No More Intravenous Procaine for Pancreatitis Pain?
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
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
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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