[Spinal cord stimulation and quality of life in patients with refractory angina].
Bibliographic record
Abstract
BACKGROUND: Spinal cord stimulation (SCS) is a treatment that exploits the antalgic and vasodilatory effects on the microcirculation produced by a stimulating electrode positioned in the peridural space. This therapy has been used for years in the treatment of refractory angina pectoris. The aim of this study was to monitor the clinical effectiveness of the technique in terms of symptomatic benefits and, above all, improved quality of life in angina patients undergoing SCS. METHODS: From November 1998 to December 2000 we used SCS to treat 17 patients with refractory angina (functional class III or IV Canadian Cardiovascular Society) with onset more than one year earlier. All patients had undergone one or more traditional revascularisation procedures and were receiving maximum drug therapy. Patients were assigned to SCS because it was not technically possible to perform other revascularisation procedures. Quality of life was measured before and after treatment using a multidimensional index (QL Spitzer's index). We also noted the mortality, acceptance and morbidity of the procedure during a follow-up lasting 10 months on average. Lastly, the number of weekly anginal pain attacks, weekly nitrate consumption and CCS functional class were recorded before treatment and 1, 3 and six months after therapy. RESULTS: SPC was effective in 13 patients out of 17 (76.47%). In responders the quality of life improved by 70%: in these patients, the number of weekly angina attacks reduced from 11.76+/-7.56 to 2.14+/-2.54, and the functional class from 3.30+/-0.75 to 1.5+/-0.53. No major periprocedural complications were reported. The annual mortality rate was 6.6%. The technique was easy to use. CONCLUSIONS: The results of this study show that SCS is effective, safe, easy to use and well tolerated by patients with refractory angina who fail to respond to traditional revascularisation. This technique substantially improves the quality of life of patients suffering from refractory angina.
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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 | 0.001 |
| 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) | 0.003 | 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".