Massive Hemothorax Following Thrombolysis With rtPA in a Stroke Patient With Undiagnosed Rib Fractures
Bibliographic record
Abstract
The majority of strokes are of ischaemic origin. Thrombolysis has led to a radical change in the outcome of these patients as far as management and prognosis. The main objective is the opening up of the occluded artery and early reperfusion of brain tissue. Only 2% to 4% of patients with acute ischemic stroke receive thrombolytic therapy resulting from the current strict inclusion criteria among other issues. Safety of intravenous and intraarterial thrombolysis in off-label situations is controversially discussed. The most feared complication related to the use of rtPA is intracerebral haemorrhage. Our case is an 84-year-old man who after receiving rtPA in the acute phase of a stroke, presented a massive hemothorax secondary to rib fractures which had not been previously diagnosed at admission. The neurological course was excellent and the hemothorax was resolved after inserting chest drainage. To obtain a meaningful database, a registry for off-label thrombolysis should be created. J Med Cases. 2013;4(7):447-449 doi: http://dx.doi.org/10.4021/jmc1250w
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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) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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 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".