322 THE TRIALS AND TRIBULATIONS OF ADRENAL VEIN ALDOSTERONE SAMPLING
Bibliographic record
Abstract
Background: The objective of this study was to determine the success rate of adrenal vein aldosterone sampling(AVS) on patients with documented primary hyperaldosteronism. Methods: From October, 2005 to April, 2011 forty cases of adrenal vein aldosterone sampling were reviewed for success in accessing the adrenal veins. Blood was obtained from both adrenal veins and the inferior vena cava (IVC). The concentrations of aldosterone and cortisol were then measured. AVS was considered successful if the plasma level of cortisol in the adrenal vein was more than 10 times higher than that in the IVC (Funder et al, 2008). Results: A total of 40 cases were reviewed with 18 (45%) cases being successful in accessing both adrenal veins. Twenty-two (55%) of the cases had adrenal adenomas. Within the 18 successful cases 5(12.5%) had the AVS repeated. Nine (50%) of the successful cases went on to have an adrenalectomy. There was 1 successful case that had a complication of bleeding into the right adrenal gland. The success rate of the two designated interventional radiologists was 61% and 20%. Conclusions: On the basis of CT results alone 22 (55%) of the subjects would have been candidates for an adrenalectomy. Although the success rate for AVS was 45%, this success rate resulted in 18% of the subjects not inappropriately undergoing surgical intervention to treat their primary hyperaldosteronism. Although the overall success rate is less than 50%, the complication rate was low (2.5%). The skill of the interventional radiologist is key to successful AVS. References: Funder JW, Carey RM, Fardella C, Gomea-Sanchez CE, Mantero F, Stowasser M,Young Jr. WF, Montori V. Case detection, diagnosis, and treatment of patients with primary aldosteronism: an endocrine society practice guideline. The Journal of Clinical Endocrinology & Metabolism 2008; 93:9:3266-3281. Mattsson C & Young Jr. WM. Primary aldosteronism: diagnostic and treatment strategies. Nature Clinical Practice Nephrology 2006;2:4:198-208. Rossi GP, Pessina AC, Heagerty AM. Primary aldosteronism: an update on screening, diagnosis and treatment. Journal of Hypertension 2008;26:4:613-621. Stewart PM & Allolio B. Adrenal vein sampling for primary Aldosteronism: time for a reality check. Clinical Endocrinology 2010;72:146-148. Young Jr. WF, Stanson AW, Thompson GB, Grant CS, Farley DR, van Heerden JA. Role for adrenal venous sampling in primary aldosteronism. Surgery 2004;136:6:1227-1235. Young Jr. WF & Stanson AW. What are the keys to successful adrenal venous sampling (AVS) in patients with primary aldosteronism? Clinical Endocrinology 2009;70:14-17.
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 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 | 0.021 | 0.110 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
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".