Reporting on Adverse Clinical Events
Bibliographic record
Abstract
A 66-year-old male inpatient with advanced HIV infection developed progressive tachypnea, tachycardia, and hypotension approximately 4 days after starting intravenous trimethoprim/sulfamethoxazole (TMP/SMX; 300 mg/1500 mg every 6 hours) for the treatment of suspected pneumonia.Upon admission the patient was taking aspirin, ibuprofen, and a nitroglycerin transdermal patch.Initial treatment for suspected pneumonia was intravenous ceftizoxime (no dosage provided) and TMP/SMX.On the second day of hospitalization, the ceftizoxime was replaced by erythromycin.Additional medications also included zidovudine, lamivudine, and saquinavir.Despite an improvement in respiratory symptoms and fever, the above-mentioned complications developed on hospital day 4.During blood sampling, the patient's blood was noted to have a blue tinge.Further analysis demonstrated a methemoglobin level of 25% and an arterial blood pH of 7.22.The antiviral drugs and TMP/SMX were immediately discontinued and exchange blood transfusions were performed.Within 24 hours, the methemoglobin levels decreased to less than 1% and symptoms resolved.Aerosolized pentamidine replaced TMP/SMX therapy.No further symptoms were noted, even after the antiviral drugs were restarted.Review of the medical records revealed that the patient had a similar episode of methemoglobinemia associated with TMP/SMX administration 7 years earlier.The authors concluded that this patient developed methemoglobinemia when rechallenged with TMP/SMX 7 years after a similar episode related to the same drug.The authors suggested that the high dosage of sulfamethoxazole used in the intravenous TMP/SMX form may contribute to the supersaturation of NADH dehydrogenase, the enzyme responsible for the reduction of methemoglobin to hemoglobin.Trimethoprim/Sulfamethoxazole ["Bactrim," "Septra"]
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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 | 0.007 | 0.045 |
| 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 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.007 |
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; both teacher heads agree on what is shown here.
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".