P-35: Gastric Metaplasia in Patients with Esophageal Atresia/Tracheo-Esophageal Fistula (EA- TEF) Aged Less Than 10 Years
Bibliographic record
Abstract
EA-TEF patients can develop Barrett's esophagus (BE) which requires careful follow-up. Chronic reflux is associated with BE in adults, but incidence and risk factors for developing BE in EA-TEF are unknown. To determine 1- The incidence of gastric metaplasia (GM) and 2- Factors associated with GM in EA-TEF patients. Retrospective review of EA-TEF clinic charts of 77 children born 2004–2012. Death (n = 6), children followed elsewhere (n = 6) or patients who had had no esophageal biopsy (n = 13) were excluded. Of 52 patients evaluated (mean follow-up 6.5 y; range 1.5–10), 6 (12%) had an endoscopy suspected BE with GM confirmed at histology. No patients developed intestinal metaplasia. There was no difference in atresia type nor associated malformations between patients with GM with those without GM (NM). The anastomotic leak rate was similar (28% vs 33%, NM vs GM). 41% of NM patients developed anastomotic strictures requiring a mean (range) of 3.3 (1–8) dilatations, vs 66% of GM patients (7 (3–17) dilatations). No patients with GM tolerated discontinuation of PPI therapy versus 53% of NM patients (p < 0.01, χ2 test). Higher rates of esophagitis were observed on endoscopy or histology in patients with GM (83% vs 37%; p < 0.01). 12% of EA-TEF patients < 10 years followed in a single center EA-TEF clinic developed esophageal GM. These patients had more severe gastroesophageal reflux. This underscores the need of a close endoscopic follow-up of these children.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".