Long-term use of subcutaneous octreotide reduces variceal bleeding in non-cirrhotic portal hypertension
Bibliographic record
Abstract
Background: Non-cirrhotic portal hypertension from a portal vein thrombus can cause variceal bleeding. The use of vasoactive agents such as octreotide is currently limited to acute bleeding episodes. Current strategies to reduce recurrent bleeding events include non-selective beta blockers, treatment of underlying disease including management of risk factors, and periodic endoscopic therapy. There is limited literature on the use of subcutaneous octreotide in the long-term management of recurrent variceal bleeding. Case: We present a 55-year-old male with progressive non-cirrhotic portal hypertension on the basis of a portal vein thrombus with extensive thrombosis leading to significant portal hypertension and episodic acute variceal bleeding over the course of 15 years. Progression of varices throughout the gastrointestinal tract led to more severe bleeding with requirement for massive transfusion protocols. He was deemed not suitable for shunting procedures or transplantation due to increased bleeding episodes and development of ascites. Results: Following commencement of twice-daily subcutaneous octreotide, no further clinically significant bleeding events occurred. He remains stable more than 3 years on from therapy. Conclusions: This case demonstrates an observed reduction in clinically significant bleeding and red cell transfusion requirements in a non-cirrhotic portal hypertension patient on daily octreotide. Further larger-scale, randomized controlled studies are required to investigate this observation.
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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 | 0.000 | 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) | 0.001 | 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".