Diverticular disease-associated segemental colitis: A 14 year follow up
Bibliographic record
Abstract
Diverticular Disease-Associated Segmental Colitis is a variant of chronic colitis which is limited to the rectal area, which is associated with diverticular disease. Histologically it can be differentiated from idiopathic colitis with limited inflammation to the segment and sparing the rest of the colon. There is no long term data on the natural history of this entity. This is a prospective fourteen year follow up on 14 patients who presented with recurrent abdominal pain, with bloody mucousy diarrhoea. Patients were referred either from the emergency room of a teaching hospital or from private offices. Investigation included haematological and biochemical parameters, stool cultures including C. difficile toxin. Colonoscopy with multiple biopsies was performed on all patients at admission and repeated at one year and every three years or earlier. Patients who had acute diverticulitis with CT scan finding of abscess or stricture were excluded. Patients who were diagnosed with acute colitis were excluded. All patients were started on Mesalamine and some received intermittent courses of topical 5ASA therapy. There were 9 males and 5 females with a mean age of 53.2±14.5. The mean duration of symptoms was 34.8± 27 weeks. All patients fit the criteria for Diverticular Disease-Associated Segmental Colitis. Endoscopically the mucosa revealed patchy hyperaemic changes without any evidence of ulceration. This involvement was restricted to the segment with diverticular involvement. Histologically the biopsies showed moderate on chronic colitis with moderate gland distortion, mucin loss and lymphoid hyperplasia. The biopsies proximal and distal to the involved areas were reported to be normal. Five patients stopped their medications and relapsed within six weeks, and were restarted on Mesalamine. The mean follow was 10.4 ± 4.2 years. All patients were treated with Mesalamine at a dose of 1220±600mg. three patients underwent resection for persistence of symptoms and remained asymptomatic. Three patients had intermittent flare ups of symptoms. One patients developed severe diverticulitis and perforated. He subsequently died. Diverticular Disease-Associated Segmental Colitis may respond to 5-aminosalicylate with improvement in symptoms. These patients are at the risk of developing diverticulitis and recurrence in symptoms. Although Mesalamine appears to control the symptoms flare-ups are not uncommon. A proper placebo controlled study is needed to ascertain the natural history of this entity.
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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 | 0.001 | 0.001 |
| 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) | 0.001 | 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".