptoms sufficiently well, and it did notseem to negatively affect the course of the disease.Many years later, when I participated in the steeringcommittee of an international pancreatitis study and sug-gested to ask in the questionnaire whether patients hadbeen treated for pain with procaine, the response of mypeers from Italy, France, Spain, Scandinavia and the UKranged from bafflement to mild ridicule. None of themhad ever heard of procaine as a treatment of pain in acutepancreatitis.The final results of said study as well as consultation ofstandard textbooks from the countries of my colleaguesmade me realise that pain in pancreatitis is special only –and treated with procaine only – in the German-speakingworld. Why the rest of the world had failed to see the wis-dom of this approach became quickly apparent during aMedline/PubMed search which, at that time, did notresult in a single article or case report when ‘procaine

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 imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.003
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.033
Threshold uncertainty score0.109

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.003
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.001
Bibliometrics0.0000.000
Science and technology studies0.0000.001
Scholarly communication0.0010.002
Open science0.0000.001
Research integrity0.0020.003
Insufficient payload (model declined to judge)0.0330.007

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 head0.013
GPT teacher head0.259
Teacher spread0.246 · 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 source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreCommentary

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

Citations10
Published2004
Admission routes1
Has abstractyes

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