Treatment of Refractory Hand and Foot Eczema with Nail Involvement Using Upadacitinib: A Case Report
Bibliographic record
Abstract
cilastatin-induced HSRs, including ours, there were not a cross-reactivity to meropenem.However, Bakir et al. had described a patient with meropenem-induced MPE, who cross reacted to ertapenem and tolerated imipenem.1 In addition to the betalactam ring, the carbapenem nucleus contains an unsaturated 5-membered ring with a carbon atom.It is the side chains attached to this basic 2ring structure that distinguishes the different carbapenems from each other.Meropenem and ertapenem display a pyrrolidine side chain present in the C-2 position, absent in the imipenem structure.1 This hypothesis could explain the selective pattern of the hypersensitivity to imipenem found in our patient and others and the potential cross-reactivity between meropenem and ertapenem as found by Bakir et al. 1 Therefore, we report a clinical case of imipeneminduced nonimmediate hypersensitivity, with a lack of cross-reactivity to other betalactams, especially meropenem and ertapenem.In light of the literature analysis, we strongly suggest that hypersensitivity to imipenem is "selective" and that the use of other carbapenems (ertapenem, meropenem) could be safe.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.006 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
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".