Severe dysphagia due to rapidly progressive pharyngoesophageal segment stenosis in systemic sclerosis
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
Purpose To describe a case of pharyngo-esophageal segment involvement by systemic sclerosis resulting in severe and rapid progressive dysphagia refractory to management. Case report A 69-year-old female with known systemic sclerosis presented with progressive solid and liquid food dysphagia. Serial video fluoroscopic swallowing studies demonstrated progressive hypopharyngeal and upper esophageal sphincter stenosis along with oropharyngeal dysphagia. Attempted esophagogastroduodenoscopy by gastroenterology using a 5.4 mm diameter gastroscope failed to pass through the hypopharynx. Operative laryngoscopy demonstrated a 3 mm hypopharyngeal lumen extending for 2 cm into the cervical esophagus. The stenosis was cannulated and dilated to 10 mm, but remained refractory to further dilations. The patient was unable to maintain any oral intake and required percutaneous gastrostomy placement. Conclusions Involvement of the pharyngo-esophageal segment is an underreported cause of severe dysphagia in patients with systemic sclerosis. Early recognition is necessary to prevent complete stenosis.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 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