Hepatobiliary alveolar echinococcosis treated with delayed resection following percutaneous drainage
Bibliographic record
Abstract
. Although incidence has been increasing, it continues to be an overlooked infectious disease in North America. In this case, the patient presented with jaundice, cholestatic hepatitis, and 14 kg weight loss over two months. He was subsequently diagnosed with metastatic alveolar echinococcosis affecting the spleen, biliary tract, and liver. Due to the extensive nature of his disease, he was initially considered unsuitable for curative resection. The patient was assessed for liver transplantation by a multidisciplinary team including Hepatobiliary/ Transplant Surgery, Transplant Hepatology, Transplant Infectious Diseases, and an Infectious Diseases physician experienced in managing alveolar echinococcosis. The patient and team opted for medical management given the high perioperative morbidity and substantial risk of disease recurrence. After percutaneous drain placement and 2.5 years of albendazole monotherapy, significant regression of the disease permitted curative intent left hepatectomy with en-bloc cholecystectomy. The surgery was completed successfully and the patient continues albendazole therapy following evidence of residual disease on PET-CT. This case illustrates the challenges inherent in the management of advanced alveolar echinococcosis, reviews decision-making regarding transplantation, and underscores the importance of a multidisciplinary approach to disease management.
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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 | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".