Operative management for extent II thoracoabdominal aortoiliac reconstruction for pneumococcal aortitis
Bibliographic record
Abstract
Infectious aortitis is an uncommon but life-threatening condition due to its potential to cause mycotic aneurysms, which may lead to vascular rupture. When signs of vascular disruption are present, isolated antibiotic therapy is insufficient, requiring combined open surgical resection of the infected aorta. A 68-year-old woman diagnosed with Streptococcus pneumoniae aortitis is presented. Multiple saccular mycotic aneurysms of varying sizes along the thoracoabdominal aorta, with intense fluorodeoxyglucose uptake on positron emission tomography scan were present in conjunction with extravascular infectious sources. Urgent Crawford extent II thoracoabdominal aortoiliac reconstruction was indicated. Due to extensive atheromatosis of the proximal descending aorta and the relative contraindication to cerebrospinal fluid drainage (spondylodiscitis), repair was performed with profound hypothermia (18°C). Renal protection was achieved using Custodiol and visceral perfusion maintained with cold blood. Each visceral artery was individually reimplanted using a 26mm multibranched graft. Distal reconstruction was completed with a bifurcated prosthesis, given the presence of severe aortic bifurcation calcification. Despite negative intra-operative cultures, histopathology confirmed extensive aortic inflammatory/reparative findings. Post-operative recovery was uneventful. At 1-year follow-up, the patient remains in good condition, with no clinical recurrence, no pathological positron emission tomography/computed tomography uptake, and a stable aortic repair without suppressive antibiotics.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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".