Pediatric cardiac toxicity associated with fentanyl ingestion
Bibliographic record
Abstract
In North America, opioid-related deaths are on the rise. We report a case of pediatric cardiac toxicity likely related to illicit fentanyl ingestion. A 14-year-old male ingested half of an illicit pill. Two hours post-ingestion, the patient experienced loss of consciousness, hypotension, cyanosis and diaphoresis. He reported chest pain 8 hours post-hospital arrival. Initial lab reports revealed elevations in lactate and high-sensitivity troponin concentrations. A chest radiograph revealed a right-sided aspiration pneumonia. An electrocardiogram showed ST elevation over the anterior leads and T wave inversion over the inferior leads. An echocardiogram demonstrated borderline systolic function. Initial cardiac magnetic resonance imaging revealed inflammation. Comprehensive urine drug screen was positive for fentanyl and its metabolites, cannabinoids, ondansetron, metoclopramide and ranitidine and was negative for xylazine. The management included administration of non-invasive positive-pressure ventilation, naloxone, acetaminophen, ceftriaxone, and clindamycin. Hypotension was treated with calcium gluconate, dopamine, and norepinephrine. He was able to wean off inotropes the next day and went home 5 days post-presentation. A repeat cardiac MRI performed six months post-ingestion was normal. Illicit fentanyl use in an adolescent appeared to cause myocardial injury with cardiogenic shock, elevated serum troponins, and transient abnormalities on electrocardiography and cardiac imaging.
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How this classification was reachedexpand
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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 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) | 0.000 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, 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".