Wikipedia talk:WikiProject Medicine/Archive 6

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Video Wikipedia talk:WikiProject Medicine/Archive 6

Introduction to virus

A request for peer review has been opened for Introduction to virus. That is a request for editors like you to review the article. --Una Smith (talk) 05:11, 21 December 2007 (UTC)

Maps Wikipedia talk:WikiProject Medicine/Archive 6

Germanic New Medicine / request for help

Hi! Could somebody, who knows enough about this matter, help? This article seems to involve legal and medical aspects... See main article Ryke Geerd Hamer... I personally would like to delete that article, but there seem to be quite rampant proponents for that article... I made that request already here, but got no reply yet... --Homer Landskirty (talk) 17:29, 22 December 2007 (UTC)

I also think the article should be deleted. There's a summary in Hamer's biography, which is plenty of attention for this bit of obscure quackery. Germanic New Medicine could turn into a redirect page for the article on its "inventor." WhatamIdoing (talk) 17:58, 22 December 2007 (UTC)

OK... I filed an afd process... --Homer Landskirty (talk) 19:10, 22 December 2007 (UTC)

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Irritable hip

I significantly expanded this stub and nominated it for DYK on the main page (although it might still be 300 words short...). Please check it out, have a read and correct my spelling/grammar/wording and all the rest. Many thanks, --Steven Fruitsmaak (Reply) 22:44, 22 December 2007 (UTC)

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Pollution and cancer

Comments invited on Talk:Cancer on the role of industrial pollutants and cancer. JFW | T@lk 16:57, 23 December 2007 (UTC)

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Rotavirus

I plan to submit for FAC early in the new year and the article would benefit from some input from the team. Please have a look at it. I will need some support on this.--GrahamColm^Talk 17:53, 23 December 2007 (UTC)

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Alaska Mental Health Enabling Act Main Page nomination

I've nominated Alaska Mental Health Enabling Act, a featured article, to appear on the Main Page on January 16 2008, the 52nd anniversary of the introduction of the Act into the US Congress. Please feel free to comment at Wikipedia:Today's featured article/requests#January 16. -- ChrisO (talk) 23:09, 23 December 2007 (UTC)

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Proliferation of Case Studies in Environmental Medicine external links

Are 158.111.4.25 (talk · contribs) adding external links on multiple topics to http://www.atsdr.cdc.gov/csem/ (ATSDR - Case Studies in Environmental Medicine) helpful ? I suspect not in this blanket manner. David Ruben ^Talk 02:10, 22 December 2007 (UTC)

I support removal of all links. What has Anniston, Alabama got to do with PCBs that is so important as to merit links? JFW | T@lk 22:00, 22 December 2007 (UTC)

So done where they were the originator of the link. A WHOIS search was most illuminating - registered to The United States Centers For Disease Control in Atlanta, so WP:COI ! David Ruben ^Talk 01:06, 23 December 2007 (UTC)

Indeed, but what's their incentive for spamming? Are they trying to promote their work or something? Cool Hand Luke 01:33, 23 December 2007 (UTC)

Do we need a motive? After the Bogdanov Affair I am convinced that scientists are not below using Wikipedia to further their personal agendas. JFW | T@lk 08:59, 23 December 2007

some a y'all are paranoids, thats an official US government agency, how could ur own government and its official departments be spamming? yes its a "sensitive agency" in this day and age, and it does look like though this department is subtley encouraging people to join in to this research area, but its not exactly a spam the one i saw, its not saying "buy our product 19.95", but i will try to make some time to look at other examples, and cool name cool-hand-luke! 83.79.143.64 (talk) 11:40, 24 December 2007 (UTC)(UTC)

"Spamming" on Wikipedia does not necessarily mean intent to sell a product. It may also serve to increase exposure to certain ideas or publications, fundraising or somesuch. Using Wikipedia for this purpose is generally frowned upon, as per WP:NOT, WP:EL and other content guidelines. JFW | T@lk 13:26, 24 December 2007 (UTC)

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Oxygen at FAC

Please comment at Wikipedia:Featured article candidates/Oxygen. --mav (talk) 21:48, 23 December 2007 (UTC)

And Reactive attachment disorder is at peer review. --WS (talk) 13:21, 24 December 2007 (UTC)

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Devic's disease

Two editors have tried to put a Google Groups URL on Devic's disease. Opinions are invited on Talk:Devic's disease. JFW | T@lk 16:13, 24 December 2007 (UTC)

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Paleolithic style diet

Should the article Paleolithic style diet be part of the Wikipedia:WikiProject Medicine (since it could be considered as a form of evolutionary medicine), or would it be more appropriately included in the Wikipedia:WikiProject Alternative Medicine? Thanks! --Phenylalanine (talk) 20:27, 24 December 2007 (UTC)

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Haloperidol

Could other editors look at Haloperidol repeated deletion of material on its emergency psychiatric role (albeit declining role as I had modified and cited), what seems POV-pushing undue-weight anti-psychiatry insertion of "Torture, Punishment, Interrogation" sections (also see discussion threads) and other minor disruption to the article. David Ruben ^Talk 20:49, 25 December 2007 (UTC)

I've semi-protected it given the volume of edit-warring by this dynamic IP. This will hopefully encourage discussion rather than edit-warring regarding these controversial proposed edits. MastCell ^Talk 20:55, 25 December 2007 (UTC)

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Merging CLINMED into MED

I just merged Wikipedia:WikiProject Clinical medicine into Wikipedia:WikiProject Medicine based on previous consensus, and I've made some changes to the Medicine project page: please comment here, or make appropriate bold changes yourself. --Steven Fruitsmaak (Reply) 02:28, 26 December 2007 (UTC)

Thanks Steven. I never quite got around to doing that, despite the widespread consensus that the WikiProjects had exactly the same scope and members.

• How about a separate area of this talkpage that serves as a "noticeboard"?
• Any fresh ideas on how to coordinate collaborative edits? At the moment, MCOTW is languishing, and I'm reluctant to roll it around until we have more consensus on how it is meant to function. The present de facto collaboration is herpes zoster. JFW | T@lk 07:58, 26 December 2007 (UTC)

As some may know, herpes zoster is currently a Featured article candidate (since 10 Dec). A number of issues have been raised at FAC and on the talk page. Eubulides's summarised some areas that need work. Project members can particularly help by checking the text against the source and ensuring the medical facts are up-to-date and reflect a world view.

Might I suggest that Rotavirus (mentioned above) see collaborative effort too. There's no reason work on both can't be overlap, so head on over there and give Graham a hand getting this to FA. Colin°^Talk 08:22, 26 December 2007 (UTC)

I've moved the current active threads from WT:CLINMED & merged into this talk page, older threads I added into WT:CLINMED/Archive_11.

• To do: Wikipedia:WikiProject_Clinical_medicine/Collaboration and Wikipedia:WikiProject_Clinical_medicine/categorizations need then moving/merging

David Ruben ^Talk 12:47, 26 December 2007 (UTC)

Noticeboard: if we reformat {{MedProjectNews}} we can use that for Project news. We have a similar template for community news on Wikinews and it works quite well, anybody can add project news and it can be displayed on several pages. The collaboration dashboard is like a noticeboard for articles. All pages need a reorganisation; I strongly suggest establishing Wikipedia:WikiProject Medicine/Proposals to coordinate proposals and split those discussions away from the general talk here.

Article collaboration: I liked the idea of having a page were editors can list 3 to 5 articles they're actively improving and seek help with. I've been spamming mine already (irritable hip, gestational diabetes) but I think if we set up a page were everyone can add up to 3 pages where they are working and they want help with, you can find the pages that are currently our top priority. It helps to see what everybody is doing and where you might find your favourite colleagues and help out. --Steven Fruitsmaak (Reply) 20:37, 26 December 2007 (UTC)

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Sudden death

Tagging some articles WPMED, I noticed Sudden death is a redirect to a disambig page, and the only medical link there is to Sudden cardiac death. Wikipedia needs an article on Sudden death (medicine). Anyone here care to take a stab at it? --Una Smith (talk) 16:02, 26 December 2007 (UTC)

Initially, sudden death was about the phenomenon in sport, and I spent a very long time changing the links.

I think the terms "sudden death" and "sudden cardiac death" are used interchangeably. Does anyone think there are other conditions that need mentioning under this header? Otherwise we can just redirect sudden death (medicine) to sudden cardiac death. JFW | T@lk 16:35, 26 December 2007 (UTC)

On Talk:Sudden cardiac death there is mention of a list of 15 causes of sudden death other than sudden cardiac death. --Una Smith (talk) 18:07, 26 December 2007 (UTC)

I agree with the contributor there (and therefore with you, Una) that we ought to perhaps list diseases that can rapidly lead to death, but that list is actually almost limitless (overwhelming sepsis, visceral perforation, status epilepticus, ruptured aortic aneurysm, etc). Unless a reliable source can be found that lists the most important causes sensibly, I cannot find grounds for an independent article. The alternative would be to mention on sudden cardiac death that postmortem examination should be performed to exclude other causes of sudden death, such as the causes mentioned on the talkpage and by myself above. Again, for such an addition a good source is needed. JFW | T@lk 22:34, 26 December 2007 (UTC)

This discussion rather proves my point, which is not that we need a list, but that we need an article defining "sudden death" in the medical sense. (If someone wants to start an exhaustive list, that would be List of causes of sudden death.) Sudden cardiac death really does not suffice. I am looking for a link to use from causes of sudden death, so that it is not necessary to explain on each linking page that the condition in question is a medical emergency on the order of "Call 911!" or worse. --Una Smith (talk) 23:55, 26 December 2007 (UTC)

I think the problem, as JFW has alluded to, is that "sudden death" is not really a medical term outside of the specific instance of sudden cardiac death. Surely we can indicate, briefly and pointedly, that a condition requires emergent care and may be rapidly fatal without creating a page defining the term "sudden death" (which in this context is essentially self-explanatory)? MastCell ^Talk 04:35, 27 December 2007 (UTC)

That's okay, because Wikipedia is not really a medical encyclopedia. "Emergent care" isn't defined in Wikipedia, by the way. And how rapid is "rapidly"? --Una Smith (talk) 04:58, 27 December 2007 (UTC)

Well, you previously defined "rapidly" as "within an hour". As I said, the list is potentially endless and hard to verify. I agree that Wikipedia is not a medical encyclopedia, and we should try to avoid giving the impression that it is. At the same time, creating articles with non-standard titles (feeling tired with red blotches on your legs or headache with vomiting) will do nobody any service.

I stand by my view that listing a few diseases that rapidly progress to death in sudden cardiac death would be useful, provided a reasonably accurate source can be found. JFW | T@lk 08:01, 27 December 2007 (UTC)

I'll second JFW and MastCell here regarding the usage of sudden death == sudden cardiac death. Una Smith, since you say you don't want to "explain on each linking page that the condition in question is a medical emergency," maybe medical emergency would be a more directly connected page? Antelan ^talk 08:25, 27 December 2007 (UTC)

Ginger and cancer

Ovarian cancer could use some attention; it is accumulating text about that new miracle cancer treatment, a dab of ginger. The same text appears on Ginger. --Una Smith (talk) 05:15, 27 December 2007 (UTC)

Ginger as a treatment is right up there with marshmallow fluff. Thanks for the note. Antelan ^talk 06:16, 27 December 2007 (UTC)

Ah, good old-fashioned skepticism... Brings tears to my eyes... Seriously, when there are further studies (i.e. in vivo ones, maybe even on people some day), this may certainly warrant a mention. Fvasconcellos (t·c) 20:10, 27 December 2007 (UTC)

Ketogenic diet: unwarranted page moves

I would like some help from project members, and specifically an admin who can undo some unwarranted page moves. User:OccamzRazor has moved Ketogenic diet to Ketogenic diet (epilepsy) and has rewritten some of the latter to reflect his POV. This long-established article is now a dictdef with a couple of newspaper links about cancer. Please see my discussion at User talk:OccamzRazor#Ketogenic diet. I would like the article moved back (there is nothing of merit at the current version of Ketogenic diet). I can repair the links and revert some of the recent edits once this is done. Thank you. Colin°^Talk 10:32, 27 December 2007 (UTC)

The move may be reasonable if the page was mainly on the epilepsy diet, but the stub that is now standing it its place is hopeless. It bears noting that the popular (and reasonably effective) Atkins diet is also ketogenic. JFW | T@lk 14:30, 27 December 2007 (UTC)

The category "ketogenic diet" may encompass aspects of the Atikins and other low carb diets. The noun "ketogenic diet" is exclusively used as a medical therapy, and its main indication is refractory epilepsy in children.

Wikipedia:Naming conventions nutshell: "Generally, article naming should prefer what the greatest number of English speakers would most easily recognize, with a reasonable minimum of ambiguity, while at the same time making linking to those articles easy and second nature." A Google or PubMed search will confirm that the medical therapy should be the main topic of the ketogenic diet article.

My problem is that I believe it requires an admin to move the page (with all its history) back to the proper place. Copy/paste is explicitly discouraged. Colin°^Talk 15:45, 27 December 2007 (UTC)

We have two options available to us. I have asked OccamzRazor (talk · contribs) to reconsider his move. I'm quite willing to move the page back when he has aknowledged that. You are correct with regards to WP:NC, but I want to see if he disputes this. JFW | T@lk 16:56, 27 December 2007 (UTC)

Triumph

I am pleased to report that every article in WikiProject Medicine's automatically assessed articles category has been manually reviewed. The category is now empty, and I'll be getting back to my usual list of unassessed articles soon. WhatamIdoing (talk) 20:28, 27 December 2007 (UTC)

That is brilliant. Compliments to the reviewers. Perhaps you could report here quickly which important articles are in serious need of improvement? JFW | T@lk 20:54, 27 December 2007 (UTC)

The WPMED Quality vs Importance table shows over 50 articles of Top importance with quality below GA. Most (all?) of the 50 are listed here. --Una Smith (talk) 22:54, 27 December 2007 (UTC)

I think these Top-rated articles are in the most embarrassing state:

• Anatomy
• Diseases of poverty
• Infection
• Physiology
• Pregnancy test
• Unprotected sex

None of them rate above a good start, and unprotected sex is actually a stub -- and not even a good stub, just a plain old didn't-get-finished-with-this stub.

As for the B-class articles in this category, what they really need is a proper Good Article review. I didn't rate any article higher than B unless some other project had previously rated it higher than B, so some of the articles doubtless deserve higher quality ratings than they have now.

It would be great if someone (or several someones) would take a quick look at the whole list of Top-rated articles and downgrade anything that seems weird. I suspect that for any given topic, we haven't always picked the single best article to represent it. For example, Pregnancy was only "High" until a few minutes ago, and it might be fair to demote pregnancy test to "merely" High. We might also want to choose either Anatomy or Human anatomy for the Top rating instead of listing both.

I have been thinking about the proportion of articles which ought to be considered Top importance. While some of our current Tops may need to move down the line a bit, I've been thinking that a review of the High-level articles is also in order, with an eye to picking things that might be particularly popular with our readers or fundamental to medicine. We could probably promote 25 or possibly even 50 "High" articles to Top without compromising the utility of the list.

And finally, on the articles I've assessed: While I've rated articles according to my understanding of the guidelines, I don't pretend to have provided the One True Assessment(TM) and will not be offended by (or even notice) changes. However, if you find anything that's wildly out of line and it seems to have my name on it (or if you just want to be reassured that your opinion is as valuable as anyone else's), then I'd be happy to hear about it on my talk page. WhatamIdoing (talk) 01:14, 28 December 2007 (UTC)

Thanks for that, WhatamIdoing. Unprotected sex needs urgent redirection to safe sex, which provides much more context and deals with the relevant topic comprehensively. I totally agree that anatomy, physiology, pathology and articles about the main medical specialties are in need of improvement. JFW | T@lk 01:28, 28 December 2007 (UTC)

I merged Unprotected sex into Safe sex. --Una Smith (talk) 03:29, 28 December 2007 (UTC)

Quality is probably judged quite accurately but we need to look at priority: I don't think we have our priorities straight, especially if you consider the commonest keywords on search engines are probably diabetes and all conditions related to gynecology (such as vaginal infection) and pediatrics. I think we should be more aware of our position on search engines, and were possible article titles should match likely keywords, plus priority should go to popular health searches. --Steven Fruitsmaak (Reply) 01:57, 28 December 2007 (UTC)

I agree. Could someone build an index to medical articles by priority (=importance)? That would be somewhat helpful here. --Una Smith (talk) 03:29, 28 December 2007 (UTC)

I would be thrilled to have other people involved in restructuring the importance lists. Do you need something beyond the main category for Medicine articles by importance? If you just want to see a list of what's been rated (or isn't yet rated, which includes 3700 stubs and the 1750 entirely unassessed articles which are on my target list), then the existing category structure is probably what you're looking for. WhatamIdoing (talk) 05:48, 28 December 2007 (UTC)

The problem with importance categories is that they are not subdivided by quality. :-) So, for example, to find the one article rated Top and Stub I estimate its relative position in the articles-by-quality index by adding the row totals for FA, A, GA, and B, and dividing by 400. That gives me a rough idea which index page to look on. In some cases, it would be helpful to have a parallel index of articles-by-importance. --Una Smith (talk) 15:23, 28 December 2007 (UTC)

In theory, CatScan will let you find articles which are in any two categories. In practice -- some days it works for me, and some days it doesn't. I think it silently gives up if it can't get a response from WP quickly enough. WhatamIdoing (talk) 19:30, 28 December 2007 (UTC)

Opinions on importance must be guided by an overarching principle. Is an important article (1) a "big killer", (2) a popular search term on Google, (3) a common chronic but non-lethal disease, (4) something weird & horrible? I have previously felt that we should have very good articles on cancer, heart disease, stroke etc, but I agree with Steven that most people will be looking for high-quality content on how to treat their acne, stop getting vaginal candidiasis or find something to take them through the day when they've got a headache. With most of us being either medical students or practising doctors, it is easily forgotten that mouth ulcers may be more debilitating than community-acquired pneumonia. Perhaps a hierarchy of importance would need to take into account both the popularity of the subject and their impact on health in general. JFW | T@lk 08:11, 28 December 2007 (UTC)

You might want to take a look at our official importance scale. Generally your instincts are on target: Ratings are the intersection between what average, non-medical people want to read about medicine (sex, kids, and the common cold), and what we think average, non-medical people should want to read about medicine (hypertension, heart disease, and the fact that those "whole wheat" fried doughnuts aren't technically a health food). My own assessments additionally reflect my POV that

• individual people who impact on modern medicine is smaller than Galen's was on pre-modern medicine,
• organizations whose impact on worldwide medicine is smaller than the FDA's,
• anatomy that isn't familiar to the average 12 year old, and
• medical signs and terms which are related primarily to a single specialty

are basically unimportant. (You aren't required to cooperate with my biases, but you might find the official scale interesting.) WhatamIdoing (talk) 08:48, 28 December 2007 (UTC)

Herpes zoster again

The article failed its FAC and perhaps we should reflect on why we couldn't get this right. The disease is very well understood, not controversial and not new, yet we still managed to get embroiled in arguments, distracted by trivia and mess up, (me included). I did not nominate the article but if I had I would be very disillusioned with Wikipedia today. Yes, the article was flawed, but nothing that could not be fixed. What went wrong? My two English pennies worth. We were treading on each others toes, me on Colin's in particular, because it became too crowded. Some were clearly learning about the disease whilst editing and not before and, for example, mistaking herpes zoster for a virus when it is a disease. We were fiddling with syntax when we should have been checking the references, (where the big problems were) and we weren't using the discussion page enough. We were being too bold and, to my amazement, the nominator never contributed or questioned what was happening. As medics, my view is, (and I know this will make me unpopular), we have an obligation to research a subject that we don't already know well, before leaping in. I'm not talking about the odd typo of course, we went in, me more than most, took the article apart and tried to put it back together in a completely chaotic fashion. Ideally, and this is with benefit of hindsight, we should have coordinated our efforts and given each other the space to work. Say, let person A sort out any WP:MOS problems because they are good at it, then ask member B to sort out any problems with the discourse because they are a good critic, then ask person C to approve the clinical stuff and person D to check the virology. Lastly ask anyone known for writing first-rate prose to give it a good polish. I know this might sound complicated but this is how a team works. I noticed last night that, despite all our hard work, someone put a clean-up template at the top of the article! Oh my. I might be getting the wrong angle on this, being new to Wikipedia, so I am happy to stand to correction but please don't shoot the messenger.--GrahamColm^Talk 17:55, 28 December 2007 (UTC)

And ... all of those necessary steps could have happened before FAC, with collaboration from the nominator. I'm as disappointed as you are, but for different reasons, which are best understood by looking at the FAC for lung cancer. I wonder if the Medicine WikiProject has clear standards? Also, I suggest a review of the path taken to FA by Polio and autism: both collaborative, done pre-FAC and successful. SandyGeorgia (Talk) 18:07, 28 December 2007 (UTC)

I knew nothing about Herpes zoster being nominated for FAC until it was spotted on the FAC page and brought to our attention here. The nominator did not ask us for help before or during the FAC, nor told us about the FAC. I agree that too much writing was and still is being done without reading the sources. That is a very common fault on Wikipedia. Editing others' writing, I failed to check sources adequately, but on the other hand it should not be necessary to check sources as completely as required on Herpes zoster. Re team work, a top down team may function in an organized manner, but Wikipedia functions in a bottom up manner. The dynamics are very different. In the case of this FAC, I think Herpes zoster should have been promptly withdrawn by its nominator or rejected by the FAC committee. That would have saved many of us the frustration of trying to fix the article on an "emergency" basis, lest it somehow pass FAC and become a Featured Article in its current state. --Una Smith (talk) 21:42, 28 December 2007 (UTC)

The "FAC committee" (sic) can't "reject" a nomination that garnered support from the Medicine Project: the "FAC committee" judges consensus, and several Medicine Project members supported the nomination before others began to uncover issues. SandyGeorgia (Talk) 21:57, 28 December 2007 (UTC)

Okay, I get it. The "consensus" on the FAC page refers to the opinions of those who express an opinion. Some of the early opinions of support were eventually revised. Would it be uncool to contact those users and ask them to review their opinion? I consider the opinions to be strictly personal; in what sense had Herpes zoster "garnered support from the Medicine Project" (sic)? --Una Smith (talk) 22:09, 28 December 2007 (UTC)

By the way, I think a clean-up tag on Herpes zoster is entirely appropriate, simply to let readers know that the article is currently unstable. The clean-up tag is a signal to readers, to recruit those who are interested in helping and send others away. I am sorry that some editors view the tag as somehow derogatory or a demerit. --Una Smith (talk) 21:52, 28 December 2007 (UTC)

Graham, the nominator Orangemarlin has been around for three years, and has 10,000 edits under his belt. The nomination failed IMO due to lack of preparation and a misunderstanding of what level of detail and quality is expected at FAC. Don't beat yourself up (or anyone else) that he might be "disillusioned with Wikipedia today" because we failed him. I originally thought, like you, it could be polished at FAC, but it became apparent that the article was so fundamentally flawed (at policy level, not dashes and commas) that I stopped believing it could be fixed in time. Let me also be quite clear that I thought you behaved like a gentleman throughout, only once quite accidentally stepped on my toes. Sure, there was some friction between some editors and the rush didn't help that. I'd like to think we can work together, at a leisurely pace, again.

I fully agree with you about research and I hope I wasn't guilty of making ignorant edits. I actually made very few edits to the article during FAC: some initial work on the refs; a very little copyediting; a revised paragraph on lysine (subsequently dropped, which I'm more than OK about); and a few reverts when I felt a rushed, non-discussed, edit had made the text worse. My preference when reviewing an article that someone else has invested in, is to make only superficial edits and to ask them, the expert, to clarify or improve the text where I see deficiencies. I don't expect all my suggestions to be implemented but was frankly disappointed at the lack of response by the nominator. In effect, Graham and other project members stepped into that gap and did their best.

This wikiproject should help with the final steps of taking an article to FAC. Some of our project members have free access to the sources used, and the training to understand them. I hope in future those abilities are used to give an article a thorough checkover prior to FAC. Yes, I feel I and others wasted a lot of time polishing prose that ultimately bore no resemblance to the quoted sources. I wish I'd spotted that earlier.

I'm not sure of the necessary for demarcation of roles, though if two people are trying to do the same thing at the same time in a hurry, they'd better be best of pals. It would sure be nice to have your ABCD talents working as a team. I don't quite follow Una's top-down/bottom-up argument. The best FACs I've seen recently involved essentially one hard-working and responsive subject expert who brought the article so far, deeply cared for the subject, and was supplemented by folk trying to help him or her improve it, but being respectful of that investment. I agree with Una that working under "emergency" conditions was stressful and the initial support it received didn't help relieve that pressure.

The key is preparation and patience. Colin°^Talk 21:58, 28 December 2007 (UTC)

Wise words indeed, and ones I need to reflect on. Thanks guys.--GrahamColm^Talk 22:17, 28 December 2007 (UTC) Time for bed.

I am glad that we are holding this "post-mortem". Already it has given me some new things to think about. --Una Smith (talk) 00:08, 29 December 2007 (UTC)

External links on Rotavirus

Could someone fix the external link template at the end of the article? I can't get the ICD 10 code to go to the right WHO webpage :-( --GrahamColm^Talk 15:37, 27 December 2007 (UTC)

Appears to have been fixed by Una Smith. Colin°^Talk 19:57, 27 December 2007 (UTC)

Indeed. By the way, nice work on this, Graham. Fvasconcellos (t·c) 20:03, 27 December 2007 (UTC)

Another illustration (public domain) of seasonal variation is here, showing the US national trend. Graham's UK peak is in January; the US national peak is in March. This could develop into an interesting paragraph, if similar data is available for other regions. --Una Smith (talk)

The US is a big country, the national peak is in March, but I remember reading a paper (which I can't find at the moment), some years ago, that clearly showed how rotavirus infections spread like a wave across the US which followed the progression of the US winter. The authors included either or Mary Estes or Roger Glass or Al Kapikian or all three. I'll search for it in the morning. The data and graph that Una wants in this paper.--GrahamColm^Talk 21:27, 27 December 2007 (UTC)

Here are US regional peaks; not a lot of evidence there for a wave. What is this (geographic?) "progression of the US winter"? --Preceding unsigned comment added by Una Smith (talk o contribs) 22:49, 27 December 2007 (UTC)

This is the paper I was trying to remember, but perhaps this discussion belongs on the Rotavirus discussion page?--GrahamColm^Talk 11:15, 29 December 2007 (UTC)

Bulged disc/neck/shoulder pain/no one knows

My husband has been going to doctors, had an MRI, had X-rays, and they can't figure out what is wrong with his shoulder/neck area. He is in so much pain, and they can't put their finger on it. Chiropractor and family doctor haven't figured it out yet. Any thoughts on what it could be? He was in a motorcycle accident about 10 years ago, and has a large scar on his shoulder blade if that means anything. Thank you68.79.97.243 (talk) 01:51, 29 December 2007 (UTC)

I'm sorry that your husband is in pain. However, this page won't attract much useful help; it's primarily about which medicine-related articles need some editing work. May I suggest that you post your question at the reference desk instead? WhatamIdoing (talk) 02:09, 29 December 2007 (UTC)

Folks, if if this were your concern, how would you use Wikipedia to answer it? Where would you start looking? How about Neck pain? Imagine for a moment you are this reader, who may be struggling to express her questions. Her husbands' doctors seem to have ruled out local physical causes of pain, which leaves what alternatives? Some come to my mind immediately: Referred pain and (ahem) zoster sine herpete and/or Postherpetic neuralgia. Can you see how Neck pain could be improved, to help this reader (and others) find answers to her questions? --Una Smith (talk) 17:11, 29 December 2007 (UTC)

I agree neck pain needs decluttering, including removal of the horible second person lecturing ("your pain", "do this, get that"). But I think 68.79.97.243's poor husband may need further support from his physicians. Until the diagnostic machine from Crichton's Andromeda Strain becomes a reality, none of us here can conduct a musculoskeletal and neurological examination on him. JFW | T@lk 20:40, 29 December 2007 (UTC)

Vitamin C on Citizendium

Anyone else noticed and/or consider it problematical that the Vitamin C article on the supposedly more authoritative Citizendium is being largely written by an ex-Wikipedia editor who exhibited a strong pro-megadosage alignment here? The Citizendium piece - currently at draft stage - has a distinctly polemical edge to its general historical section, and its links focus heavily on sources that would be viewed as partisan here. 86.155.205.144 (talk) 18:30, 29 December 2007 (UTC)

Good luck dealing with this Paulingite. I'm afraid we can do little about problems on Citizendium. JFW | T@lk 20:42, 29 December 2007 (UTC)

Isn't it interesting, though, that a more authoritative, accurate, and neutral representation of the state of the art can be achieved via controlled chaos (Wikipedia), as opposed to Citizendium's approach? Of course, entrusting the Vitamin C article to an editor with a chip on his shoulder about "the costs in terms of suffering and early deaths of the lack of conscience of many scientists in the life sciences", who was unable to work within the constraints of verifiability, neutrality and collaboration on Wikipedia, probably does not help matters. MastCell ^Talk 20:37, 30 December 2007 (UTC)

To be fair to Citizendium, the article hasn't yet been approved; but that it's been allowed to develop so far, even as a draft, with such blatant bias isn't a good sign. Anyhow, just a heads-up for anyone interested. 217.44.18.22 (talk) 00:27, 1 January 2008 (UTC)

Participant welcome

Hi all,

could anyone create a little Project welcome message for new editors who add themselves to Wikipedia:WikiProject Medicine/Participants, so that people watching that page can welcome newcomers and point them to essential resources like this talk page, collaboration, WP:MEDMOS, Portal:Medicine, ...

--Steven Fruitsmaak (Reply) 21:21, 31 December 2007 (UTC)

New collaboration of the fortnight

I'm sorry for the late update, but I didn't want to choose a new collaboration until the reconstrution process is finished. So we should start the new year with focusing on the Rhabdomyolysis article. Happy new year and thank you for your important and valuable contribution to the medical part of our encyclopaedia. I hope we can work together in 2008 as well. NCurse _work 22:02, 31 December 2007 (UTC)

Thanks Berci. I think most us will have something to contribute to rhabdomyolysis. From the discussions (now archived) I think there was consensus that MCOTW needed overhaul, but there is no consensus as to what needed to happen. So I agree that we might as well continue trying... JFW | T@lk 00:45, 1 January 2008 (UTC)

Fate of "Unprotected sex"

The article Unprotected sex was until recently just two definitions for the term. 1)Sex without protection from STDs and 2)Sex without protection from pregnancy. The two different definitions are generally used in entirely different contexts.

Two editors here believed the article should be redirected to safe sex and one performed the merge. In the diff of the merge one sees that sites discussing fertility awareness were used to support the statement "safe sex practices can be used as a form of family planning". The editor obviously misunderstood; fertility awareness is commonly used to enable unprotected sex without risk of pregnancy. Fertility awareness can be used as a method of family planning, but it has nothing to do with safe sex. It is overwhelmingly used in stable monogamous relationships where not using a condom is generally not considered "unsafe", thus the preference for the term "unprotected" instead of "unsafe" to refer to the lack of birth control use.

This merge deleted that usage of the term "unprotected sex" from Wikipedia. I'm also not sure that someone typing "unprotected sex" into Wikipedia is going to be happier arriving at safe sex and not bareback (sex).

There seems to be long-term dissatisfaction with "unprotected sex" as an article (see its talk page), so I propose two alternatives:

• Make unprotected sex a disambiguation page to bareback (sex), safe sex, and fertility awareness, or
• Make "unprotected sex" a soft redirect to the Wiktionary entry (which doesn't currently exist, but I'm willing to create it if this option is accepted).

I hope this is the correct place to bring this up - it was suggested to me on my talk page. Any thoughts on my proposals would be appreciated. Lyrl^Talk _C 16:22, 29 December 2007 (UTC)

Thanks, Lyrl. I think we all agree that Unprotected sex was an unsatisfactory article. I considered making it a disambig page, but decided the topic would be better addressed within the context of Safe sex, which is why I did the merge. However, in some respects Safe sex has a rather limited POV. On Talk:Safe sex I have mentioned some aspects of safe sex that are missing from the article. The discussion here brings up yet another aspect:

"Fertility awareness can be used as a method of family planning, but it has nothing to do with safe sex. It is overwhelmingly used in stable monogamous relationships where not using a condom is generally not considered "unsafe", thus the preference for the term "unprotected" instead of "unsafe" to refer to the lack of birth control use."

Fertility awareness can be used both to avoid pregnancy and to achieve pregnancy. Also, if one member of a couple has an STD, then unprotected sex is unsafe sex. Such a couple might use safe sex practices except when trying to conceive, and use fertility awareness to limit their use of unprotected hence unsafe sex. --Una Smith (talk) 16:58, 29 December 2007 (UTC)

Re the dab idea, 1)Sex without protection from STDs and 2)Sex without protection from pregnancy imply the disambig would be:

• Sex without protection from STDs: contrast to safe sex
• Sex without protection from pregnancy: contrast to birth control

That is a rather awkward disambig. --Una Smith (talk) 17:17, 29 December 2007 (UTC)

For a disambiguation page, I had more in mind:

Unprotected sex may refer to:

• Bareback (sex), any type of penetrative sexual act without the use of a condom.
• Sexual activity that is not safe sex.
• In discussions of fertility awareness, sexual intercourse without any use of birth control.

That's an interesting observation about fertility awareness and a discordant couple trying to conceive. I'm really not sure a citation could be found for that, however, and just us agreeing it's a possible use is original research. I don't believe the "no birth control" definition of unprotected sex fits into the "safe sex" article, so a merge leaves it deleted from Wikipedia.

If you believe the disambiguation page is a bad idea, how about a soft redirect to Wiktionary? Lyrl^Talk _C 17:20, 30 December 2007 (UTC)

I am on the fence re a disambiguation page, but opposed to a redirect to Wiktionary. Re HIV discordant couples trying to conceive, here is just one of many web citations. That is why I prefer the merge into Safe sex. --Una Smith (talk) 20:08, 30 December 2007 (UTC)

Thanks for the link, that's interesting that advice like that is common. Sad that so many couples have to make such choices.

Back to the merge, though, I have two objections. First, unprotected sex is most commonly used to mean barebacking. In this sense, safe sex is the opposite of what most people are looking for when they type "unprotected sex" into Wikipedia. Second, the "no birth control" usage is commonly used in relationships where sex without a condom is not considered "unsafe". I'm just not able to wrap my mind around including a discussion of birth control and pregnancy risk in an article where the stable introduction (prior to your edits) talked only about STDs and ended with the statement, "Although safe sex practices can be used as a form of family planning, the term refers to efforts made to prevent infection rather than conception."

What are your objections to the disambig and soft redirect options? You had stated earlier that you thought the disambiguation page would be awkward, did my formatting suggestion address any of that? Are you OK with the three links I included, or do you think one or more should be changed? Lyrl^Talk _C 23:09, 30 December 2007 (UTC)

I just noticed, "fertility awareness is commonly used to enable unprotected sex without risk of pregnancy." I certainly hope things like this aren't getting into any article on Wikipedia, unless "without risk of pregnancy" is commonly undertood to mean, "with a 20% annual risk of pregnancy." Antelan ^talk 23:12, 30 December 2007 (UTC)

With a significantly lower risk than random unprotected intercourse. If the couple understands and has the motivation to follow the rules, a risk of less than 1% per year. The actual article goes into the detail of perfect use and typical failure rates, I skipped over those details in this discussion to try to focus attention on my point that safe sex and unprotected sex can be unrelated topics, depending on how the terms are being used. Lyrl^Talk _C 00:29, 31 December 2007 (UTC)

It appears that we are getting our numbers from widely diverging sources. My concern about those numbers isn't really germane to your point in posting here, though, so I'll back off. Antelan ^talk 00:44, 31 December 2007 (UTC)

Antelan, could you be conflating fertility awareness with the (rudimentary) rhythm method? --Una Smith (talk) 07:11, 31 December 2007 (UTC)

Probably not. Problems with instruction (particularly among the self-taught) and compliance (it is not a suitable method for couples without the discipline to maintain accurate records and abstain or use barrier methods for a significant portion of each cycle) result in high pregnancy rates in some populations. I believe 20% was the failure rate found by the U.S. National Survey of Family Growth and cited in the 17th edition of Contraceptive Technology. Lyrl^Talk _C 18:37, 31 December 2007 (UTC)

I object to a soft redirect because, as this discussion illustrates, the meaning of the term "unprotected sex" is complex enough to need explanation here, not in Wiktionary. I also object to limiting Wikipedia articles to "common" meanings, ignoring other meanings verified in reliable sources. After some thought about this, I now also object to a disambiguation page. As Talk:Bareback (sex) shows, "bareback" and "unprotected" are not equivalent. And Lyrl asserts (and I agree) that "unprotected sex" and "unsafe sex" are not equivalent. Hence, a disambiguation page would not be appropriate. "Unprotected sex" might be unsafe sex, or safe sex, depending on the circumstances. So now I think "unprotected sex" belongs in a section on Safe sex, or on its own page that is not a stub. To break this impasse, it might help to research the history of the use of these terms. --Una Smith (talk) 07:11, 31 December 2007 (UTC)

Looking at the above discussion, I think disambiguation is exactly what the awkward title unprotected sex should become, and I take back my previous opinion that it should redirect to safe sex. It depends completely on protection from what exactly. From STIs? From pregnancy? From birth defects (if the male is taking finasteride or thalidomide for some reason, or the female is on tuberculosis treatment or warfarin)? We need a short page that disambiguates between those various meanings in a sensible way. I see no problem mentioning barebacking there. If we start a whole new article that simply rehashes all the meanings I've mentions we'll end up with duplication. JFW | T@lk 07:36, 31 December 2007 (UTC)

Let's try it. See Unprotected sex now. --Una Smith (talk) 16:16, 31 December 2007 (UTC)

Looks pretty good. I did have a couple of comments I pulled from MoS:DAB, "Each bulleted entry should, in almost every case, have exactly one navigable (blue) link" and "The link should be the first word or phrase in each entry." We can't comply exactly with the first-word rule on all the pages being linked to, but a grammatical phrase can be started with the bareback link, at least.

The link to thalidomide confused me - is sex without a condom dangerous for someone whose partner is taking that drug?

I'm not sure the links to specific barrier methods meet the manual of style guideline "Keep in mind that the primary purpose of the disambiguation page is to help people find the information they want quickly and easily. These pages are not for exploration, but only to help the user navigate to a specific article." The current last line might just be dropped from the page?

I appreciate all the thought Una has put into this. I hope this feedback is helpful. Lyrl^Talk _C 18:37, 31 December 2007 (UTC)

The "first word" style does not apply here, because the link titles are not variants of the dab title. --Una Smith (talk) 19:49, 31 December 2007 (UTC)

Following the lead of WhatamIdoing, I've continued discussion on this topic at Talk:Unprotected sex#Drugs. Lyrl^Talk _C 13:30, 1 January 2008 (UTC)

Common cold nominated for GA

Common cold has been nominated for good article status. Comments (and improvements) solicited. Regards--G716 <^T·_C> 04:11, 3 January 2008 (UTC)

Infectious diarrhea needs cleanup

Help would be appreciated. --Una Smith (talk) 04:43, 3 January 2008 (UTC)

Vasoconstriction

Factors that trigger vasoconstriction are of exogenous origin, i.e. medication, endogenous, i.e. as a response from the body itself and others.

Isn't the use of endogenous as an example of exogenous a contradiction? 201.230.69.224 (talk) 17:50, 2 January 2008 (UTC)

That appears to be a copyediting error. Please be bold and fix it. --Una Smith (talk) 18:24, 2 January 2008 (UTC)

?t says adenosine is a vasoconstrictor it is not it i vasodilator,there is a table kind thing on the page and lists the adenosine as vasoconstrictor.Docteur (talk) 21:56, 3 January 2008 (UTC)

Please be bold and fix it. --Una Smith (talk) 15:03, 4 January 2008 (UTC)

Dysmetria article

On the dysmetria page it is stated that: "Hypermetria describes undershooting intended position and hypometria describes overshooting intended position". As far as I'm aware, hypermetria means 'too much movement' which would imply the overshooting of the intended position. Hypometria implies a lack of movement, which results in undershooting. In other words: shouldn't those two descriptions be switched? --Preceding unsigned comment added by 86.82.49.207 (talk) 12:01, 4 January 2008 (UTC)

Yes, they should. Please go right ahead and do it. --Una Smith (talk) 15:01, 4 January 2008 (UTC)

I did it myself. --Una Smith (talk) 16:06, 4 January 2008 (UTC)

The article appears to be a cut and paste job from somewhere else, so there may be a copyvio problem. Also, it needs wikilinks throughout. --Una Smith (talk) 16:06, 4 January 2008 (UTC)

Fibromyalgia Pathophysiology

The intro to Fibromyalgia includes this statement cited from Rheum Int, specifically here:

"Though recognized as an independent clinical syndrome, the pathophysiology behind fibromyalgia may actually be secondary to several clinical entities, ranging from a mild, idiopathic inflammatory process in some individuals, to a somatoform disorder resulting from clinical depression in others, with probable overlaps in between. Current diagnostic criteria are insufficient to differentiate these entities."

This statement has been repeatedly removed by one individual b/c he states that it is "controversial."

My recollection was that the American College of Rhemotology issued a very similar statement in times past. Is this statement truly controversial, or am simply misinterpreting medical consensus? Djma12 ^(talk) 04:16, 6 January 2008 (UTC)

Is this individual providing any mainstream sources that dispute that the ACR article? Antelan ^talk 05:01, 6 January 2008 (UTC)

No, he is not. He simply states that he finds it "dubious". Djma12 ^(talk) 14:08, 6 January 2008 (UTC)

The solution is simple: find a source for the disputed statement, and cite the source. --Una Smith (talk) 15:05, 6 January 2008 (UTC)

The burden, of course, will be on the person who thinks that this source exists. Not saying that I doubt it exists, because I simply don't know, but I am saying that Djma12 should certainly not be expected to bear this burden. Antelan ^talk 17:20, 6 January 2008 (UTC)

Totally agree with Antelan that the burden of proof should always be on the party claiming that there is a "controversy". Everything in medicine can be regarded as a controversy of some form or description. The Rheum Int paper fairly accurately describes current thinking about the enigmatic condition that fibromyalgia is (together with all those related syndromes). Obviously this is controversial, because all conditions that overlap with FM (such as chronic fatigue syndrome, multiple chemical sensitivity etc etc) are "controversial". But then the use of antibiotics in bronchitis is "controversial", or the existence of Brugada syndrome. JFW | T@lk 21:29, 6 January 2008 (UTC)

Heck, on Wikipedia the fact that HIV causes AIDS is apparently "controversial". :) I agree with the earlier comments, but would just add that the sentences listed at the top of the thread by User:Djma12 contain some heavy-duty medicalese. I'm not in favor of unecessarily dumbing things down, but is this material described more accesibly elsewhere in the article? MastCell ^Talk 22:02, 6 January 2008 (UTC)

I can try to make the intro a little more accessible if that will help :-) Djma12 ^(talk) 02:14, 7 January 2008 (UTC)

• There is an RFC on this issue on the Fibromyalgia discussion page if anyone would like to contribute. Djma12 ^(talk) 02:26, 7 January 2008 (UTC)

RfC on Talk:Biopsychiatry controversy

An RfC has been created on Talk:Biopsychiatry controversy on the subject: "Is the majority viewpoint of the psychiatric profession, and particularly of the psychiatric research community, that the biopsychiatric model of psychiatry is, by and large, accepted or rejected?" Comments from editors involved in this article/project may prove useful. Hrafn^Talk_Stalk 06:49, 6 January 2008 (UTC)

Gastroenteritis articles cluster

Re the request for help with Rotavirus (see above), I notice there is a large cluster of closely related pages with overlapping content:

• Rotavirus (and possibly others)
• Gastroenteritis (merge Gastritis, Enteritis, and Bacterial gastroenteritis?)
• Diarrhea
• Oral rehydration therapy

Norovirus is notable for not having much content overlapping with other pages. --Una Smith 00:37, 1 December 2007 (UTC)

I think gastritis and enteritis have individual merits, because there are many causes of each that are unrelated to the clinical syndrome of gastroenteritis (e.g. regional enteritis, atrophic gastritis). Bacterial gastroenteritis can probably be merged in the GEitis article without loss of information.

The ORS page has individual merits.

Diarrhea has at least 100 causes, from cholera to hyperthyroidism and back again to carcinoid and laxative abuse. It can stand on its own merits.

I totally agree that infectious gastroenteritis-related content should all be moved to one article. I'll see if I can lend a hand. JFW | T@lk 22:52, 1 December 2007 (UTC)

I don't propose a wholesale merge of all these pages, but most would benefit from moving around some of their content. If Gastritis and Enteritis are not merged with Gastroenteritis, then the distinctions between them need to be made clearer. --Una Smith 00:11, 2 December 2007 (UTC)

There is more discussion of this on Talk:Gastroenteritis. --Una Smith 00:27, 2 December 2007 (UTC)

I totally agree that we need to make this clearer. JFW | T@lk 09:48, 2 December 2007 (UTC)

I have added still more articles in this cluster for cleanup. See Talk:Gastroenteritis. ----Una Smith 14:45, 4 December 2007 (UTC)

Rotavirus is improving steadily, but would benefit from some fresh eyes, particularly lay readers' eyes. Please take a look, comment on Talk:Rotavirus, or jump right in and edit Rotavirus. --Una Smith (talk) 03:46, 12 December 2007 (UTC)

• Rotavirus is being groomed for FAC soon; before it appears as a Featured Article it would be really good if related, supporting pages were cleaned up. --Una Smith (talk) 17:59, 26 December 2007 (UTC)

• Gastroenteritis needs some attention. An anonymous editor is making some strange edits and incorrectly attributing vandalism to me. --Una Smith (talk) 23:56, 2 January 2008 (UTC)

• Infectious diarrhea needs cleanup. --Una Smith (talk) 18:22, 8 January 2008 (UTC)

Emmanuelm, again

Our friend User:Emmanuelm has reinserted his "soft redirects" into tumor and neoplasia articles again. Several editors disagreed with his zero-consensus decision to discourage expansion of those articles a few weeks ago. I have restarted the talk page discussion on Talk:Neoplasia. Does anyone have a suggestion for making this stop on a more permanent basis? WhatamIdoing (talk) 20:00, 3 January 2008 (UTC)

One constructive solution would be to clean up both of those pages. --Una Smith (talk) 15:58, 4 January 2008 (UTC)

I discussed these points in the talk page of Neoplasia. Emmanuelm (talk) 20:04, 8 January 2008 (UTC)

"Functional"

The medical term "functional" is something that many patients do not understand, and as yet it is also not well explained on Wikipedia. --Una Smith (talk) 17:24, 9 January 2008 (UTC)

• Functional
• Functional symptom

Cynically, jfdwolff commented: are you suggesting doctors do understand? JFW | T@lk 18:31, 9 January 2008 (UTC)

Thyroid hormone resistance

Anyone in the mood to tidy up a recent addition to thyroid hormone resistance. I looked at it, realised it was potentially useful, but then lost the will to do anything potentially complicated. JFW | T@lk 21:55, 9 January 2008 (UTC)

Felt sorry for you, then started to actually read the turgid soul-sapping article promoting idea of T3 deficiency as cause fibromyalgia and chronic fatigue syndrome ... deletion seemed a simple approach, but suspect might just breach WP:NPOV, WP:OWN, WP:AGF and everything else we hold dear :-) Lets see how far I can get (I doubt very far)....David Ruben ^Talk 01:50, 10 January 2008 (UTC)

No apparent PubMed hits to directly support 3 doctors views as boldly as the edits suggest. Totally lacks citations from reliable sources to verify, and even if this addressed then WP:UNDUE weight applies to length of this. see Talk:Thyroid hormone resistance#January 2008 edits. For now I've moved to its own section of Thyroid hormone resistance#Claims of cause of fibromyalgia and chronic fatigue syndromes and suitably tagged, but in all honesty might be better removed and placed into talk page to be discussed & worked-up, to be then promptly précised-down :-) David Ruben ^Talk 02:55, 10 January 2008 (UTC)

Did you notice that, according to one of the sources, the 8th International Workshop on Resistance to Thyroid Hormone was held in October 2007 on San Miguel in the Azores? I think priority one is for us to attend the next meeting (in Ibiza?) and go from there. We need to be educated on the subject, after all. MastCell ^Talk 04:03, 10 January 2008 (UTC)

Hey sounds good to me, certainly an improvement on past wikimeetup locations :-) But what to call it on my year performance assessment - Wikidays or holipedia clearly not work-related, certainly wikiference less suspect than conpedia ? David Ruben ^Talk 23:25, 10 January 2008 (UTC)

Relevant articles indexed on PubMed are very recent, so I expect there are more, still newer articles not yet indexed on PubMed. So, apart from medical conference junketing, the first step is to add citations, then read the cited articles for verification / clarification. Ask the editor who added the text to go back and add citations? --Una Smith (talk) 05:09, 10 January 2008 (UTC)

It appears that the information was added by an anonymous editor who was describing her (his?) personal experience/beliefs. I don't really think we'll be able to get useful sources from the editor. I doubt that we'd even be able to successfully contact the editor. WhatamIdoing (talk) 06:21, 10 January 2008 (UTC)

WhatamIdoing is hitting the nail on the head. I left a message on Mr Anon's talkpage asking for some further copyediting and so on. Evidently nothing happened. Thanks to David and also to Arcadian for quickly sourcing a whole load of stuff. JFW | T@lk 22:12, 10 January 2008 (UTC)

Acoustic Neuroma (Vestibular Neuroma): Treatment outcomes

The Acoustic Neuroma article discusses the two available courses of treatment (microsurgery and radiotherapy), but does not discuss available literature on treatment outcomes. While a surgical procedure is a 'success' if the neuroma is removed, to the patient, post-surgery consequences are extremely important, and are not discussed to any great extent, but should be.

There appears to be conservative bias towards microsurgery in this article. The very high proportion of microsurgery patients that experience post-operative disability, long recovery periods, hearing loss and facial nerve damage, including pain and numbness of facial muscles should be taken into account in recommending treatment, especially since radiosurgery results appear to be improving and post operative complications are few.

Current literature seems to recommend microsurgery in cases where the neuroma is very large in size, growing rapidly or both and threatening imminent injury to the patient -- in that case, radiosurgery is not indicated as it is likely to produce short term post procedure swelling.

However, in many cases, the long recovery period, risk of facial nerve damage and hearing loss can be a very significant factor to most patients, especially if it interferes with future employment or activity. Radiosurgery is an important treatment alternative and may be the only reasonable course of treatment for those with slow growing, relatively small neuromas. Rarkm (talk) 15:54, 4 January 2008 (UTC)

Go right ahead. That article needs work. So do the related articles below. --Una Smith (talk) 16:24, 4 January 2008 (UTC)

• Schwannoma
• Neuroma
• Acoustic neuroma
• Neurinoma

---

I would, but I'm not a medical professional and have no medical training -- my interest is subjective (I have this condition, unfortunately). I have been perusing as much of the literature as is available on the net, and have been struck by the distinctly binary points of view offered by those that do traditional microsurgery and those that do radiosurgery. It's the 'when all you have is a hammer, everything looks like a nail' problem. However, if noone steps forward with better credentials, I'll take a crack at it. Rarkm (talk) 04:06, 10 January 2008 (UTC)

Rarkm, you have the advantage of being an ideal reader for these articles. Edit them for the person you were back when "neuroma" was not part of your vocabulary. Make a list of the things you were confused about, the "oh, now I get it" key details, etc. To get sources that are not free on the internet, try interlibrary loan at a public library in your area, or e-mail the corresponding authors. You can get their e-mails often by following links from PubMed to the journal publisher website, where the article abstract page may reveal the e-mail address. Sometimes the e-mail address is in the PubMed record and will display if you use one of the more detailed views such as Abstract or Abstract Plus. Or do a Google search on the first or last author in the author list, and find the author that way. Explain you want a reprint of the article for Wikipedia. In my experience, most authors are delighted to help in this way. If all else fails, let us know what you need and maybe someone here can get you a copy. --Una Smith (talk) 22:02, 11 January 2008 (UTC)

Dose

There's a small overlapping mess in the Dose-related articles. Dosing has been asserted to be materially different from Dose (toxicology, medicine). Pages in the orbit include:

• Dose Profile
• Dose concentration
• Effective dose
• Absorbed dose
• Equivalent dose

and possibly more. Anyone want to take a crack at it? WhatamIdoing (talk) 21:44, 11 January 2008 (UTC)

Ryke Geerd Hamer / classification & background

Hi! That article is quite disputed. I would be glad, if somebody could classify it, and if somebody could write some lines about the aura of incompetence around some doctors of medicine (one female psychiatrist told me, that in psychiatry being correct is not essential -- although I would expect that it is essential that a victim of a hate crime gets another treatment than somebody who has imaginative enemies... especially I would think, that it is essential, that the violence doesn't continue in the psychiatric ward... but nobody listened to me...), so that the user can understand, why patients might decide to have severe pain instead of morphine... Maybe some notes about a grievance system within the health care system would be useful, too... And some notes about the usefulness of psychotherapy in case of an oncological diagnosis... --Homer Landskirty (talk) 19:52, 31 December 2007 (UTC)

Given the sheer volume of problematic WP:BLP information in that article, are there any reliable independent secondary sources in English? MastCell ^Talk 20:05, 31 December 2007 (UTC)

In a quick seach I just found this: http://www.ncbi.nlm.nih.gov/pubmed/15702221 (seems to be an abstract of a longer article)... --Homer Landskirty (talk) 20:37, 31 December 2007 (UTC)

A biographical article should not be the place for generalisations about a profession. This rubbish about an "aura of incompetence" is not encyclopedic - this always remains between the practicioner and his regulating body. There are good and bad doctors like there are good and bad rocket scientists, politicians and streetsweeps.

Whichever psychiatrist told you about "being correct", you seem to have misinterpreted it. The point is not about the treatment people get (which should be equal whatever a person's background), but the level of accuracy that can be achieved in psychiatry. It is well known that several psychiatrists will reach different conclusions in the same patient. But the same phenomenon exists mutatis mutandis in other branches of medicine. Radiologists, pathologists and neurophysiologists will disagree with colleagues over a certain proportion of their cases - because nothing in life is 100% (apart perhaps from death and taxes). JFW | T@lk 20:51, 31 December 2007 (UTC)

more details about that man and his victims: [1] and here [2] and here [3] --Preceding unsigned comment added by 87.122.80.78 (talk) 17:03, 4 January 2008 (UTC)

People hear about 50% of the information at a doctor visit. Medicine is an art and a science, one may not know the exact diagnose for a mental illness as there is less hard test data in that particular field. It's more about listening, and the therapeutic encounter. It is the clinical outcome that matters.Buddydog21 (talk) 08:28, 15 January 2008 (UTC)

Medical advice

Why is medical advice a simple redirect to physician? I think that something more like legal advice would be appropriate. WhatamIdoing (talk) 20:18, 1 January 2008 (UTC)

I agree. --Una Smith (talk) 14:55, 2 January 2008 (UTC)

All right, I've started the new medical advice page. I can't believe how hard it was to find sources. Surely there's a textbook someplace that says, "Medical advice involves these three things, and don't do it until you're duly licensed"? WhatamIdoing (talk) 04:04, 11 January 2008 (UTC)

................

I hope this helps your starting point.

Medical advice presupposes a professional relationship, between a doctor or qualified health care provider and a willing patient. It is based on the standard ethics of a doctor patient relationship and carries the rights and duties inherent in a relationship esteemed by society as unique amd held at a high level of trust and respect. The greater the burden on the clinician not to violate this trust and not to destroy this unique relationship.

Aspects of medical advise have certain pre-requisites such as confidentially between clinician and patient. An a priori condition to giving medical advise is the examination of the patient with a standard format involving a history, physical examination, review of pertinent studies and tests and records, the ordering of additional studies and tests, if it advances diagnosis and treatment.

The function(s) of medical advice can be broad: To alleviate disease, to prevent disease, to educate patients for wellness and healthy life style, simply to educate the curious, reassure the anxious and above all employing the therapeutic art of listening.

Medical advice in the care of the ill should include a clearly stated diagnosis. Side effects of medications and treatments are discussed and alternatives, risks and benefits of treatment are made clear and transparent.

General information may be given, to either individuals, or groups, as in lectures, internet message boards, newspaper articles and the like. This instance does not create a doctor patient relationship.

The quality of the clinicians decision making, from ordering the appropriate tests, to interpreting the tests, to forming a diagnosis, to recommending treatment are the usual and customary duties of a clinician. When any of these activities cause harm to the patient and if reasonable members of the same profession can be shown to have done the thing differently to avoid harm, then the clinician may, or may not, have breached their duty to their patient and the case is evaluated for deviation from standard of care.Buddydog21 (talk) 07:09, 14 January 2008 (UTC)

Alzheimer's disease

We are having a discussion on the Alzheimer's disease page regarding what should be included under a section called Potential Therapies. Because most potential therapies have failed in this disease, we instituted a local rule that kept the list only to Phase 3 compounds or large-scale clinical trials (e.g., the GEM study for ginkgo has 2800 patients studied for 6 or 7 years). If you have an opinion about this, please join us on the talk page. Also, can we move the article up in importance to High or even Top for medicine, given that the burden of the disease in terms of health care costs is on a par with heart disease and cancer. We had a peer review in the fall of 2006, but it may be time to have some new eyes take a look at how it might be moved toward a featured article in English. It was featured in Romanian, but that is going to be tough to translate from. --Chrispounds (talk) 03:57, 12 January 2008 (UTC)

I totally agree that a good, reliable article on this common devastating condition is urgently needed. I also agree that its priority should be "high" at the very least. I once had big plans for it, and even retrieved a recent review in Ann Intern Med (PMID 12614093) that is available free and could be used to improve the AD article.

While we have never formally discussed this, I have personally always felt that phase III human trials are the absolute edge of what might be notable in terms of experimental/potential therapies. Obviously there are exceptions, especially when there is broad agreement in the literature that a particular intervention is likely to make a major difference. JFW | T@lk 22:03, 12 January 2008 (UTC)

"Notability" for experimental medical treatments

This comment is a response to the Alzheimer's topic, listed immediately aboe, but may be of more general interest.

An article about Alzheimer's would seem to be urgent.

I do, however, have very serious misgivings about the proposed rule to consider only Phase 3 treatments and above as "notable." The logic of this "Phase 3 rule" seems backwards or, at best, incomplete.

• The contention (mentioned on Talk:Alzheimer's disease that "most potential therapies have failed in this disease" does not seem like a reason to be less inclusive. Forgive me for disagreeing, but it means we should be more inclusive. More readers will be seeking treatment or may be approached for informed consent. Our role ought to be to supply more information, not less -- or, at least, to redirect readers to sources that are equipped to be more inclusive. It is not a service to fail to mention things they may be interested in or hear about elsewhere.

• If the obvious therapies have failed in a devastating disease then the community needs to accelerate the pace of development, particularly of innovative approaches. In practice a main thing hindering this is not lack of possible therapies or lack of evidence of efficacy: it's lack of mindshare. It's practicality. A serious difficulty facing investigators is recruiting centers, physicians, and subjects. If Wikipedia takes the stuffy attitude that we only mention a therapy after it's proven -- and we thereby make an uninformed, non-evidential judgment of its lack of efficacy -- then we make the situation worse.

• As an example of the tendency to make such hasty judgments, look at the wholesale comment on Talk:Alzheimer's disease that "there were 3 compounds across 5 trials that did not show positive results (statistically significant primary endpoints) in Phase 3." In fact, few Phase 3 trials really have sufficient statistical power (Is 80% power really enough? Was the target effect size chosen as the smallest clinically significant difference, or merely as the observed average in a small-but-lucky pilot?). Even more, extremely few Phase 3 trials have adequate provision for subgroups and covariates in their primary analyses, and certainly lack power to detect any effect in a subgroup. As we statisticians try to point out, failure to find an effect may only mean you didn't look hard enough.

• There is essentially no increase in the evidence base for a drug in Phase 3 compared to one in Phase 2. Contrary to early optimism years ago, when the "Phase" terminology was invented, statisticians do not have special "approximate, quick-and-dirty" sample size tables for Phase 2. We have to use the same ones as Phase 3 -- and the news from those tables is never optimistic. Phase 2 trials cannot, in principle, have the sample size or organizational structure to prove efficacy -- except perhaps sometimes via surrogate markers. In fact, at least one NIH institute, in its Program Announcement for pilot trials, explicitly, emphatically, and repeatedly denigrates proposals for pilots that really are "underpowered, miniature Phase 3 trials." Thus, the sad fact is that when a major decision has to be made whether to invest huge resources in launching a Phase 3 trial, the debate is more often about the design structure than about the evidence base, which may be shockingly small.

As an example of evidence, please look at Experimental Treatments for Spinal Cord Injuries, which I happened to be involved in. This records the efforts of a large, international group of senior, mostly academic investigators in a field that resembles Alzheimer's in as far as being a devastating disease where previous trials have been unsuccessful but there are now many new experimental therapies on the horizon. We were unconstrained by Wikipedia's notions of "notability." We merely were a bunch of experts trying to tell the community, as clearly and usefully as we could, what we wanted them to know. We accepted from the start that we'd need several documents, for different purposes. The result was

1. a 10-page summary and overview,
2. a 40-page guide for people with spinal cord injury, their families, friends and caregivers,
3. a series of 4 academic papers defining what we thought was the state of the art in trial design -- published in Spinal Cord.

We had 3 principles throughout, all non-negotiable:

• be inclusive
• be informative
• be accurate about science.

Wikipedia Project Medicine might take a similar attitude. Multiple articles might be needed on any of the major diseases. We need to either tell people what they need to know or, being an encyclopedia not a textbook, we need to point them to other sources that can tell them. William P. Coleman (talk) 01:02, 13 January 2008 (UTC)

Whilst appreciating your earnest sentiments, Wikipedia:General disclaimer states that we do not give specific advice, and Wikipedia:Medical disclaimer states both "WIKIPEDIA DOES NOT GIVE MEDICAL ADVICE" and "Nothing ... should be construed as an attempt to offer or render a medical opinion or otherwise engage in the practice of medicine". Your noble work, described above, to help formulate real-world consensus advice, by utilising people's expertese to give best guidence upon often incomplete evidence (with all the provisos of using acedemic research, constrained clinical research and then having to manage real patients) is quite different from an encyclopaedia's construction. WP can not itself propose a particular approach as promising (under WP:Cite, WP:Verify and WP:No original research), but only report on a reliable source as stating that it seems promising or, at a later date, use a 3rd party source as confirming that in retrospect it did prove promising. As WP itself can not go predicting (unlike the highly considered opinions that your real-world group will have made), it can not be used as a source of information for those (patients, relatives or doctors) at the coal face of making decissions in uncertain or developing-knowledge situations. A drug in development seems, IMHO, rarely to warrent any mention in wikipedia at all:

1. claims from the company itself are not independant, and thus reliable, to confirm the claim of a drug being promising
2. the researchers opinions in the midst of a trial are generally unreliable until the study is completed, data collated, rates for any unexpected catastrophic side effects duly assessed and the paper having gone through the peer review process of journal publication. For if the trial data is really proving in the midst of a trial to be so overwhlmingly positive, then comments by the researchers begs questions: either the study should be discontinued as having demonstrated sufficient power that further withholding active treatment from the placebo group has become unethical, or the study is continuing because the weight of demonstrated effect is not really that strong yet (and as per previously points, needs to await the report writing and journal publication processes).
3. other doctors can not yet have commented on the overall role of the pudative treatment for a particular condition, as it is still undergoing testing.

The exception is where wider medical or general media have commented upon the trial, and notablity is established by that reporting (rather than directly from the trial/trialists). Hence a financial report of say Pizfer's shares soaring on the basis of preliminary results and how the company's future now depend on the success of the drug, probably would be notable. Whereas a small biochem research unit starting work on a drug with only a few patients trialled in local surrounding hospitals and no worldwide media reporting, really fails to rise to the horizon of notability inclusion, and so yes wikipedia is both never going to be a news banner reporting on work in progress, and will always lag (hopefully only slightly) behind real world developments. David Ruben ^Talk 02:00, 13 January 2008 (UTC)

Some reactions to User:Davidruben's comments:

• Could you point to anyplace in my remarks where I suggested that Wikipedia under any circumstances should recommend anything? Or even to describe any treatment as "promising?" My discussion was not about recommending treatments, but about covering them. Your warnings (even in capital letters) seem misdirected.
• If you look at the context of the discussion, I was replying to a comment suggesting that we limit our coverage. I contended instead that we should try to expand coverage. The discussion was about the degree of coverage, and not about whether or not to recommend.
• The work that I cited does not recommend any treatments, either -- or anything other than that patients and potential subjects should be informed about the availability of evidence and that trials should be scientific.
• My post was time-stamped at 01:02 -- and yours at 02:00. Did you read the sources that I linked to and about which you have given opinions?
• Your attempts at sarcasm and dismissiveness ("earnest sentiments" and "Your noble work") are not helpful.
• My medical colleagues and friends that I mentioned do "manage real patients" on a day-to-day basis. Working with spinal cord injury can be especially heartbreaking -- and so we're especially aware of the consequences of our research and publications.
• You attempt to paint me as starry-eyed about the promise of research. On the contrary, I'm a member of an NIH committee (not speaking here, or ever, officially) whose job it is to evaluate research with a cold eye and help set funding priorities. I view attempts at research with suspicion.
• I'm not sure what you're advocating.
• I'm advocating the following:
  • science (namely, objective reporting of lines of evidence).
  • compassion,
  • keeping people informed.

William P. Coleman (talk) 02:46, 13 January 2008 (UTC)

Appologies if you took any of above as a warning, certainly not meant to be, but rather discussion where, as editors, we should draw the line on inclusion/exclusion (PS capitalisation not mine but that of the relevant wikipedia disclaimer page). I did indeed have a look at Guidelines for the conduct of clinical trials for spinal cord injury as developed by the ICCP panel: clinical trial design which seems a particularly well written article (both in content and particularly the ease of reading for a non-statistitian non-expert) - much (most) of it is equaly applicable to research in other conditions. My praise for your real-life work was therefore quite in earnest. What I'm advocating is that as wikipedia is not a directory or merely a collection of facts, so it should not merely list a drug in development just because a phase 3 trial exists (rather that after completion of this process then the inclusion in pharmacopeas and widespread use acts as the relevant notability). David Ruben ^Talk 03:27, 13 January 2008 (UTC)

Qualification: of course many large or important studies are reported upon before completion and this in itself may make the trial notable, but my initial feeling is to agree with JFW's initial stated reasoning. Whilst I think formulating any formal policy by this wikiproject on trial notability is probably too difficult (each case needing consideration on its own merit and relationship to the disease and community of affected patients), I do feel some general guidence points might usefully be discussed amongst ourselves :-) David Ruben ^Talk 03:39, 13 January 2008 (UTC)

I've posted a heads-up to WT:PHARM, as an area skated around in their past work. David Ruben ^Talk 04:12, 13 January 2008 (UTC)

I am in favor of giving more information, not less. I think clinical trials are intrinsically notable and their presence in a registry such as clinicaltrials.gov is more than sufficient to establish notability for literal-minded types. Clinical trials don't appear in the media unless there is a major positive or negative outcome, which goes far beyond notability. Few lay readers are able to grasp the more technical details without something like Wikipedia as a guide, and even specialists may have trouble connecting a given trial with published articles about it. For the sake of all patients who are asked to participate in clinical trials, please let us not hide them under a rug and call it notability. --Una Smith (talk) 05:57, 13 January 2008 (UTC)

It seems to me that it would be extremely difficult to write a thoroughly non-speculative segment about clinical trials (WP:CRYSTALBALL). I haven't really looked, but off the top of (anyone's) head, is there an example of a well-written, non-speculative piece on a clinical trial that has yet to receive major media coverage? Antelan ^talk 06:07, 13 January 2008 (UTC)

Thank you for the clarification. I, in turn, apologize if I seemed unnecessarily prickly in response.

You make one point that I totally agree with: "each case needing consideration on its own merit and relationship to the disease and community of affected patients." If you are saying that there should be no general policy, but rather an attempt at consensus of editorial judgment for each article (no different, really, from any other kind of Wikipedia article) about the merits of the reliably published evidence -- this being taken to apply to notability and certainly not to any recommendation or endorsement of specific therapies -- then this is essentially all I was arguing for. My personal opinion would perhaps go a little farther: that completion of a phase 3 trial is neither necessary nor sufficient, and that current inclusion in phase 3 is even less so.

I think we need to remember how widespread clinical trials are. For example, the Sygen multi-center trial in spinal cord injury (which I was involved in) started while the NASCIS 3 study was still running. At one point an informal estimate was made that, between the two major trials, the combined tertiary care centers cooperating with them saw about 2/3 of the serious spinal cord injuries in the US and Canada. Therefore, for any patient meeting the inclusion/exclusion criteria, there was perhaps a better than even chance of being offered randomization to possibly an experimental therapy. Similarly, the reasoning of the more recent ICCP group was that, although, the newer trials are perhaps smaller, there may be so many of them that a large portion of the spinal injury population is likely to be approached for informed consent. Obviously, such patients are desperate for hope. For the sake of the present patients, we felt that it was important to provide them with impartial evidence about the state of research worldwide so that they understood their options. For the sake of research (and of future patients) we thought that transparent dissemination of objective information would improve public response and cooperation.

What I'm trying to say is that I don't think Wikipedia's goals should be that much different -- to sift evidence and try to relay it objectively, or to point to other sources.

Again the point is about notability and coverage. There's a folklore witticism about the fact that banks never lend you money until you're financially sound enough not to need it (or at least it was that way in the old days). To stretch the point and overemphasize, we don't want to be so conservative that nobody gets information on a treatment from us until it's so well proven and widely adopted that no information is necessary.

One other note. Since you mention the pharmacology project, I might mention that I offered to help one group there. I'd be willing to do the same here in Medicine -- with the same caveats. For me, researching and writing in these areas is work: it's my day job. Other things being equal, I'd like spend my volunteer, personal time on Wikipedia in other areas: the arts, poetry, novels. So, I'm not actively seeking projects in medicine or pharmacology -- but I will try not to refuse requests for my expertise -- assuming, of course, that it were in demand. William P. Coleman (talk) 06:18, 13 January 2008 (UTC)

I think the Phase 3 rule is appropriate for Alzheimer's disease. My primary reason for thinking this is because the article is already enormous (76 kb! 141 separate refs! 15 screenfuls!). If everything in clinical trials (or even Phase 2) was included, then the article would be unworkably large. Furthermore, the article would be seriously out of balance, and end up giving undue weight to research. I wouldn't necessarily apply this rule to all articles, but I think that it's appropriate for this article. If there is (average-reader-level) demand for a comprehensive review of AD research, then we can create a separate article that focuses on research. WhatamIdoing (talk) 07:02, 13 January 2008 (UTC)

I think the pharmacology WikiProject will give you roughly the same response, Mr Coleman. The problem with Alzheimer's research is the enormous hype about every positive trial result. Here in the UK we have the Daily Mail, a newspaper strangely obsessed with "cures" for severe or chronic conditions. Every phase I trial result on Alzheimer's becomes a headline here. The important task of an encyclopedia is not to regurgitate these confusing messages (which are often disproved weeks later in other studies), but to identify major trends in research.

There may be good arguments for including more preliminary results, but preferably in context. For instance, we can have a section about attempts to stop amyloid beta aggregation or inhibit gamma secretase action, and the various compounds being investigated. This is much more helpful than just blasting the poor reader with long lists of substances that may never reach clinical development. JFW | T@lk 08:45, 13 January 2008 (UTC)

Thank you for your response. I don't wish to be argumentative (and I worry that perhaps I am being so). Please forgive me but, as I said at the beginning of my original comment I don't understand the logic. The existence of widespread misinformation seems like more -- not less -- reason for Wikipedia to include coverage that's accurate and reliable. Our response to each blast from the Daily Mail need not be verbose. It could be crisp, factual, and short. If eventually a separate article were needed to hold all the responses, then it would be needed.

I don't read the Daily Mail and don't know how they obtain their fodder. Normally, well-designed positive studies (in whatever phase) should not often be refutable in other studies (whether a few weeks later or not). It's inherent in the nature of the concept Type I Error that false positives with p=.05 should only happen about 5% of the time. (Also, as I mentioned earlier, phase 1 and phase 2 studies should not normally be designed for clinical efficacy at all because they would be necessarily under-powered and potentially misleading.)

• If 100 Alzheimer's studies are completed each year for ineffective treatments, then about 5 of them can be expected to show positive results. We should be able to refer readers to a single infobox or a general article called, "The commonness of false positives in overly-repeated research," or some title that's more public-friendly.
• Or, if the Daily Mail's favorite studies have obvious design flaws, then we should be able to dismiss each in a well-chosen sentence or two pointing the flaws out.
• Or, if the Daily Mail is in the habit of hyping studies with non-significant (p>.05) positive trends, then perhaps we need an infobox with a simple list of them, citing the non-significance of their p-value (while cautioning about the possible lack of statistical power). This infobox could be called, "Potential Alzheimer's treatments that might conceivably be effective, but currently are subject to the Daily Mail's tendency to over-interpret random paint splatter and curious cloud formations."
• On the other hand, if there are only a small number of Alzheimer's studies, if they are well-designed, and if a disproportionate number of them are positive, then we need to consider the possibility that even the Daily Mail is sometimes right.

I wouldn't know which of these is plausible. I don't know anything about Alzheimer's. I'm merely a mathematician. All I know about is numbers and the logically possible ways of interpreting them. William P. Coleman (talk) 13:39, 13 January 2008 (UTC)

I was using the Daily Mail only as a figure of speech, but I get your point: shouldn't we mention all avenues of research presently being pursued, and comment on the methodology. I don't think it is our job to point out flaws in studies, like Una Smith also reminds us below; to do so is flirting with no original research violation.

When I talked about "refutation" in other studies I was not talking about statistical errors at all. In medicine it is very common for different studies, sometimes with exactly the same methodology, to have conflicting outcomes. Furthermore, interventions may work very well in a Petri dish containing ground-up rodent brain, but have little or no effect in humans - or lead to intolerable adverse events. Interventions in phase I or II trials have the odds stacked against them of ever leading to a useful treatment. These are just some of the reasons why we have WP:MEDRS, our own medical reliable sources guideline. The fact that there are >18000000 articles on PubMed (and many more in unindexed journals) does not mean that all of them have relevance to Wikipedia readers (or even to medical professionals). JFW | T@lk 20:30, 13 January 2008 (UTC)

Information without judicious opinion

It is not our job as WP editors to say whether or not a given clinical trial has merit. I know it can be hard for a physician (or physician in training :-) to suspend the practice of giving advice. In the case of a condition such as Alzheimer's disease, or AIDS, where there are many, many trials underway, I think WP can play an important role in grouping these trials according to approach, in explaining their immediate objectives and the scientific reasoning behind their designs, and in reporting their outcomes.

On Spina bifida, I wrote a very brief summary of one clinical trial, replacing text added by someone with an apparent interest in recruiting patients for the trial. It is not a very good example of "just the facts ma'am", but it is an example.

There is incredible bitterness among many parents of children enrolled in clinical trials, the common theme being that although the parents were informed they did not really understand what they were signing up for. Their primary sources of information are twofold: recruiters and other parents on private support groups. Recruiters have a vested interest. Support groups often are weak on the crucial technical details and sometimes forbid debate and full exchange of information (which may be mis-labeled as "medical advice").

Another gap in information that I see often is this: when a clinical trial is suspended or terminated, there may be no public explanation of why, and patients often do not recognize these steps as red flags.

--Una Smith (talk) 17:44, 13 January 2008 (UTC)

You've identified two major problems in clinical research: the quality and "informedness" of informed consent, and the non-publication of negative results or suspended trials. However, the leap seems to be that Wikipedia should try to fix these problems. I don't think that's the role of Wikipedia. We should definitely not be tolerating overt "recruitment" for clinical trials here. On the other hand, we should not be in the business of raising "red flags" or trying to explain a clinical trial more fully than its IRB-approved consent documents do. MastCell ^Talk 22:01, 13 January 2008 (UTC)

... which is why we need some general guidelines an which studies are and which ones are not useful/notable without prejudice on the methodology etc. When faced with a multiplicity of research (as in Alzheimer's), a lot of weeding out can be done by selecting phase III (or maximally phase II in extremely promising interventions) trials in journals with a highish impact factor. JFW | T@lk 06:08, 14 January 2008 (UTC)

I agree in general. However, some fields are less evidence-based than others (I'm thinking of my own here). Many interventions are adopted based on Phase II (or worse) data, while some Phase III trials fail to have an impact on practice for a variety of reasons. I don't know what the best answer is - I wouldn't want to exclude important studies with a "Phase III" requirement, but we ought to have some formal means of filtering out the dozens of pilot studies which tend to find their way into articles. It might be best to start with standard practice guidelines from major organizations, or Cochrane-type evidence reviews, and work backward to the primary sources used by those expert groups (to avoid potentially idiosyncratic use of the evidence). Of course, not every topic has a Cochrane review available... MastCell ^Talk 23:52, 14 January 2008 (UTC)

Please help with Fibromyalgia!!

This article is in desperate need for editing from qualified individuals well versed in the medical literature. There is also an edit war with a solitary editor who keeps reverting RFC opinion concerning the intro.

Please feel free to stop by and give your opinion in the RFC on the talk page. Djma12 ^(talk) 14:13, 14 January 2008 (UTC)

I have the feeling that solitary editor is well on his way to the Arbitration Committee. JFW | T@lk 23:37, 14 January 2008 (UTC)

OPV AIDS hypothesis

Anyone with knowlege or interest in the OPV AIDS hypothesis is invited to stop by and contribute. I'm not an expert by any means. There is a definite push to assign more WP:WEIGHT to the hypothesis, and currently we're being offered citations to the Papua New Guinea Medical Journal (seriously) and to rejected submissions to Science available on various websites as weighty and reliable sources. MastCell ^Talk 19:33, 14 January 2008 (UTC)

Down syndrome move request

A move of Down syndrome to Down's Syndrome has been proposed. Anyone care to weigh in? My watchlist is quickly, quickly becoming unmanageable...Fvasconcellos (t·c) 00:00, 15 January 2008 (UTC)

PMID

Hi all, our PubMed magic word seems to be a little outdated... Compare PMID 12697071 with the current one: http://www.ncbi.nlm.nih.gov/pubmed/12697071?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum . Where is the MediaWiki for this, and can an admin please update our system?

Thanks, --Steven Fruitsmaak (Reply) 22:40, 15 January 2008 (UTC)

Just http://www.ncbi.nlm.nih.gov/pubmed/12697071 would be better. --WS (talk) 15:04, 16 January 2008 (UTC)

"Magic word"? --Una Smith (talk) 17:46, 16 January 2008 (UTC)

If you just type PMID 12697071, MediaWiki converts it into an external links like this: PMID 12697071. Normally you would expect a template like {{PMC|12697071}} or {{eMedicine}}, but in this case there is (probably) a MediaWiki script to do this automatically.

Re Wouterstomp: yes that looks even better. --Steven Fruitsmaak (Reply) 19:31, 16 January 2008 (UTC)

I requested PMID magic-wordiness in a bug report in 2004. It came almost as a surprise when it was implemented suddenly and without further warning. Petersam (talk · contribs) subsequently had to remove all the template links to {{PMID}} that we had been using before then.

In other words, this needs to be discussed with a developer. I have had a look on meta, but there is no documentation on when and by whom the feature was implemented. JFW | T@lk 21:26, 16 January 2008 (UTC)

The answer is: MediaWiki:Pubmedurl (thanks to Dashiva on Mediawiki IRC channel). --Steven Fruitsmaak (Reply) 14:03, 17 January 2008 (UTC)

I've changed it; it will lead to faster parsing of large medical pages, as the resultant URL is shorter. This is a mediawiki default, so my present version overrides whatever is hardcoded into the software. In fact, the old version was deleted on 7 January for this reason. Perhaps a full bugzilla report is needed to have the hardcoded URL changed as well. JFW | T@lk 14:42, 17 January 2008 (UTC)

Argh. I have been using {{PMID}}. I could use a "WPMED tips for editors" page. --Una Smith (talk) 16:26, 17 January 2008 (UTC)

See Wikipedia:Manual of Style (medicine-related articles)#Citing medical sources. Colin°^Talk 17:28, 17 January 2008 (UTC)

That's where I learned about {{PMID}}. Now that I read it again, I see the plain text PMID 1234567 trick is mentioned in the text above the list of tricks. --Una Smith (talk) 05:41, 18 January 2008 (UTC)

Requested article

Anybody want to write Critical illness polyneuropathy? --Steven Fruitsmaak (Reply) 15:00, 17 January 2008 (UTC)

I'd love to, but not before I've improved rhabdomyolysis, myasthenia gravis, stroke, alcoholic hepatitis etc. JFW | T@lk 21:46, 17 January 2008 (UTC)

I'm just surprised we don't have this... I keep being surprised by the amount of work that is still ahead of us. --Steven Fruitsmaak (Reply) 22:58, 17 January 2008 (UTC)

Pfft. We're just trying to capture centuries of medical discovery, worldwide. --Una Smith (talk) 05:38, 18 January 2008 (UTC)

I made a start. --WS (talk) 23:12, 17 January 2008 (UTC)

I'm looking at it too. There is quite a bit of overlap with critical illness myopathy, so I'm thinking of making that a redirect and covering both in the article. Probably too much overlap to generate two separate articles. MastCell ^Talk 23:19, 17 January 2008 (UTC)

Hmm. If CIM is a cause of inability to wean from a ventilator, what is the equivalent on Wikipedia? JFW | T@lk 07:08, 18 January 2008 (UTC)

Help please

I am brand new to Wikipedia. I would like some help spreading the word about a treatment for Alzheimer's called Cognitive Retention Therapy that was developed by my Uncle based on my Grandmother Mira Ashby's work for Brain injury rehabilitation. Thanks for any help you can provide. Chris Ashby (talk) 23:14, 18 January 2008 (UTC)

Adult-child sex - article nominated for deletion

This is a courtesy notice that the article Adult-child sex has been nominated for deletion.

Discussion in progress at this link:

Wikipedia:Articles for deletion/Adult-child sex (2nd nomination)

All editors are welcome to enter comments. --Jack-A-Roe (talk) 21:13, 18 January 2008 (UTC)

Fair warning: External links

I killed a bunch of chat rooms and blogs from medicine-related articles today. There's probably many more to go, but it's a start. You are hereby warned that the usual patient advocates may be irritated about having their favorite chat room delisted. I am watching very few of these pages, so please feel free to find me on my talk page if you want me involved in any discussions that come up. WhatamIdoing (talk) 07:08, 13 January 2008 (UTC)

An anonymous editor keeps deleting an encyclopedic reference and adding links to his/her Yahoo! Groups chat board at Seborrhoeic dermatitis. I've left a note on the Talk page. If several people would add that article to their watchlists for the next week or two, then we might be able to step on the reversions a little faster. Thanks, WhatamIdoing (talk) 18:46, 15 January 2008 (UTC)

Watchlisted. MastCell ^Talk 18:58, 15 January 2008 (UTC)

By the way, this list is a bit horrifying. I removed a couple dozen links to Yahoo! health discussion forums, but started fatiguing. Anyone else want to take a look? MastCell ^Talk 19:22, 15 January 2008 (UTC)

Argh, 271! That's a job that needs premedicating with caffeine and modafinil. JFW | T@lk 21:33, 15 January 2008 (UTC)

Uh oh: Wikipedia:WikiProject Spam/LinkSearch/groups.yahoo.com. 4261. That needs a different kind of premedication altogether... JFW | T@lk 21:56, 15 January 2008 (UTC)

Perhaps you could suggest that as a task for a bot? Colin°^Talk 22:18, 15 January 2008 (UTC)

It's a mess, of course, but we don't need to remove links from Talk pages or User pages, so we're really not looking at *that* many in the health.groups.yahoo link (which, BTW, is down to 194 links at this point). WhatamIdoing (talk) 08:03, 17 January 2008 (UTC)

Microtia

An anon editor is unhappy that I deleted a link to a microtia-related charity. (It provides funding for microtia surgery, but I saw very little information about the condition on their website.) If the complaints keep going, then it would be nice to have someone else involved. WhatamIdoing (talk) 21:18, 19 January 2008 (UTC)

A medicine question...

I'm working on a project dealing with heart transplants, and I needed to know the "field" in which heart transplantation would be considered. Rather, what field all transplants would come under. Would this be immunology? Please help! (I wasn't sure if this was where to ask my question...) 68.109.10.26 (talk) 14:46, 19 January 2008 (UTC)

Hello! Nice to see that this important topic will improve! I think we should use the immunology category and the Category:Transplantation medicine as well. Let us know if you need any kind of help. NCurse _work 18:02, 19 January 2008 (UTC)

I think this is a helpdesk-style question, actually. Transplantation is surgical, for starters. Transplantation of individual organs probably comes under the purview of the surgical specialty that deals with those organs normally. That is, there is no overarching "transplantation" specialty. For example, a cardiothoracic surgeon would do heart transplantation, but not a liver transplantation. Hope that makes some sense. Antelan ^talk 19:46, 19 January 2008 (UTC)

68.109.10.26, are you planning to improve transplant-related articles, or are you just tapping into our collective fount of knowledge here at the WikiProject? I agree with Antelan that organ transplants tend to be carried out by surgeons already familiar with the organ in question, but generally superspecialised into the transplant of that organ. I think renal transplants, which are common, are carried out by dedicated transplant surgeons.

I don't actually agree with NCurse that all transplant articles should be categorised under immunology. That would clutter the category very much. However, Category:Transplantation medicine should be a subcategory of the immunology category. JFW | T@lk 23:15, 19 January 2008 (UTC)

Rage Epilepsy

I am traveling, with limited access to a slow dialup. There is no such diagnostic entity as "rage attacks", they are not linked to Tourette syndrome, and there is no such thing as "rage epilepsy". I think this article needs to be AfD'd; it appears to be the work of one author. It is speculation unsupported by medical evidence as far as I know. SandyGeorgia (Talk) 23:18, 19 January 2008 (UTC)

"Explosive kids"? I mean, really? The first cited source states "Rage attacks is not a recognized diagnostic disorder or term [...]"! Fvasconcellos (t·c) 01:10, 20 January 2008 (UTC)

When has that ever stopped Wikipedia? MastCell ^Talk 07:57, 20 January 2008 (UTC)

Anyone know anything about sublingual immunotherapy?

I have run across an article called Sublingual immunotherapy just now. I know nothing about it except what's in the article. Has anyone heard of it? Is it effective? Should it have an alt-med tag on it? WhatamIdoing (talk) 00:45, 20 January 2008 (UTC)

The science behind the idea is sound, but this is an emerging treatment approach. PMID 18174969 and PMID 18087165 are promising; PMID 18081563 abstract says guidance issued, but someone will have to read the paper to find out what that guidance is. --Una Smith (talk) 01:31, 20 January 2008 (UTC)

From the article (feel free to move or remove):

Sublingual immunotherapy

SLIT has been proposed as an alternative to the subcutaneous route [145]. SLIT has been shown to be effective in both rhinitis and asthmatic patients and to have a good safety profile (no anaphylactic reactions reported) [145, 146]. A recent Cochrane meta-analysis [147] concluded that 'SLIT is a safe treatment which significantly reduces symptoms and medication requirements in AR. The size of the benefit compared with that of other available therapies, particularly injection immunotherapy, is not clear, having been assessed directly in very few studies. Further research is required concentrating on optimizing allergen dosage and patient selection'.

Recent studies performed in large samples of patients have shown a clear dose effect of tablet-based SLIT in patients with grass pollen-induced rhinoconjunctivitis [148-150]. In one study in which subcutaneous and SLIT for seasonal rhinitis were compared, both were effective compared with placebo, although the study was underpowered to detect differences between treatments [151]. A further recent trial of grass allergen tablets for sublingual use demonstrated a 30-40% improvement in symptom and medication scores and an approximate 50% increase in the responder rate, compared with placebo [152]. A further follow-up for 5 years is planned in order to assess possible long-term benefits of SLIT as has already been confirmed for the subcutaneous route.

Antelan ^talk 08:32, 20 January 2008 (UTC)

I've read about it, this has been studied for quite a few years now as an alternative to desensitisation using injections. It has little to do with alt-med. --Steven Fruitsmaak (Reply) 12:19, 20 January 2008 (UTC)

Snore... gasp...

Obesity hypoventilation syndrome has been improved (I think). Comments and ruthless copyediting invited. I will try to find some illustrations. JFW | T@lk 12:51, 20 January 2008 (UTC)

Could anyone add anything about the importance of papilloedema in this condition? JFW | T@lk 14:54, 20 January 2008 (UTC)

High stubs

I went through all ~40 articles rated High and Stub, and demoted many of them from High or promoted them from Stub. A few I think deserve special attention:

Short list for improvement:

• Microsleep
• Patient education
• Pelvic examination
• Stethoscope  Done

Merge into / reorganize wrt others:

• Arthroplasty
• Allograft
• Fetal screening  Done
• STD testing
• Stethophone  Done

--Una Smith (talk) 05:54, 1 January 2008 (UTC)

Stethophone and several other stubs have been merged into Stethoscope. --Una Smith (talk) 16:43, 1 January 2008 (UTC)

Fetal screening has been merged into Prenatal diagnosis (which needs cleanup). --Una Smith (talk) 17:05, 2 January 2008 (UTC)

Stethoscope is now rated Start. --Una Smith (talk) 17:05, 2 January 2008 (UTC)

The table and index have been updated, and these articles are listed here. --Una Smith (talk) 18:30, 8 January 2008 (UTC)

Updated again, now just 13 high stubs, listed here. --Una Smith (talk) 16:43, 20 January 2008 (UTC)

FYI: I've just merged Actimetry and Actigraph into Actigraphy. Maybe not just a stub anymore? --Hordaland (talk) 02:49, 22 January 2008 (UTC)

Actigraphy is at least a Start-class article now. I don't know enough about the subject to tell you whether it's B-class; the standards are here and you can make your own decision. WhatamIdoing (talk) 03:16, 22 January 2008 (UTC)

Thanks, you are quick! I'm no expert, just thought the 3 articles about essentially the same thing was unnecessary. It can't be 'good' without more references, which shouldn't be hard to find. And I'm not sure all the commercial links are a good idea. It's a Start, as you say. --Hordaland (talk) 03:30, 22 January 2008 (UTC)

Here is the current list of (15) high stubs:

• Abstinence, be faithful, use a condom (mid)
• Barrier contraception (mid)
• Biopsy (no longer a stub)
• Emaciation (mid)
• Functional symptom
• Medical advice
• Microsleep
• Patient education
• Pelvic examination (mid)
• Pharmacotherapy (low)
• Self-care (mid)
• Standards of care
• Sudden cardiac death
• Terminal illness
• Vitamin A deficiency

My inclination is to demote most of them to mid importance. Does anyone object? --Una Smith (talk) 15:46, 22 January 2008 (UTC)

I think most of the recent re-classifications are fine, but "pelvic exam" and possibly "self-care" may deserve extra points based on their potential for popularity with normal readers. I wouldn't object to lowering the ratings on several others: functional symptom, medical advice, patient education, standards of care. I can see these both ways: they are clearly fundamental concepts for professionals, but they may not attract any normal readers. I've also been wondering whether pharmacotherapy ought to be merged with Medication. WhatamIdoing (talk) 19:22, 22 January 2008 (UTC)

Yes, merge Pharmacotherapy into Medication. I think functional symptom, medical advice, and standards of care are high importance; they are very important to patients too. --Una Smith (talk) 20:10, 22 January 2008 (UTC)

I moved the information from Pharmacotherapy into Medication. However, I see that there are links to a journal by that name; should the now-redundant stub become a redirect to Medication, or a stub for the journal? WhatamIdoing (talk) 23:51, 22 January 2008 (UTC)

Sounds like Pharmacotherapy should be a disambiguation page. --Una Smith (talk) 00:18, 23 January 2008 (UTC)

Okay, I looked around. I would make Pharmacotherapy a redirect to Medication, and work the external links etc into that article. The link to that journal website is link spam, by the way, I'd delete it. --Una Smith (talk) 00:21, 23 January 2008 (UTC)

Image:Doppler ultrasound analyzer of blood velocity.jpg

For which article can it be usefull? Alex Spade (talk) 17:14, 21 January 2008 (UTC)

My Russian is quite rubbish. Transcranial doppler, which is what I suspect this machine is for, already has an image that seems to have been cropped from the one under discussion. Why are you asking? It's an image on commons, so it may be in use at other projects. JFW | T@lk 21:19, 21 January 2008 (UTC)

I think he's asking because he uploaded the picture and he wants to add it to any relevant articles. Axl (talk) 15:04, 22 January 2008 (UTC)

PMC links

I'm slightly confused about how we should be linking article fulltext in references when the fulltext is available free on PubMed Central. My personal practice is not to include the link in the "url=" parameter of {{cite journal}} but to use the template {{PMC}} with the PMC article ID (not the PMID) as the article's identifier. What am I meant to be doing? Is there any need for the PMC template at all? JFW | T@lk 22:07, 21 January 2008 (UTC)

I never use {{cite journal}} so I use {{PMC}} a lot; I see no need to delete it. I thought PMC had switched all of their IDs to PMID, and the differences had disappeared? --Steven Fruitsmaak (Reply) 22:22, 21 January 2008 (UTC)

I always use PMC when it's available; when the article is available from the journal website or Medscape, I simply add a regular link titled "Free full text"--I never use the url= parameter, though I'm not sure why :) {{PMC}} does still use the PubMed Central ID, not the article PMID. Changing this would be simply a matter of making the template use [http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid={{{1}}} {{{1}}}] instead of [http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid={{{1}}} {{{1}}}], but then all links would have to be updated! Fvasconcellos (t·c) 23:12, 21 January 2008 (UTC)

PMC takes PMID codes but still parses them to its own article ID. I think the {{PMC}} template should continue to use PMC article identifiers preferentially. I was simply wondering whether there was any agreement on where to put the PMC link - in the {{cite journal}} template or separately. JFW | T@lk 07:23, 22 January 2008 (UTC)

Common cold and toothbrushes?

Any one have a good source for making the link between the common cold and toothbrushes?

I found one article with a PubMed search-- but don't have access to it:

[No authors listed] I'm just getting over a really bad cold. Would it help if I tossed out my old toothbrush and got a new one to avoid reinfecting myself with any cold virus that may be on the brush? Mayo Clin Health Lett. 2001 Jun;19(6):8. PMID 11398217.

There is an article in the Daily Mail. It quotes one Professor Ronald Eccles, director of the Common Cold Centre at Cardiff University:

FACT: You must change your toothbrush.

Once you are beginning to recover from your cold, throw away your old toothbrush and buy a new one. This will lessen the risk of prolonging the symptoms thanks to the virus living on the old toothbrush.

I tend to think the changing toothbrushes is hooey. Any thoughts? In any case-- it seems like an interesting discussion to add to the toothbrush article. Nephron  T|C 01:07, 22 January 2008 (UTC)

Given the state of the immune system during the couple of days after rhinovirus symptoms abate (I assume that viable virus might last a couple of days in reasonably optimal circumstances), I doubt that the small amount of viable virus on a toothbrush is able to cause a clinically significant reinfection in a typically healthy person, but this recommendation is widespread (e.g., see the AOA website).

I've always wondered why those recommendations always involve throwing away the toothbrush (and buying a new one) instead of disinfecting it. Is it just because most people keep their toothbrushes longer than they should anyway, and this makes a good excuse?

Furthermore, with the "Once you are beginning to recover" rules, you could easily throw out a contaminated toothbrush too soon, with the result that the new one will become virus-coated the first time you use it.

Here's basic information on toothbrush hygiene. There's a sentence here which could be used to contradict the usual advice, but I'm not sure that they're thinking about the common cold. They may be thinking primarily about cold sores or yeast infections or something like that. WhatamIdoing (talk) 04:04, 22 January 2008 (UTC)

Yeah, the CDC says: "No published research data documents that brushing with a contaminated toothbrush has led to recontamination of a user's mouth, oral infections, or other adverse health effects." As an aside, we should never be using the Daily Mail as a source in a medical article. As a wise man once said, the Mail is in the business of classifying every naturally occurring substance as either a cause of, or cure for, cancer. MastCell ^Talk 05:25, 22 January 2008 (UTC)

WP:Peer review/Concussion

I've submitted a peer review request for concussion, I was hoping someone familiar with neurotrauma could check it over for any factual errors or distortions that I may have introduced by accident (I'm not an expert). Thanks much! delldot talk 18:54, 23 January 2008 (UTC)

www.rothbartsfoot.info -- quackery or useful

We have an anonymous editor, 84.222.140.56 (talk · contribs · count), who's been adding links plus text to various articles such as Scoliosis, Low back pain?, Fall prevention, etc. He's continued doing this despite requests to stop. Before we blacklist these links, I want to check with more knowledgeable editors as to whether these are links we want or not.

These links are being discussed at:

• Wikipedia talk:WikiProject Spam#Help with user 84.222.140.56

Thanks for any light you can shed on this. Thanks, --A. B. ^(talk) 20:58, 23 January 2008 (UTC)

It's obvious COI spam. Any secondary sources that could help us? JFW | T@lk 23:11, 23 January 2008 (UTC)

Oral allergy syndrome

In the first two sentences, this article asserts that Oral allergy syndrome is an allergic reaction to various kinds of food, and that it is not a food allergy. Do we have anyone here who knows where, exactly, to draw this line? WhatamIdoing (talk) 02:35, 25 January 2008 (UTC)

Aggh - Article is in a mess. Term "Oral allergy syndrome", as the article currently uses, would suggest specific food allergies to various fruits where associated with various pollen-allergies. However some papers on PubMed use term for any fruit-allergy even where no pollinosis, and some even for non-fruits (raw fish in Japan). The article need radical lead-in definition rewrite, or merger to Food allergy. I've posted a long series of discussion points and references at Talk:Oral allergy syndrome#Merge proposal with Food allergy. Please discuss there to help clarify use of the term, or whether to merge.David Ruben ^Talk 04:11, 25 January 2008 (UTC)

homeopathy quackery?

There is an RFC which will be of interest to wikiproject participants at Talk:Homeopathy#RFC: Should homeopathy be described as quackery in the intro? and heated discussion elsewhere on that talk page. Please weigh in. Thank you. MilesAgain (talk) 05:20, 27 January 2008 (UTC)

Inflammatory diseases of unknown etiology

This newish page, Inflammatory diseases of unknown etiology, appears to need an editor (or several) to -- well, I basically think the whole article should be deleted, no matter what its primary author thinks about his favorite article. I'd be willing to entertain a merge with List of syndromes and diseases with unknown etiologies or other improvements, but the basic idea seems to be promoting some WP:SYNTH ideas. I really don't understand how it survived the original prod. WhatamIdoing (talk) 00:01, 15 January 2008 (UTC)

A hopeless WP:SYNTH - would support WP:BOLD and redirecting, but try to involve the original author Reasonablelogicalman (talk · contribs) before doing so. JFW | T@lk 00:20, 15 January 2008 (UTC)

Unless the primary author can give a little more clarity on the organization of this article, I would support you in WP:BOLD efforts. Djma12 ^(talk) 02:28, 15 January 2008 (UTC)

AfD List of syndromes and diseases with unknown etiologies

Wikipedia:Articles for deletion/List of syndromes and diseases with unknown etiologies - hopeless list IMHO. Please vote. JFW | T@lk 22:07, 21 January 2008 (UTC)

Please vote: Wikipedia:Articles for deletion/List of syndromes and diseases with unknown etiologies JFW | T@lk 02:16, 27 January 2008 (UTC)

Vote now closed, outcome was list deleted. David Ruben ^Talk 04:03, 28 January 2008 (UTC)

DeMent vs. Dement

Wikipedia has 2 articles: William C. Dement and William C. DeMent. Can one of you doctors please ask Dr. De[mM]ent how he wants his name spelled? Maybe it's a matter of contention within the family, but Wm. C. must have (had) a standard signature? We need to know which of these article titles to keep if we're to merge them. Please be so kind as to answer on one of the two articles' talk pages. Thanks. --Hordaland (talk) 14:43, 27 January 2008 (UTC)

His website at Stanford does not capitalise the M. I am merging the pages into the former. JFW | T@lk 17:24, 27 January 2008 (UTC)

WPMED tag issue

Based on what I see here, we need an "FL" (Featured List) class parameter. Does anyone know how to make that happen? WhatamIdoing (talk) 00:11, 23 January 2008 (UTC)

I think just expand Template:WPMED to include that class among the others. --Una Smith (talk) 00:17, 23 January 2008 (UTC)

Looks like the template is protected, and can be edited only by administrators. WhatamIdoing (talk) 06:08, 23 January 2008 (UTC)

Stevenfruitsmaak did the initial coding. Perhaps he can help. JFW | T@lk 17:52, 23 January 2008 (UTC)

Oh, it is actually quite straightforward. The "class" parameter can now be "fl" (lowercase), which places the article in Category:FL-Class medicine articles. Hope this resolves matters. JFW | T@lk 17:55, 23 January 2008 (UTC)

I'm really confused - it seems to be working, but the category remains empty despite List of medical schools in the United Kingdom bearing a category link to it! Perhaps we should wait until the server has updated itself (yes, I've purged the cache for the template). JFW | T@lk 18:04, 23 January 2008 (UTC)

The coding looks fine. From my past experience, it can sometimes take days for articles to be placed in newly added categories from templates. Making an edit to Talk:List of medical schools in the United Kingdom may cause immediate proper placement into the category, though this isn't necessary. I'm not sure if anyone cares, but I do not think {{FL-Class}} articles are included in the article statistics table. Also, why was Template:WPMED protected? --Scott Alter 18:27, 23 January 2008 (UTC)

I think it just needed to have a change made to the Talk page to get the category updated. It's working now. Thanks, WhatamIdoing (talk) 20:25, 23 January 2008 (UTC)

I've manually added FL-Class to the statistics table. See if the WP 1.0 bot will update it for us. As for the protection, I am willing to consider unprotecting it, but on the other hand it is transcluded onto 1000s of pages, and vandalism to templates has historically been a major problem because they tend to be on few people's watchlists. Views invited. JFW | T@lk 20:32, 23 January 2008 (UTC)

Unfortunately, the WP 1.0 bot doesn't work that way. I just re-ran it for this WikiProject, and the FL-Class row you added is now gone. There has been some discussion about adding the non-standard classes (see Wikipedia talk:Version 1.0 Editorial Team/Archive 15#List-class), but no decision has been made and the talk has died out for now. If we want FL-Class articles to be included, we would need to put them in an additional category (which is easy enough to do via {{WPMED}}). If the bot recognizes sub-categories (which I doubt it does), another option would be to have Category:FL-Class medicine articles as a sub-category of Category:List-Class medicine articles.

With regard to protection of high-visibility templates, most of the article assessment templates have become protected in the past few months. The only rationale I have heard is that they are potential targets of vandalism. Although these are widely-used templates, they are not in the main namespace and receive little vandalism (of which I have seen none). If any restrictions were placed on them, I would expect semi-protection and not full-protection. I used to be somewhat active in maintaining the assessment templates, but now it takes days or weeks to have administrators make changes using {{editprotected}}. --Scott Alter 21:39, 23 January 2008 (UTC)

Part 2

I think we have the same kind of problem with Template_talk:Obstetrical_procedures. It's tagged, but it's not getting placed in the correct category. WhatamIdoing (talk) 01:58, 29 January 2008 (UTC)

Nope - different problem. The "C" in "class" was capitalized, and the template requires it to be in lowercase. I fixed this on the talk page. --Scott Alter 03:24, 29 January 2008 (UTC)

Speciality (Consultant) "Emergency medicine"?

Dear colleagues from the English wiki; concernig our article on Emergency medicine I don't know, if "emergency medicine" is in anglo-american countries (for example the US) really a speciality like surgery or urology? - Redlinux (talk) 13:34, 28 January 2008 (UTC)

It is in the UK, although only recently developed its own Royal College and specialty examinations. Axl (talk) 13:54, 28 January 2008 (UTC)

Hallo Axl, to enable us to compare it with the German speciality examinations; do You know how long it - approximately - takes to achieve the title "emergency medicine"? 2 years, five years? Many greetings Redlinux (talk) 15:11, 28 January 2008 (UTC)

In the U.S., emergency medicine is a recognized specialty, accredited by the American Board of Emergency Medicine. The residency is typically 3 years following graduation from medical school, though some are 4 years. It's a relatively new specialty but a fairly popular one. MastCell ^Talk 18:53, 28 January 2008 (UTC)

Thank You for Your answer. I don't know much about the US- system of accreditation. In our country a speciality can just be accredited by the "chamber of physicians"; so a speciality of a "Board of Surgeons" or "Board of Emergency medicine" would not officially be recognized, although there are also non-official organisations doing similar. So my questions - is this different in the United states? Who accreditates an official speciality maybe like surgery, internal medicin, urology and so on; also a similar "Board of surgery"? - Maybe this question sounds silly in Your ears, but I'd ask You to answer, cause otherwise, I cannnot compare the education of Your country and ours. We also have the speciality "Emergency medicine" in in many German countries; but it is of less value then surgery or urology; we call those specialities "additional speciality". So for example in my case, I have the speciality "Internal medicine" and some additional specialities like "Sportsmedicine, Emergency medicine ..." Many greetings Redlinux (talk) 22:41, 28 January 2008 (UTC)

Emergency medicine used to be predominantly a surgical subspecialty, but it is now attracting more physicians as well. The British Association for Emergency Medicine is the "Royal" College as David indicated. Under Modernising Medical Careers, emergency medicine has its own core training ("acute care common stem") that includes intensive care, acute general medicine, emergency medicine and so on. I have the feeling this is going to be a temporary thing. JFW | T@lk 07:13, 29 January 2008 (UTC)

Ooh, the BAEM and the College for Emergency Medicine are merging this months and are applying for Royal Charter: http://www.emergencymed.org.uk/Merger/ - wish them luck. JFW | T@lk 07:17, 29 January 2008 (UTC)

Thank You for the hints; so I think, what we call speciality is the same as a Consultant. - So can a physician became a Consultant in Emergency medicine, Sportmedicin or so on? Redlinux (talk) 13:43, 29 January 2008 (UTC)

Coronary stents

I was updating some info on CABG and PCI today and came across the coronary stent and drug-eluting stent articles. The DES page appears to have been largely created as a marketing page by one of the device companies - it has since been cleaned up by other users. The coronary stent page was a stub and did not meet wiki guidelines. A lot of the information on the DES page should be moved onto the PCI or coronary stent page. The DES page should be about the drug-eluting stents themselves; the info on placement and complications should be on the PCI page, the history of stents should be on the coronary stent page. The credit for the picture of the stent on the DES page is the FDA - the FDA may not be the originator of the picture - it could be used with permission of Boston Scientific. I have already made some of these changes, but there is still more to be done - more eyes looking at it would be good. Dlodge (talk) 23:15, 28 January 2008 (UTC)

I think the readership would be best served if we merged everything into coronary stent (or even percutaneous coronary intervention). There would be ample space to discuss the bare metal vs drug-eluting stent controversy. We need a place to discuss the rationale for a choice between stents (e.g. it is better to use bare metal stents in situations where anticoagulation for other indications in ongoing, e.g. in atrial fibrillation, and 1 year of clopidogrel in addition to warfarin would give an unacceptable bleeding risk). JFW | T@lk 07:13, 29 January 2008 (UTC)

I still think DES deserves its own article, but a lot of the content of that article can definitely be merged into a coronary stent article, again separate from PCI. --Steven Fruitsmaak (Reply) 10:29, 29 January 2008 (UTC)

Random hypertension phases

Has anyone ever heard of Random hypertension phases? Google's only hits are derived from copies of this article. WhatamIdoing (talk) 01:47, 29 January 2008 (UTC)

I've prodded it. The original creator seems to have left, and it is unverifiable waffle. JFW | T@lk 07:13, 29 January 2008 (UTC)

Reminder of the Philip Greenspun Illustration project

Hi. You may be familiar with the Philip Greenspun Illustration Project. $20,000 has been donated to pay for the creation of high quality diagrams for Wikipedia and its sister projects.

Requests are currently being taken at m:Philip Greenspun illustration project/Requests and input from members of this project would be very welcome. If you can think of any diagrams (not photos or maps) that would be useful then I encourage you to suggest them at this page. If there is any free content material that would assist in drawing the diagram then it would be great if you could list that, too.

If there are any related (or unrelated) WikiProjects you think might have some suggestions then please pass this request over. Thanks. --Cherry blossom tree 16:54, 29 January 2008 (UTC)

Raynaud's

Raynaud's phenomenon and Raynaud's disease disagree about the proper name for secondary Raynaud's: whether it is Raynaud's phenomenon or Raynaud's syndrome, and if it's the former, what to call the concept that embraces both primary and secondary. I made some lengthy comments on both talk pages, and built a tentative Dab at Raynaud's (replacing a worse Rdr). But i refrained from making any changes to the substance of the two articles, leaving that to someone who has some idea what they are doing.
It is also unclear to me whether Raynaud's is worth 2 or 3 articles: the 3 would be primary, secondary, and an article they would both lk to, stating the aspects they have in common and defining the core distinction.
They probably also lack Cat tags, and all the incoming Dabs and Rdrs should be checked against editor's responses to the belief that R's p and R's d are synonyms.
--Jerzyot 09:10, 30 January 2008 (UTC)

Oh, yeah: it's probably worth trying to get separate pics where the patients have secondary and primary respectively. (As it is, i guess the shared pic could be primary without either article's caption lying, but it looks suspicious, and sleazy even if the suspicions are unfounded.)
--Jerzyot 09:20, 30 January 2008 (UTC)

Raynaud's phenomenon may occur in primary and secondary Raynaud's syndrome. I would only refer to primary Raynaud's as "Raynaud's disease", as all secondary causes are diseases themselves (e.g. scleroderma). I think the whole kaboodle can easily be merged without loss of information. For instance, it is easier to make comparisons (e.g. that secondary Raynaud's is more likely to lead to ulceration and gangrene) and we can discuss the treatments en bloc. JFW | T@lk 21:10, 30 January 2008 (UTC)

Maze procedure

I have recently had personal discussion with Jamie McClelland regarding the naming of Maze procedure, particularly if it should be renamed back to the original minimaze. A discussion can be found on the talk page. Unless there is objection, could someone with admin privileges rename maze procedure to minimaze and move the associated history. Dlodge (talk) 03:00, 31 January 2008 (UTC)

Peer review

Rhabdomyolysis is on peer review. Please offer your comments on Wikipedia:Peer review/Rhabdomyolysis. JFW | T@lk 15:36, 31 January 2008 (UTC)

Pregnancy

Requesting assistance at Pregnancy - some questions and issues have recently arisen concerning the accuracy and layout of the article (see current discussions on talk page). Also, the article was originally written in British English, and I suspect much of the spelling is now American, so Brit members of the project would have a dual task - it would be helpful if you would "correct" any inconsistencies in spelling. Thanks in advance - KillerChihuahua^?!? 19:25, 31 January 2008 (UTC)

Rotavirus

I'm going to list this article for FAC. So now's the time for input. I've had a lot of help already, (see the talk page). I hope that any issues can be resolved before submission. Please help where you can. --GrahamColm^Talk 22:55, 1 February 2008 (UTC)

Hereditary multiple exostoses

Forgive me as I'm still getting used to the conventions used here. What I want to suggest is that the line which reads - A person with HME is also more likely to develop a rare form of bone cancer called chondrosarcoma as an adult, be edited to say the same thing but with a rewording of 'more likely'. I say this because it reads at present as though it's more likely that someone with the disorder WILL get bone cancer than NOT - if you see what I mean? I stress the importance of phrasing it such as I have four children who all suffer from the abnormality. When reading it, I wouldn't want them thinking they were 'more likely' to get cancer than not get it which is one way the current form of the sentence can be interpreted (and that would scare the life out of any kid reading it who suffers from the condition). I don't want to go ahead and do it myself as someone has obviously worked hard to get it into its current form. Thanks. OzScot (talk) 02:39, 2 February 2008 (UTC)

I've tried to address this in the article. Let's finish the conversation on the article's talk page. WhatamIdoing (talk) 03:12, 2 February 2008 (UTC)

Athanasius Kircher FAR

Athanasius Kircher has been nominated for a featured article review. Articles are typically reviewed for two weeks. Please leave your comments and help us to return the article to featured quality. If concerns are not addressed during the review period, articles are moved onto the Featured Article Removal Candidates list for a further period, where editors may declare "Keep" or "Remove" the article from featured status. The instructions for the review process are here. Reviewers' concerns are here. Nishkid64 (talk) 05:24, 2 February 2008 (UTC)

Epinephrine vs Adrenaline (again)

With no clear consensus (IMHO) in past discussions to use Adrenaline over Epinephrine and with WP:MEDMOS giving clear guideline to stick with INN, the article recently got moved. I have reverted back, to what IMHO the WP:MED & WP:PHARM projects would generally consider as a useful approach set out in our WP:MEDMOS guidelines. As previously, Google results being cited, but if this is to be the case, then paracetamol would be Tylenol and penicillin would be whatever is the No 1 US brand (Google reflecting the US-predominant internet) and we would have no use of any generic names, let alone INN terms.

Anyway could WP:MED members comment at Talk:Epinephrine David Ruben ^Talk 12:28, 2 February 2008 (UTC)

Infobox Disease

I've posted a heads up at Template talk:Infobox Disease re a proposed infobox for phobias, which IMHO might be best merged with this template. Also I have then floated the idea of adding a classification parameter for field-of-medicine (eg Cardiology, Neurology).. David Ruben ^Talk 03:22, 3 February 2008 (UTC)

Second opinion

Second opinion doesn't exist. Is there an article on this general subject somewhere? I've tried several names with no success. WhatamIdoing (talk) 21:48, 2 February 2008 (UTC)

I think an article on that subject should be under that name anyway. It's going to be a sweet darling to populate, because I'm not sure which kind of primary studies addressing the impact of "getting a second opinion" in general have been performed. Still, PubMed gives 700 results for "second opinion" and 55 reviews, but a quick look shows that most of these results are very specific to one particular modality or disease. Best of luck. JFW | T@lk 22:55, 2 February 2008 (UTC)

If we get >1500 words and references, suggest it for Template:Did you know. --Steven Fruitsmaak (Reply) 19:07, 3 February 2008 (UTC)

Baby Face Foundation

COuld someone do an external links/spam check on Baby Face Foundation? I suspect that this article's existence is related to a minor edit war in microtia earlier this month. My vision is screwed up in that about-to-have-a-migraine way, so it's time for me to sign off. (I'll be fine. I get the world's mildest migraines for about two hours, once every year or two -- nothing to worry about.) WhatamIdoing (talk) 05:50, 3 February 2008 (UTC)

Did you mean Little Baby Face Foundation? It looks like it's about more than just microtia. It seems to have an international reach and is probably notable on those grounds. Is there press coverage related to its work? Much of the Google links to its work are YouTube/Myspace/Veoh videos. JFW | T@lk 07:49, 3 February 2008 (UTC)

Yes, thanks for figuring out what I was talking about. I couldn't see most of the screen while I was typing. Let's take up the notability discussion on the article's talk page. It's the idealist.org link that caught my eye; idealist is kind of an overgrown chatboard/advertising service/volunteer recruiting website for nonprofits. WhatamIdoing (talk) 03:23, 4 February 2008 (UTC)

Medical news on Portal:Medicine

Thanks to Wikinews Importer Bot, health stories from Wikinews are now listed automatically on Portal:Medicine. You're all welcome to have a look, and of course if you come by any important health stories, in the news or in articles you read, you're welcome to suggest them to me -or better yet, you can write an article on Wikinews! --Steven Fruitsmaak (Reply) 19:05, 3 February 2008 (UTC)

General housekeeping comments/cleanup

Hey all. I might have missed this discussion already but I just wanted to ask a few things regarding the recent changes done:

• Currently Wikipedia:WikiProject Clinical medicine has a soft redirect onto this page? Wouldn't it make more sense just to use a standard redirect?
• Will there need to be a process where all the clinical medicine templates/userboxes etc get deleted?
• What will happen to the articles already tagged with clinical medicine project templates? Are they already removed or will they automatically be removed upon deleting the template?
• Is Wikipedia:WikiProject Clinical medicine/Collaboration and Wikipedia:WikiProject Clinical medicine/categorizations still necessary? Should they be moved somewhere onto[Wikipedia talk:WikiProject Medicine?
• As how clinical medicine project is done, should something also be done with Wikipedia:WikiProject Preclinical Medicine? (And like above, if it does get removed, should all the templates/userboxes/ etc also should be removed? Maybe the Preclinical aspects should be writen up somewhere along the main medicine wikiproject? (And additionally have the talk page archived into this talk page? As is done with clinical wikiproject)
• Should a taskforce (of either preclinical or clinical medicine or both) be implemented as done by other wikiprojects? Or possibly only in the future if it is requested by a number of individuals?

Sorry if these issues have already been brought up/are fixed/on the process of being fixed. Comments are welcome :). Calaka (talk) 05:53, 28 January 2008 (UTC)

re soft redirect - used whilst merger done and allows access still to its past hsitroy and subpages, until teh points you correctly set out above are/were completed :-) Yes the user boxes need merging .David Ruben ^Talk 14:12, 28 January 2008 (UTC)

ClinMed's userbox now (hard) redirects to Template:User WPMed David Ruben ^Talk 14:19, 28 January 2008 (UTC)

I like the idea of a 'taskforce' approach. The Philosophy project seems to use that system, so that there's only one template for the large group, but you can specify that this article is supported by the ethics sub-group (for example). If there were a way to easily replace all the ClinMed tags with a "WPMED (ClinMed taskforce)" tag, I'd support that.

This might actually be useful for several 'child' projects, actually, especially if there are any dormant ones. It could also cut down on the stack of WikiProject tags on some talk pages. (Imagine a hypothetical drug that treats a viral eye infection in several animal species: that could easily acquire WPMED, Virus, Clin Med, Eye, Pharma, Vet Med, Dog and Cat tags). WhatamIdoing (talk) 21:31, 28 January 2008 (UTC)

I second the task force idea for Clinical medicine. I also would support merging the child projects as task forces. Looking at Wikipedia:WikiProject Council/Directory/Science#Medicine, the projects that would fit within Medicine include Clinical medicine, Preclinical Medicine, Anatomy, Dentistry(?), First aid, Gastroenterology, Medical Genetics, Nephrology, Ophthalmology, Pathology, and Radiology. Most of these projects appear inactive, but we still need to have discussions in each of their project talk pages for their opinions. The initial "takeover" could be as simple as moving the child WikiProject pages to sub-pages of Wikipedia:WikiProject Medicine. This would be followed with the talk page banner integration with {{WPMED}} and changing the verbiage of the new child pages to reflect the status of a task force, rather than a separate WikiProject. --Scott Alter 23:52, 28 January 2008 (UTC)

Thanks for the reply so far people. Glad to know eventually everything will be sorted out with the clin med tags/userboxes etc. As for the task forces, I am surprised it got a response but I would more than be happy to support them being implemented into the main medicine wikiproject. Have a look at Wikipedia:WikiProject Military history for the large number of task forces implemented (far more organized than having 40 diferent sub history wikiprojects), and look here Wikipedia:WikiProject Military history/Assessment for how the implementation of task forces is organized to give individual ratings of particular sub-groups (wow the history wikiproject should be featured status :P ). Anyway I have no objections for merging all the projects that you have suggested, I just don't know how active/inactive the projects are apart from pre-clinical (not very active I think) and anatomy (I got a assessment tag set-up but I didn't get around to tagging all the anatomy articles with the tag... No one else seemed to have gotten to doing it either :(, )... However having said that, a wikiprojects talk page and main page is not an indicator of how active the wikiproject is I think? (I.e. people might be working on the 'anatomy' articles by wikifying them, improving them etc with out actually needing to discuss the progress on the talk page... So dunno, I guess more opinions are needed :).

Oh and here is an example of how the 'task forces' are indicared in the assessment tags for the history wikiproject (Talk:Battle of Omdurman), just to give you an idea of how the task forces will appear on the assessment tag. Furthermore here is the actual page of a particular task force (Wikipedia:WikiProject Military history/African military history task force). So in reality it seemes to just make the whole thing more organized instead of having seperate amounts of wikiprojects. Cheers.Calaka (talk) 03:11, 29 January 2008 (UTC)

CLINMED has for all intents and purposes been absorbed into WPMED. Whatever content remains can be merged here, with redirects to WPMED subpages. I'm not sure if CLINMED should be a taskforce of WPMED, but I can see the logic of groups of editors with a specialist interest becoming members of specific taskforces. We have several small WikiProjects (WP:GASTRO, inactive, and WP:RENAL, occasionally active) that actually come close to being taskforces of WPMED (or subprojects). There's no one perfect answer here. JFW | T@lk 07:13, 29 January 2008 (UTC)

Yeah, perhaps for now maybe it can be left as it is, and in the future if it is demanded by a number of people, then taskforces or whatever can be implemented. The only reason I would think of suggesting those seperate wikiprojects as task forces is that this might give more opportunity for them to be noticed (as I assume this wikiproject would be the most viewed) in comparison to the leser known specialised ones... But then again I guess that wont guarantee increased activity just because they are subgrouped into this main wikiproject instead of being on their own..Hmmm your right JFW, no real correct way of thinking it. Oh well, whatever the case be, I will be for it. Thanks Calaka (talk) 14:07, 29 January 2008 (UTC)

Since CLINMED has been completely absorbed into WPMED, then it should be okay to remove {{CMedWikiProject}} from talk pages (and replace it with {{WPMED}}, if not already there). If there are no objections, I will begin this soon. --Scott Alter 19:43, 2 February 2008 (UTC)

I have completed this task. There should be no more talk pages with {{CMedWikiProject}} transclusions. --Scott Alter 23:49, 2 February 2008 (UTC)

WikiProject Preclinical Medicine

Regarding Wikipedia:WikiProject Preclinical Medicine, does anyone here NOT want to merge with them? That project seems to have been inactive for almost a year now. As the parent of Preclinical medicine, WPMED should have the responsibility to absorb it if it is inactive and there is no opposition. Most of their intended scope, stated at Wikipedia:WikiProject Preclinical Medicine#Scope, is already covered by other projects:

• Anatomy -> Anatomy, Biology, & Medicine
• Physiology -> Biology & Medicine
• Cellular and molecular -> Biology, Cell Signaling, Chemistry, Medical genetics, Medicine, Metabolic Pathways, Microbiology, & Molecular and Cellular Biology

There are currently 9 articles tagged with their template ({{WPPCM}}) and an additional 6 articles tagged with their expansion template ({{Medexp}}). The scope of the current preclinical medicine project is so narrow that it probably would not even warrant a task force here. Is there any opposition for a merger? If not, we can begin discussion at Wikipedia talk:WikiProject Preclinical Medicine and see if there is any response. --Scott Alter 23:49, 2 February 2008 (UTC)

I think the status quo is already the way you have described. If you are happy to lead the way, I'm sure this merge will be pretty uncontroversial. JFW | T@lk 23:52, 2 February 2008 (UTC)

Good JOB Scott! Hehe I didn't think there would be so few articles taged with the clinical and preclinical tags :). As Jfdwolff said, feel free to begin incorporating the preclinical onto here. Calaka (talk) 02:15, 3 February 2008 (UTC)

Sounds great! Tkjazzer (talk) 02:52, 3 February 2008 (UTC)

I just made a post at Wikipedia talk:WikiProject Preclinical Medicine#Merger with WikiProject Medicine. If there is no opposition, I'll start the merger in a few days. --Scott Alter 03:31, 3 February 2008 (UTC)

Everything should now be merged. All of the Preclinical Medicine project pages and templates now redirect here. --Scott Alter 00:29, 5 February 2008 (UTC)

Computer/Wikimedia problem

Category:Unassessed-Class medicine articles is down to two pages: the project page and Wikipedia talk:WikiProject Medicine/Archive 5. The problem in the archive appears to be in one of my own comments, which refs the category without a leading colon. I've tried to fix it... but the page doesn't somehow recognize the change. WhatamIdoing (talk) 00:08, 5 February 2008 (UTC)

I did a colonoscopy. There was another instance of the category link without a colon. Should be fixed now. JFW | T@lk 00:24, 5 February 2008 (UTC)

Mnemonics

For a little while now I have been removing mnemonics from articles when they are not of the GET SMASHED calibre. I'm sure every medical school has another rude mnemonic for the cranial nerves, and I would be hesitant to accord these any degree of encyclopedicity. Does anyone disagree on this? I'm asking because of this edit to Whipple's disease. I am not saying that all mnemonics are outlawed, but I would limit this to mnemonics with such a large support base (e.g. GET SMASHED) that verifiability is the least of their problems. JFW | T@lk 16:06, 4 February 2008 (UTC)

I can't see any encyclopaedic purpose. Even the GET SMASHED example is poor. There are no sources for that section and you have to read to the bottom to find out that alcohol and gallstones are the most significant causes in the west. The inventor of such a mnemonics will at times have to pick a less obvious word, to make it fit, or to select a less common cause/sign rather than a more common one simply because the letter isn't available. I'd much rather read some prose that contained the information X: 60%, Y: 30%, Z: 5%, others ... The geographical differences between west and east, or the differences between rich and poor countries is much more interesting to me than some lame mnemonic. The reader doesn't have to sit an oral exam afterwards :-) Colin°^Talk 17:02, 4 February 2008 (UTC)

I agree with Colin. Axl (talk) 17:09, 4 February 2008 (UTC)

I tend to agree, but I was considering exceptions to a complete ban on mnemonics. My reason for quoting GET SMASHED was because it can be found even in highly authoritative textbooks and very popular handbooks (such as Longmore's OHCM) - this is evidently not the case with most other mnemonics I've been removing.

I will update WP:MEDMOS to specifically exclude mnemonics. JFW | T@lk 17:37, 4 February 2008 (UTC)

Generally, I'm anti-mnemonic in medical articles. However, in a few cases, it may be acceptable to include the mnemonic without actually labeling it: an article "just happens" to list potential signs in the same order as a common acrostic. This might be an acceptable way of including the information for those who will recognize it, without giving it undue weight. WhatamIdoing (talk) 20:59, 4 February 2008 (UTC)

The other option is to leave these mnemonics out of the articles themselves and just create a list of medical mnemonics, including only those that can be shown (via sourcing) to have achieved a wide currency. MastCell ^Talk 22:29, 4 February 2008 (UTC)

I share your concerns about undue weight for the sake of convenience, WhatamIdoing. Regarding MastCell's proposal: I can feel my listcruft alarm going off already. Quick, sister, some haloperidol! JFW | T@lk 23:26, 4 February 2008 (UTC)

While there does seem to be a recent epidemic of hypohaldolemia on Wikipedia these days, I don't think JFW meets the diagnostic criteria. MastCell ^Talk 23:33, 4 February 2008 (UTC)

The problem with haldol is an idiosyncratic reaction displayed by trolls (Homo sapiens trollis). For them, generous doses of lorazepam may be more suitable. JFW | T@lk 23:58, 4 February 2008 (UTC)

Hi!
Respected JFW,
I thank you for your message.
The reason why I added that mnemonic in Whipple's_disease was for students. Except that no other hidden meanings.
"GET SMASHMED" and etc - Well... I like them. But I will no more add them...
I just wanted to help students.
I respect your opinions, and I do agree with wikipedian thought.
Thanking you
AnThRaX Ru (talk) --Preceding comment was added at 19:07, 5 February 2008 (UTC)

Glad you agree. Your contributions are otherwise very much welcomed! Stay around & help out - there's plenty more to do. JFW | T@lk 22:51, 5 February 2008 (UTC)

AS again

Asperger syndrome has been subjected to extensive off-Wiki canvassing on numerous autism activist websites, and may need sustained attention from knowledgeable editors. SandyGeorgia (Talk) 16:36, 5 February 2008 (UTC)

For the non-initiated, could you describe the nature of the advocacy being solicited, just so I know what to be on the lookout for? MastCell ^Talk 16:56, 5 February 2008 (UTC)

It's mostly WP:UNDUE issues, giving extra weight to minority viewpoints, and advocacy claims that the article is dominated by "NT"s. If you want specific links to the off-Wiki posts, pls e-mail me. SandyGeorgia (Talk) 16:59, 5 February 2008 (UTC)

Progressive myoclonic epilepsy

Can someone please add information as I have seen it a lot of times and there is not much on it besides links to other pages. I have also noticed that it says epilepsy instead of epilepsies.

I tried to make a few changes but I got confused. I am now using the copy and paste method to copy the formatting from other posts so this may end up in the wrong palce. --Preceding unsigned comment added by 90.192.192.131 (talk) 20:48, 24 January 2008 (UTC)

Progressive myoclonic epilepsy looks like an extremely specialised topic. 137 papers on PubMed, most of them technical. What kind of information are you looking for? JFW | T@lk 22:20, 24 January 2008 (UTC)

I was looking for the information on the genetics and how the diseases connect. --Preceding unsigned comment added by 90.192.192.131 (talk) 22:36, 24 January 2008 (UTC)

The page already lists the three main causes, and the articles on these diseases mention the genetics for each. JFW | T@lk 23:36, 24 January 2008 (UTC)

Hi 90.192.192.131! I suspect JFW's PubMed search only found a fraction of the papers since there's little consistency in naming. This isn't one disorder, hence some authors use "epilepsies" when talking about the group of a dozen different diseases, and one probably wouldn't be diagnosed with PME as it isn't specific. Some authors (e.g., the International League Against Epilepsy) use the term "Progressive myoclonus epilepsies". For information, some lay-accessible web pages include Epilepsy.com: Progressive Myoclonic Epilepsies and WebMD: Progressive Myoclonus Epilepsy. Shorvon's book, "The Treatment of Epilepsy", says PMEs "account for approximately 1% of cases in referral centres, and are mostly due to inherited metabolic abnormalities." He goes on to list "mitochondrial encephalopathies and lipidoses as the most common causes." That 1% isn't of all epilepsies, but of the most difficult-to-treat epilepsies that get referred to the top hospitals and clinics. If you can get access to Engel's "Epilepsy: A comprehensive textbook", there's a chapter on it. That book is so big and expensive, I suspect only a university medical library would have it. Colin°^Talk 23:41, 24 January 2008 (UTC)

Heh, it was a matter of time before Colin would end up dealing with this. JFW | T@lk 00:05, 25 January 2008 (UTC)

I'll try to add to the article what I've found (but it will still be a stub). I didn't have time last night to do more than jot down the above. Colin°^Talk 08:11, 25 January 2008 (UTC)

Done. I'd appreciate if someone could read it over to check it all makes sense. Colin°^Talk 23:17, 26 January 2008 (UTC)

You have worked wonders. It looks great. Thanks, WhatamIdoing (talk) 02:31, 27 January 2008 (UTC)

Thanks Colin it now seems to have more information then the PME disorders themselves. Hopefully in due course someone will edit the articles on the diseases themselves. --Preceding unsigned comment added by 90.192.192.122 (talk) 21:25, 6 February 2008 (UTC)

Suicidality and Antiepileptic Drugs

A recent edit to Phenytoin inserted news from the FDA of an increased risk of suicidal thoughts and behaviours in patients taking antiepileptic drugs. The source was yahoo news, but better sources are the FDA news and FDA Information for Healthcare Professionals. I initially removed this insert since (a) the editor had added it only to phenytoin and (b) the FDA report didn't look at any studies involving phenytoin. The news has been reinserted with a clarification that the FDA expect all antiepileptics to have the same problem. A news item on MedlinePlus has feedback from two experts, one of whom expected it and the other who questioned it.

Now, I'm sure the FDA know what they are doing, but I'd love to know (and read) the research. From a quick search, I've been unable to find the published study behind this. I'm puzzled about the existence of a set of patients with epilepsy who are taking only placebo pills. This generally isn't done as it is unethical. Most drugs are studied as add-ons initially, and later in comparison with a known antiepileptic drug. I'm aware these drugs are also tested on healthy volunteers, but the report specifically mentions patients with epilepsy. So I'm curious about how they reached this conclusion. Any help in this matter would be appreciated.

Assuming this adverse effect is notable, should it be added to all our anticonvulsant drug articles, and how? Colin°^Talk 14:02, 6 February 2008 (UTC)

This was the closest thing I found, and it doesn't say that they're all like that. Did they really say that epileptic people were taking placebo pills?--Rmky87 (talk) 16:49, 6 February 2008 (UTC)

I found that, but it is just one guy from Moscow. The US FDA study looks like a meta-analysis and would probably require loads of authors. The FDA Information for Healthcare Professionals contains the most info. They group the studies by "Trial Indication" and say "the relative risk for suicidal thoughts or behavior was higher for patients with epilepsy compared to those patients with psychiatric or other disorders" (relative risk being defined "Incidence of Events in Drug Patients/Incidence in Placebo Patients"). I'm puzzled. Sure there are studies that involve placebo pills, but they are taken on-top of existing medication, so nobody in these studies, with epilepsy, is off drugs. Sorry, guys, if this is a bit off-topic, but I'm hoping some Wikidoc has access to the journal that contains this study. Unless, it isn't published yet... Colin°^Talk 18:02, 6 February 2008 (UTC)

Sometimes the source is a private document of the clinical trials research community; maybe clues exist on clinicaltrials.gov. --Una Smith (talk) 21:49, 6 February 2008 (UTC)

There is almost certainly no published study. The FDA requested this data from the drug manufacturers, who were responsible for going back to their trial databases and assessing the number of suicides ("The individual sponsors of the drugs were responsible for identifying suicidal behavior and suicidal ideation events in their databases based on the instructions provided by FDA.") In other words, this is unpublished data requested by the FDA for regulatory purposes. Only a portion of data collected by drug companies and submitted to the FDA makes it into publication - see the recent NEJM article for a related example (PMID 18199864). There may (probably will) be a publication at some point in the future, but at this point it's raw data belonging to the drug companies, who are likely not in a huge hurry to rush it to publication. The absolute risk suggests that for every 1,000 patients treated with AED's, 2 will experience suicidal ideation as a result of the AED treatment. In terms of completed suicides, there were 4 among 27,863 treated patients. MastCell ^Talk 23:21, 6 February 2008 (UTC)

MEDMOS and MoS

MEDMOS currently enjoys a unique position wrt MoS, in that we submitted our guidelines to broad community consensus, outside the Project. Other subpages of MoS don't/haven't, creating contradictions. Input needed. SandyGeorgia (Talk) 02:47, 7 February 2008 (UTC)

Not sure where best to add this

I'm not very familiar with the medical articles (not to mention I haven't access to the fiull article), so I'll leave this here for those more interested: Bartlett, Nathan W.; et al. (2008). "Mouse models of rhinovirus-induced disease and exacerbation of allergic airway inflammation". Nature Medicine (14): 199-204. doi:10.1038/nm1713.  CS1 maint: Explicit use of et al. (link)

Basically (IIUC), they've rendered mice vulnerable to rhinovirus, which normally affect only humans and apes, which should make the study of them simpler. Circeus (talk) 21:39, 7 February 2008 (UTC)

Thanks for pointing this out. I would imagine it will shed light on the reason why asthmatics get attacks after suffering a cold. But I'm not sure if the development of an animal model needs mention in any of the articles. JFW | T@lk 21:47, 9 February 2008 (UTC)

Perhaps it's a big step towards a vaccine?--GrahamColm^Talk 22:01, 9 February 2008 (UTC)

Medicine is not my field, so I'm not sure which spin, if any, would be appropriate to use. If I knew, I would have added it myself! Circeus (talk) 22:13, 9 February 2008 (UTC)

Awards Nobel Prize to GrahamColm for discovering a vaccine for the common cold. JFW | T@lk 22:26, 9 February 2008 (UTC)

High stubs

Here's the current list of stubs rated high-importance:

• Disorder (medicine)
• Enuresis
• Functional symptom
• Medical advice
• Patient education
• Standards of care
• Sudden cardiac death
• Terminal illness  Done (now start-class)

I'm going to see whether I can figure out how to expand terminal illness. WhatamIdoing (talk) 00:32, 10 February 2008 (UTC)

Post viral cough

Can anyone tell me the difference between Post viral cough and a minor case of Asthma that lingers after an upper respiratory infection? WhatamIdoing (talk) 03:10, 10 February 2008 (UTC)

Asthma is a chronic condition, not something that comes and goes. Postviral cough is a poorly explained phenomenon that is, as the page states, probably due to increased sensitivity of nerve endings in the bronchi. In constrast, asthma requires chronic airway inflammation and reversible bronchoconstriction, and patients typically report wheeze as well as cough. JFW | T@lk 12:26, 10 February 2008 (UTC)

Eponymous disease possessive naming

• I'm sure we have had past discussion that the modern convention is that eponymous diseases should nolonger use the possessive forms; as they are named after a person, rather than being the disease they personally had. Anthony Appleyard (talk · contribs) has just moved Graves disease to Graves' disease.

1. I can't locate/recall where previous discussion was had on this, can anyone help ?
2. Should I revert back the Graves disease move ?
3. Eitherway, some mention of this need adding to WP:MEDMOS#Naming conventions.

David Ruben ^Talk 01:28, 11 February 2008 (UTC)

• I made the move obeying a request by User:Quuxplusone at 22:05, 9 February 2008 (UTC) in [4]. Anthony Appleyard (talk) 10:50, 11 February 2008 (UTC)

A previous discussion took place at Talk:List of eponymous diseases, which is a footnote of MEDMOS. Reading it again, I like Espoo's response to my post. There is no grammatical, politically correct, or logical reason to keep or drop the apostrophe; claiming so is merely spinning the facts to fit one's own preference. Many eponymous disease names are quite divided in their use of the apostrophe. I note that MEDMOS suggests an authority such as ICD to setting naming disputes, and ICD seem to prefer the apostrophe! Looking at List of eponymous diseases, there is no current consensus on WP to use one form or another. If we, as MED project members, decided among ourselves that the apostrophe should go (say), we'd have to edit a lot of articles and links. I note that "Graves disease" sounds the same with or without the apostrophe, and "grave disease" is something else entirely!

If both forms are of merit and widespread usage, I suggest we go with WP practice for US/US disputes: first usage wins. There is no good reason to change Graves disease to Graves' disease so the change should not have occurred. I'm aware that it was only recently moved there from Graves-Basedow disease.

I'm essentially saying that MEDMOS shouldn't rule one way or the other, and that "inconsequential naming choices, where both forms are in widespread use, such as the presence of "'s" in an eponymn, should be decided in a similar manner to UK/US naming disputes"? Thoughts?

Colin°^Talk 14:14, 11 February 2008 (UTC)

Thanks for Talk:List of eponymous diseases link, and agree for now with above suggestion. It was not the expression of editor views I vaguely recall, but it is a far better description of the issues - so thank you Colin. Personally I'm rather pleased if the appostrophy is kept, both for historical reasons and it just "sounded better" (hmmmm not the educated use of language sought in that talk discussion thread). David Ruben ^Talk 23:34, 11 February 2008 (UTC)

New Medicine Collaboration of the Fortnight!

NCurse _work 17:00, 11 February 2008 (UTC)

Project Welcome Templates

Dear all,

I just created two long-needed templates (thanks to WikiProject Cycling):

• {{MedWelcome}} : adapted from {{Wel}}, this template can be used to welcome new users (both for anons and registered users, which is detected automatically by the template), and has a little message pointing to our project and portal.
• {{MedGreeting}} : for people who add themselves to Wikipedia:WikiProject Medicine/Participants. I would like to ask everyone to add the latter page to their watchlist, and if a new member reports for duty, please greet them!

--Steven Fruitsmaak (Reply) 13:22, 12 February 2008 (UTC)

Good job, I amended the invite to contribute more to "cycling articles" to "medical articles" ! Where did you derived this from :-) Anyway, agree much over due, I've added them to list of templates shown on the project page. David Ruben ^Talk 03:37, 13 February 2008 (UTC)

Yes, that's excellent. Another user (Wouterstomp?) was kind enough to notify me of the project's existence early in my Wikipedia career and invite me to join, which was quite helpful. Let's use these. MastCell ^Talk 04:39, 13 February 2008 (UTC)

Perianal hematoma

Greetings, I just wrote Perianal hematoma, and I haven't written a medical article before, so I was hoping for some guidance? Any comments greatfully received... Fosnez (talk) 14:01, 12 February 2008 (UTC)

Featured Article Candidate

This article is a candidate for FAC. Wikipedia:Featured article candidates/Reactive attachment disorder. If anyone has any expertise in this area, it would be appropriate to read the article and provide feedback on the article contents. It is a DSM-IV-TR diagnosis, so it a good candidate for medical input. If there is a psychiatric portal, I cannot find it, so I am listing it here. Thanks! Mattisse 22:01, 13 February 2008 (UTC)

Assessment stumpers

Would someone else like to express opinions about the WPMED assessment rating of Bacterial flora and Medication? They're kind of weird pages and don't really fit neatly into the usual scheme. WhatamIdoing (talk) 00:40, 14 February 2008 (UTC)

NREMT

The NREMT page had been deleted twice in the past because of poor writing (meaning no references or copyvio or whatever). Now it is back in a form that is perfectly acceptable to Wiki. (It was just a matter of taking the time to write and reference it.) What the National Registry of Emergency Medical Technicians article needs now is the attention of additional Wikipedia-capable editors to expand it heavily. VigilancePrime (talk) 05:11, 14 February 2008 (UTC)

PMC

I note that PubMed now clearly displays the PMCID code for articles that are available free in PubMed Central. I have corresponded with PMC about this, so perhaps this is the result of that exchange.

I think the time has come to integrate a field for PMC codes in the {{cite journal}} template. Alternatively, I can file a bug report to give PMCID the same "magic" as PMID does at the moment. The problem with the latter option is that people will neglect to cite the full article and instead just write PMCID 1234567. The problem with the former is that we would have to manually alter all the references (unless someone has a bot that could do this). JFW | T@lk 11:36, 15 February 2008 (UTC)

A bot could be an option for both the template and other non-template citations if it can replace external links to PMC with {{PMC}}. Even better, a bot could check PMID-references for free full text in PMC and add this automatically? --Steven Fruitsmaak (Reply) 12:44, 15 February 2008 (UTC)

We can ask David Iberri to adjust his tool, but I think we need consensus first on the way we should integrate PMCIDs in citations. JFW | T@lk 13:52, 15 February 2008 (UTC)

Integrated care/shared care/transmural care

Integrated care, shared care and transmural care are important and related issues in modern medicine. The first has no article (but there is integrated primary care as a stub). The second has a short article needing work. The third I created as a stub ages back, but it's now been put up for AfD (Wikipedia:Articles for deletion/Transmural care?) having been transwikied as a dictionary definition. This is a huge topic area and I barely know where to start, nor whether there should be one, or three, or more articles. So, I'm flagging this up as a problem area and will try to do some work on it myself. Without prejudicing the outcome of the AfD, interested parties may wany to take part in the discussion there. In terms of resources, one good starting point is the International Journal of Intergrated Care. Bondegezou (talk) 15:40, 15 February 2008 (UTC)

needs assessment by your project

this may be in the wrong space, but i'm running out the door. The Canon of Medicine - this medical text looks like it is extremely important in the field of medicine but has no assessment/wikiproject template. thought you'd might like to know. JoeSmack ^Talk 17:39, 15 February 2008 (UTC)

 Done Thanks. WhatamIdoing (talk) 20:22, 15 February 2008 (UTC)

Reactive attachment disorder

Hi. This article has passed GA and been peer reviewed. I'd be most grateful if someone with knowledge of the subject could pass their beady eyes over it before I nominate it for FAC. Thanks. Fainites ^barley 14:10, 5 February 2008 (UTC)

Reactive attachment disorder is now a FAC, reviews here. --Una Smith (talk) 00:51, 17 February 2008 (UTC)

Overactive disorder

Apparently this is in the scope of wikiproject medicine.

I won't duplicate my full remarks here, but I believe the article Overactive disorder needs severe attention from someone far more knowledgeable in the field.

For more specific remarks see Talk:Overactive disorder Horst.Burkhardt (talk) 05:48, 17 February 2008 (UTC) edited Horst.Burkhardt (talk) 09:47, 17 February 2008 (UTC) to reflect move

How about listing it on requested moves and following the instructions there? JFW | T@lk 08:27, 17 February 2008 (UTC)

Done thanks, but still it needs a thorough going-over by a clinician or someone informed. Horst.Burkhardt (talk) 09:47, 17 February 2008 (UTC)

I don't understand. First you come here to discuss the need to move the page, and then you move it without further discussion! The fact that you feel the need to mention the article here indicates to me that this is potentially a controversial move, and obviously at least a modicum of discussion should have prefaced a move.

I think overactive disorder would be better off being a disambigation page, because there are several disorders with overactivity. This page deals specifically with a type of behaviour displayed by people with mental retardation. I would really suggest you don't move the present page unless this has been discussed further. JFW | T@lk 10:24, 17 February 2008 (UTC)

Hyperviscosity syndrome

The article Hyperviscosity syndrome is rather hard to read at the moment. I found myself adding in wiki links for five words in the short 'Diagnosis' article... but I doubt that having to look up five words just to make sense of a paragraph is a good idea. Now, I'm not sure if I've even understood any of it at all, so I wanted to leave the rewrite to the experts. Just wanted to leave you guy's a head's up! :) -pinkgothic (talk) 23:01, 17 February 2008 (UTC)

Critical merge

Although they could be different subjects, immunization and vaccination appear to cover basically the same material. Should we merge the pages or split the content? If the decision is to merge, I think the resulting page should be rated 'Top' priority for the WPMED project. WhatamIdoing (talk) 01:18, 18 February 2008 (UTC)

Merge, without a doubt. Vaccination is an obsolete term but used by absolutely everybody because it sticks. Most immunisations are not actually vaccinations anymore but variolations. JFW | T@lk 01:33, 18 February 2008 (UTC)

Excellent point -- but that means we should consider the variolation page (redirects to inoculation) in this conversation as well. WhatamIdoing (talk) 01:55, 18 February 2008 (UTC)

Diabetes

Does anyone know what the current recorded incidence of diabetes is? The articles on WP relating to type 1 and type 2 seem to be singularly reticent about this, except that type 1 is said to be 5-10% of type 2, as far as I can tell! I see all sorts of speculation, mostly totally without foundation, in various talk pages around the subject. We've recently had a campaign called "The missing million" in the UK about diabetes, so I guess that might give us some clues. Soarhead77 (talk) 10:40, 18 February 2008 (UTC)

Incidence is not a very useful indicator in a chronic condition. Prevalence will give you much more information. The prevalence of diabetes is different in each country. This page has some useful data sources on the subject. JFW | T@lk 14:37, 18 February 2008 (UTC)

Don't have the fulltext, but doi:10.1046/j.1464-5491.2003.00955_1.x discusses the epidemiology of diabetes in the UK and its methodological issues. JFW | T@lk 14:40, 18 February 2008 (UTC)

Thanks for that, I also now have a better understanding of incidence and prevalence. You learn something every day! I'll make an epidemiologist one day Soarhead77 (talk) 14:24, 19 February 2008 (UTC)

GNIF COI watch

Please check in on possible COI issues here. SandyGeorgia (Talk) 17:05, 22 February 2008 (UTC)

Further conversation here and here; blog removed, COI issues, and source added to many articles, is it a reputable journal? SandyGeorgia (Talk) 17:23, 22 February 2008 (UTC)

I left a note here about the journal. It basically seems to be legit, but that's not the same as "good." WhatamIdoing (talk) 17:47, 22 February 2008 (UTC)

Can some medical folk look in on Schizophrenia (edit | talk | history | protect | delete | links | watch | logs | views)? SandyGeorgia (Talk) 20:28, 22 February 2008 (UTC)

Gluten sensitivity

Can an experienced medical editor please take a look at Gluten sensitivity and suggest ways in which the article can be improved? At the moment, many of the terms in there are beyond the average reader, yet the information may be very useful, so should not necessarily be thinned out. Thank you. Socrates2008 (Talk) 23:12, 23 February 2008 (UTC)

I've asked its principal author to work on it. JFW | T@lk 23:34, 23 February 2008 (UTC)

Naming/terminology help

I left a question at Talk:Concussion#Move to Mild TBI? about terminology. It's a tough one because there's no consistent use of the terms, and I wondered if anyone with expertise could offer advice.

Similarly, I've been trying to figure out if post-traumatic seizure and post-traumatic epilepsy (Currently at User:delldot/pts and User:delldot/pte because they're still very crappy) should be one article or two, because it seems like they're sometimes used to mean the same thing and sometimes not. Any help there would also be much appreciated. Thanks much, delldot on a public computer talk 05:48, 24 February 2008 (UTC)

The ILAE have a task force that works to classify and define the terms for epilepsy. Their web site may contain some useful info. Another useful resources is their journal, Epilepsia, of which a chunk of their archive is free. The ILAE's list of epilepsy syndromes explicitly excludes "immediate and early post traumatic seizures". PTS and PTE are not the same thing: one is a clinical event that may be a one-off, and the other is a diagnosis and is by definition a chronic condition. I recommend you keep them separate. I'll try to leave some comments on your drafts on your talk page later tonight. BTW: I'm not a doctor; WP:MED doesn't seem to have any active neurologists, which is a shame. Colin°^Talk 19:46, 24 February 2008 (UTC)

We had Sanjpatel1 (talk · contribs) for a while. His last edit was on the 17th. You could also send him an email. Otherwise, we have no long-term neurological contributors. JFW | T@lk 20:44, 24 February 2008 (UTC)

Unilateral IV Lines

We have been utilizing unilateral iv therapy on major trauma patients. Most of the paramedics are trained in bi-lateral iv therapy but not in unilateral.

I have searched several internet links, but had no success in finding any citations or credit worthy information regarding the usage of bilateral vs. unilateral intravenous therapy in the pre-hospital trauma environment.

Any ideas? Your comment/discussion would be appreciated. Paramedix (talk) 18:30, 24 February 2008 (UTC)

Are you asking this in connection with a particular Wikipedia article? JFW | T@lk 20:40, 24 February 2008 (UTC)

I doubt that this question has been studied in any systematic way, for a number of reasons from the ethical to the logistical. With a trauma patient, more access is usually better, so why would you choose to limit yourself to 1 IV if you could place more? IV's infiltrate and veins blow all the time. Is that the question you're asking? MastCell ^Talk 22:33, 24 February 2008 (UTC)

Ryke Geerd Hamer / recent chg-es

hi! i would like to recommend that these edits: [5] r cross-checked vis-a-vis WP:NPOV and WP:OR... thx... --Homer Landskirty (talk) 21:14, 24 February 2008 (UTC)

They fail it, for the most part. What would you like us to do? MastCell ^Talk 22:28, 24 February 2008 (UTC)

Whatever is ethically and legally feasible... :-) --Homer Landskirty (talk) 22:35, 24 February 2008 (UTC)

Gluten sensitivity

Gluten sensitivity turned up on my list of articles to review today. Something about this cluster of articles (see Template:Gluten sensitivity) doesn't smell quite right to me. They may have some WP:UNDUE issues: a quick scan leaves you wondering whether every problem in the world is due to eating wheat. My quack-o-meter tripped when I realized that most of these articles were basically written by a single dedicated editor, with remarkably few familiar names in the history.

To be fair, the articles reference many reliable sources, and they may be just fine; I just don't feel qualified to judge the big picture here. If anyone here has an interest in this subject, please consider this to be an invitation to provide some "oversight" to the articles. WhatamIdoing (talk) 19:52, 25 February 2008 (UTC)

I have resisted hacking into those articles for some time. With the increased recognition of gluten sensitivity it has become fashionable to link every condition to it in some form or description. Pdeitiker (talk · contribs) obviously knows a lot about the subject but has not been able to frame the content in an accessible way. I agree that enumerating single case reports is not helpful and definitely fails WP:WEIGHT. JFW | T@lk 22:55, 25 February 2008 (UTC)

I think the article is great! It just gets too technical, too fast. I'd let it ride for a while and see if the normal editing process gets some introductory information into it. Kd4ttc (talk) 04:15, 26 February 2008 (UTC)

Dysphagia

Talk:Dysphagia could use attention from a wider audience. The issue is whether or not it is possible for a patient to have dysphagia without being aware of it. --Arcadian (talk) 04:05, 26 February 2008 (UTC)

Arcadian beat me to the request. The dysphagia article is quoting a number of medical dictionaries that say dysphagia means "Difficult Swallowing" without saying that it is a symptom. Gastroenterology and Medical textbooks say that Dysphagia is a symptom. It has been proposed that wikipedia needs to reflect the diversity of opinion on usage of the term. Alternatively, wikipedia does not need to propagate an error. Beyond the simple issue of definition, I am interested in reworking the Dysphagia article into an article on Swallowing Disorders, which the Dysphagia article has become, and to add an article on Symptoms of Esophageal Dysfunction (or something like that) where dysphagia, odynophagia, globus, phagophobia, cough, abnormal phonation, salivation, water brash, hiccoughs, heartburn, and other symptoms can be compared and contrasted. With dysphagia being represented as disordered swallow instead of a symptom the future articles will be quite confused.

Thanks in advance for commenting. Stephen Holland, M.D. Kd4ttc (talk) 04:35, 26 February 2008 (UTC)

In the UK, the term "dysphagia" is certainly used in situations where the patient has swallowing abnormalities without necessarily being aware of it. This scenario arises most commonly in acute stroke settings. This is not quite the "dysphagia" that I try to elicit when hunting for oesophageal carcinoma or achalasia. JFW | T@lk 06:39, 26 February 2008 (UTC)

Biology and medicine featured articles

Wikipedia:Wikipedia Signpost/2008-02-25/Dispatches (and yes, some serious review of the medicine and health-related articles languishing at WP:FAC would be most appreciated). SandyGeorgia (Talk) 19:13, 26 February 2008 (UTC)

Some of those articles are really quite technical and limited in scope. I don't treat reactive attachment disorder on a daily basis. JFW | T@lk 23:12, 26 February 2008 (UTC)

Yep, apparently no one on Wiki knows what to do with that one; too bad, since the authors put a lot of work into it. There's also Paleolithic-style diet. SandyGeorgia (Talk) 23:49, 26 February 2008 (UTC)

I read both of those articles at FAC, but I find I have nothing to say about them, pro or con. They remind me of science articles that don't make it into Science and Nature; possibly excellent work but not my area of expertise nor a topic of broad interest nor a wildly brilliant treatment. --Una Smith (talk) 05:23, 27 February 2008 (UTC)

The History Behind Electronic Personal health Recods

Comments welcome here on this AfD nom. Coffee4me (talk) 00:19, 27 February 2008 (UTC)

The Article for Deletion nomination is [here]. --Una Smith (talk) 05:13, 27 February 2008 (UTC)

Unilateral Intra Venous Therapy

Follow up / Clarification to previous question posed...

We would like to gather some thoughts on the use of placing two intravenous lines (IV) unilateral vs placing bilateral intravenous lines for the severely heamodynamically compromised patient. Currently, in the pre-hospital setting, our training does not provide a clear yes "do it" or no "don't do it" answer. We have searched on the internet but failed to find any definitive or conclusive information.

The areas of discussion sourrounding the topic (Two IV lines on one arm) are as follows:

1. Should you elect to place two intra venous lines unilateral, do you start placing them distal to proximal as per usual, or do you place them from proximal to distal??, as the latter appears to be the sensible choice in this case scenario. Should you however place the 1st IV line distal, you have a chance of compromising the 1st distal IV line if you perform an unsuccessful veni-puncture at a site proximal to the 1st IV line.

2. Does it not make sense to have have the IV lines on one side of the patient as it allows for a less cluttered scene?? You will only need to watch out for one side, with regards to pulling out already successfully placed IV lines, by hooking them etc. You would also only need one IV stand or holder.. Both the flow controls will be next to each other which will allow for easy management there of, and preventing trying to find the other one.

3. On how many occasions have you taken a patient the to emergency department and the staff complains as you have now left them without any veins to perform their veni-puntures for blood samples. By performing 2 IV lines unilateral, you will leave the hospital staff an arm with intact veins.

4. Anything else??? Paramedix (talk) 00:22, 27 February 2008 (UTC)

You are posting on a page intended very specifically for discussions on how to improve Wikipedia articles on medical articles. If you want to find a forum of doctors managing medical emergencies there are numerous other avenues available. JFW | T@lk 13:24, 27 February 2008 (UTC)

Medicine Collaboration of the Fortnight: Osteoporosis

NCurse _work 17:46, 27 February 2008 (UTC)

2 suggestions (key/caption to trophy box and unaccessed articles with wpmed template)

Please add a key or caption to the trophy box template on this page. what do the stars mean? what the red x s through the stars mean? It may seem intuitive to a regular, but for a first timer, it is not easily understood.

Also, please add a way to see which articles are tagged with wpmed template but are not accessed or ranked in the box/template at the top. ThanksTkjazzer (talk) 03:13, 28 February 2008 (UTC)

Thank you for your comments. I am pleased to report that at this time all WPMED-tagged articles been assessed for quality, and that about 80% of them have been rated for priority. Apparently the bot that counts them removes the "Unassessed" line automatically when the entire line is zeroed. WhatamIdoing (talk) 03:55, 28 February 2008 (UTC)

The images on the trophy box are already labeled: featured articles and former featured articles. SandyGeorgia (Talk) 02:16, 29 February 2008 (UTC)

Impetaigo

Why is there no article or redirect on Impetaigo? I'd like to read about it here on wiki and don't know enough to write it myself. -- Rlevse o Talk o 14:44, 28 February 2008 (UTC)

Impetaigo is a variant spelling of impetigo; I'll make a redirect. --Una Smith (talk) 15:01, 28 February 2008 (UTC)

That article could definitely stand some expansion - I'll put it on my list. Anyone else feel up to it? MastCell ^Talk 22:44, 28 February 2008 (UTC)

Prostate cancer

The FA article Prostate cancer has had changes that leave it substandard for its rating. Specifically, a Diet section was added with writing that fails, at a minimum, the criteria of "well-written", "neutral", and "consistently formatted inline citations". Besides wording issues in the new content, Diet does not use standard referencing, though it does have references listed at the end of the section, which may have balance concerns. I have made changes to patch up some of faults, but proper correction here extends beyond modest copyediting. -- Michael Devore (talk) 01:50, 2 March 2008 (UTC)

What - lycopene and then what? We are seeing time and time again that dietary approaches to prevent cancer are supported by either inconclusive or no evidence. JFW | T@lk 07:50, 2 March 2008 (UTC)

I don't understand the question. I didn't add Diet section to the article, but the section is broken and would currently fail the article of FA status if it were submitted in its current state. Prostate cancer should be fixed or, failing that, the article needs to go to Featured article review. I hope it could be fixed through WikiProject Medicine (the project in scope, per Talk:Prostate cancer) before taking that step. If the fix should be removal of the section entirely per reliable sources, then that is a decision which could be made by the project team. I am not qualified to make it. -- Michael Devore (talk) 10:53, 2 March 2008 (UTC)

Ah, I see MastCell had acted upon the section since my initial post. Good job, that. -- Michael Devore (talk) 11:14, 2 March 2008 (UTC)

My point was that dietary interventions in the prevention and treatment of cancer are utterly overrated. The research is dodgy (e.g. it is performed on rodent cell lines), overhyped by the press and conflicting. I think you were quite right to take the content in question to this forum, and perhaps we need to ensure that all our featured articles are properly patrolled. JFW | T@lk 12:24, 2 March 2008 (UTC)

NPOV noticeboard

Heads up. Here is a discussion about NPOV involving wikilinks to Homeopathy. --Una Smith (talk) 15:46, 2 March 2008 (UTC)

Getting the wind knocked out of you

I invite all of the usual suspects to figure out a more formal name for Getting the wind knocked out of you. I have no idea what it should be, and I cheerfully leave it up to your excellent judgment. WhatamIdoing (talk) 06:35, 2 March 2008 (UTC)

I wonder if there is actually a name for this all-too-well-known phenomenon. JFW | T@lk 07:51, 2 March 2008 (UTC)

There are several technical terms for this; see redirects that link to the page. --Una Smith (talk) 15:48, 2 March 2008 (UTC)

I believe the medical term is exwindication. :) MastCell ^Talk 19:28, 2 March 2008 (UTC)

Heh MastCell. The Straight Dope lists some possible causes but does not provide a medical term. Using Una's approach we get the terms "diaphragmatic spasm" (which is actually more like hiccups) and "temporary paralysis of the diaphragm" (which is possibly not correct because it is possible to breathe using intercostal and accessory musculature). This sounds like a hard one. JFW | T@lk 21:03, 2 March 2008 (UTC)

When I last edited pages on that topic, months ago, I searched some literature and the web, and came up most often with something between "diaphragmatic spasm" and "temporary paralysis of the diaphragm". --Una Smith (talk) 21:50, 2 March 2008 (UTC)

A hiccup is a synchronous diaphragmatic flutter (I have made some edits to Hiccup); "wind knocked out" is a transient diaphragmatic spasm. --Una Smith (talk) 17:48, 3 March 2008 (UTC)

I found one source that uses "transient diaphragmatic spasm (after excluding all of the "epidemic transient diaphragmatic spasm" pages). WhatamIdoing (talk) 18:53, 3 March 2008 (UTC)

I made a new disambig page: Diaphragmatic spasm. --Una Smith (talk) 19:39, 3 March 2008 (UTC)

Um (anatomy)

Would someone please review the tiny stub on lesser auricular nerve, which begins: "The lesser auricular nerve does not exist"? Thanks, WhatamIdoing (talk) 22:37, 3 March 2008 (UTC)

Paleolithic-style diet at FAC

Paleolithic-style diet is a featured article candidate. SandyGeorgia (Talk) 02:49, 17 February 2008 (UTC)

Reviews here. --Una Smith (talk) 15:30, 17 February 2008 (UTC)

Can anyone have a look? SandyGeorgia (Talk) 02:30, 24 February 2008 (UTC)

Hi, Paleolithic-style diet is now featured. Could anyone update the rating at Wikipedia:WikiProject Medicine/Article rating. Thanks! --Phenylalanine (talk) 02:45, 7 March 2008 (UTC) Done

Project welcome templates subst: use

Maybe its just me, but I've not got either of the two templates to work (ie bizzare display) in user's talk pages unless substituted. Hence I use {{subst:MedWelcome}} and {{subst:MedGreeting}}. Am I getting this wrong? For now I have altered the details so that one can copy & paste with "subst:", but do revert if I'm just being a WikiDunceCap <:-) David Ruben ^Talk 19:13, 5 March 2008 (UTC)

Wheals

Anyone like dermatology? Welt (medicine) and Wheals need some sorting. WhatamIdoing (talk) 07:17, 6 March 2008 (UTC)

Both horrible micro-stubs. Should be merged, with close cross-referencing with generalised wheals or urticaria. JFW | T@lk 09:49, 6 March 2008 (UTC)

Worse Wheal and Wheals exist ! Clearly can be solitary so singular (and better article with refs) should be used ( Wheals merged in to Wheal). I'll also merge in Welt (medicine) next. Finally can people comment on Talk:Wheal as BrE usage seems to be without an "h" i.e. "weal". David Ruben ^Talk 13:16, 6 March 2008 (UTC)

Gaiter, medical usage?

on Gaiter is a peculiar section "Medical usage"; does that section belong in the article? Or is some form of disambiguation needed? --Una Smith (talk) 20:03, 6 March 2008 (UTC)

Never heard of the use of gaiters for venous insufficiency. I don't think disambiguation is needed: if "medical gaiters" are verifiable, they should remain part of that article. JFW | T@lk 20:18, 6 March 2008 (UTC)

The intended meaning seems to be that "gaiter" is a synonym for crus and the rest of the paragraph is extraneous. I have moved the text to Crus and Venous ulcer. --Una Smith (talk) 20:37, 6 March 2008 (UTC)

Rotavirus

Is going to FAC this Sunday, please take a look.--GrahamColm^Talk 21:21, 6 March 2008 (UTC)

Action Potential

Action potential has been nominated for a featured article review. Articles are typically reviewed for two weeks. Please leave your comments and help us to return the article to featured quality. If concerns are not addressed during the review period, articles are moved onto the Featured Article Removal Candidates list for a further period, where editors may declare "Keep" or "Remove" the article from featured status. The instructions for the review process are here. Reviewers' concerns are here.

Why can't I post this: http://adventuresincardiology.wordpress.com/ --Preceding unsigned comment added by 76.26.130.129 (talk) 11:39, 8 March 2008 (UTC)

Enuresis

Enuresis was a "high stub", the main article on its topic being Urinary incontinence. I made the former a redirect and merged text from the former into the latter, except for two wikilinks to "enuresis" on other Wikipedia. Should I move the wikilinks to Urinary incontinence? --Una Smith (talk) 02:11, 29 February 2008 (UTC)

On whatlinkshere, I see more than just two pages that wikilink to the enuresis redirect (a perfect solution, BTW, which I gratefully support). Did you have two pages in particular in mind? WhatamIdoing (talk) 03:40, 29 February 2008 (UTC)

Sorry, I meant Enuresis has two outbound links to other wikipedia; what to do with those? --Una Smith (talk) 05:18, 29 February 2008 (UTC)

Enuresis is not the same as incontinence. JFW | T@lk 07:27, 29 February 2008 (UTC)

That would be a good topic for discussion on Talk:Urinary incontinence, and probably also important to add to the article. --Una Smith (talk) 15:00, 29 February 2008 (UTC)

As usual, there is a cluster of overlapping articles:

• Urinary incontinence
• Daytime wetting
• Nocturnal enuresis
• Bedwetting

Although enuresis may refer to urinary incontinence while asleep, these articles do not make that clear. --Una Smith (talk) 15:10, 29 February 2008 (UTC)

Enuresis is a term that is shifting. I would appreciate input on how to best handle this issue. Please see further discussion on the Talk:Urinary incontinence page. Wshallwshall (talk) 03:38, 9 March 2008 (UTC)

Myelophthisis

An anon added some info to the myelophthisis stub today. I've just cleaned it up, based on my best guess of what the ref probably covered. We now have a redlink to acute megakaryoblastic leukemia. I haven't yet found AMegL under any other names; does anyone know if we're missing this article entirely? WhatamIdoing (talk) 02:36, 8 March 2008 (UTC)

We are. It's essentially a subtype of Acute myeloid leukemia. Some children with Down syndrome get it, due to GATA1 mutations. Probably worth an article. --Steven Fruitsmaak (Reply) 02:49, 8 March 2008 (UTC)

French Catheter Scale

Can anyone provide a definitive definition of what a French is equal to. The Wikipedia article states that 1 F = D(mm)*3. I think this is clearly incorrect. It may be 1 FR = 1/3 mm or is it 1 FR = 1/? mm? I believe 10 FR is about 3 mm in diameter. I would like to add this to the Conversion of Units page in Wikipedia; but, I want to make sure it is correct. Can you provide references? --Rpwolfgram (talk) 19:45, 8 March 2008 (UTC)

I may be missing something, but I think all of your examples are mathematically equivalent to the 1F = D(mm)*3 equation which you're uncertain about. Here are some refs: from a surgical supply company, and Stedman's medical dictionary. Hope that's helpful. MastCell ^Talk 04:26, 10 March 2008 (UTC)

AIDS

Yikes. Through the Rotavirus FAC, the AIDS article just came to my attention. It passed WP:FAC a long time ago, and really needs a WP:FAR tuneup. Lots of uncited text, MoS issues, external link farm, unformatted refs ... probably more. SandyGeorgia (Talk) 20:05, 9 March 2008 (UTC)

Thanks for the note. I took AIDS and HIV off my watchlist over a month ago. There are lots of anti-vandal editors, and endless debates with conspiracy theorists, but not much interest in improving the article. I suspect that any such effort is going to require an enormous amount of "political management." I remember proposing that Wikipedia's main section on HIV transmission actually be in the HIV article, for example, and the article's usual editors thought that was inappropriate -- even though the virus, and not the immune collapse, is what's actually transmitted. I think I gave up sometime after the long debate about whether women who had anal sex would recognize that they were having anal sex and therefore that the anal sex transmission risk applied to themselves (and not just gay men).

Perhaps if we want to take this project on, there should be some advance planning over here, or it should be a MCOTW. WhatamIdoing (talk) 21:11, 9 March 2008 (UTC)

I took an initial shot at the external links. It might help to propose article-specific criteria for external link inclusion, since there are billions of links on HIV/AIDS that satisy the fairly permissive requirements of WP:EL. The duplication of material between HIV and AIDS is also an issue. I'm happy to work on any improvement drive for these articles. There was a temporary spike in AIDS-denialist activity on-wiki a few weeks ago, but we're currently back down to a Blue Alert Level, so maybe it's a good time to work on it. MastCell ^Talk 04:31, 10 March 2008 (UTC)

My feelings about external links in featured articles are clearly displayed at autism, Asperger syndrome and Tourette syndrome :-) If we need a bunch of external links, we're either becoming a support group, an advocacy article, a POV-pushing vehicle, or the text isn't comprehensive. Everything worth saying should already be said in a featured article, and there should be little need for external content. And, external content can be solved by just providing the DMOZ link, as in the articles listed above. Sounds like I'd best not wade into AIDS, but it's really lacking in citations. SandyGeorgia (Talk) 04:35, 10 March 2008 (UTC)

the refs were correct at one time... unfortunately, many denialists and vandals keep messing up the page. Keeping external links off is also a combatitive issue, with 3RR coming into play to keep them down. Holistic medicine, anal sex fetishists and others also contribute to the disruption - with them disagreeing on terminology employed by the scientfic community. One user wanted to list every alternative herbal medicine used in treating AIDS and overextending that section far more than the section pertaining to ART! However, the article has 162 references, and no citation tags at the moment (I have gone back and retagged the references that had been removed). --Bob (talk) 21:06, 10 March 2008 (UTC)

I think this article can be tuned up without a WP:FAR, but it does need tuneup. OrangeMarlin is there, I'll do what I can, and I pinged Eubulides to see if he'll look at Epidemiology. The article has just gotten a bit stale, and has some features that wouldn't pass FAC today, but I think it's all fixable if everyone would spend a day or two in there. SandyGeorgia (Talk) 22:47, 10 March 2008 (UTC)

So there are actually two different phenomena: there is FA rot and there's higher standards. To stop FA rot you need 2-3 dedicated contributors that monitor all new contributions to any FA. Higher standards can't actually be enforced retroactively. JFW | T@lk 22:50, 10 March 2008 (UTC)

List o' tasks

Here's the messes I've found this evening but haven't cleaned up yet. In some cases, I'm not sure what to do.

• Anion gap needs de-mnemonic'd.

 Done. Quick job, but not really any worse than the article was ten minutes ago. WhatamIdoing (talk) 04:36, 14 March 2008 (UTC)

• Amen classification should be considered for deletion. (See the talk page comments.)

 Done. I've merged it with Daniel G. Amen. There's also an Amen Clinic page if anyone's interested in considering anothe rmerge. WhatamIdoing (talk) 04:44, 14 March 2008 (UTC)

• Abnormal basal metabolic rate should be considered for a merger with Basal metabolic rate, except that ABMR has an infobox that I don't think will make sense in BMR. Someone who understands the infoboxes should make a decision about this.

• Cortef sounds like a brand name steroid instead of a generic. Is that the case? Is there a generic name that it should be called?

"Cortef" is a brand name. The generic name is hydrocortisone. Axl (talk) 10:13, 8 March 2008 (UTC)

Should it be a simple redirect? Do we need an article that lists the inactive ingredients for this particular brand? That's the only thing I saw that's likely to differ from the main drug page. WhatamIdoing (talk) 18:25, 8 March 2008 (UTC)

It should be a simple redirect. The inactive ingredients are irrelevant (i.e. not worthy of entry in an encyclopedia). Axl (talk) 13:56, 10 March 2008 (UTC)

 Done WhatamIdoing (talk) 19:36, 11 March 2008 (UTC)

• CMF (therapy) might want a better name. It sounds like it has more to do with the psychologist's office than with the chemotherapy infusion unit.

There are three related page names:

• CMF (therapy)
• MOPP (medicine)
• CBV (chemotherapy)

Presumably we should standardize the titles. Any preference? Alternatively, we could declare them to be dicdefs and kill them all. WhatamIdoing (talk) 04:53, 14 March 2008 (UTC)

• Interleukin 9 is a gene? Really? And Interleukin 16 and Interleukin 21 and Interleukin 23?

If you feel like looking into any of these, I won't complain. ;-) WhatamIdoing (talk) 07:37, 8 March 2008 (UTC)

Lenoir Memorial Hospital

I don't see where to list new articles for this project, so I'll add it here. I just created it and will expand the stub(iness) sometime this week. AgnosticPreachersKid (talk) 23:11, 12 March 2008 (UTC)

You don't have to list new articles unless you need help with something. Just placing the {{WPMED|class=|importance=}} template on the article's talk page is enough. The template will automatically add your article to Category:WikiProject_Medicine_articles for you. WhatamIdoing (talk) 00:17, 13 March 2008 (UTC)

Rotavirus

Is a FAC and apart from Colin, why are there no comments from the project? --GrahamColm^Talk 20:59, 10 March 2008 (UTC)

I was about to do a gentle copyedit but got distracted. Have offered comments now. Brilliant work and of major importance. JFW | T@lk 22:35, 10 March 2008 (UTC)

Good of you to weigh in Jfd. SandyGeorgia (Talk) 22:48, 10 March 2008 (UTC)

Result is pass. Congrats, Graham. (And congrats also to everyone else who helped get it there.) --Una Smith (talk) 01:54, 16 March 2008 (UTC)

Psychomotor epilepsy

Can anyone suggest what should be done with this heading?

According to http://www.emedicine.com/NEURO/topic365.htm, "Temporal Lobe Epilepsy" (note that to see this text requires scrolling down the page),

TLE was first recognized in 1881 by John Hughlings Jackson, who described "uncinate fits" seizures arising from the uncal part of temporal lobe and the "dreamy state." In the 1940s, Gibbs et al introduced the term "psychomotor epilepsy." The international classification of epileptic seizures (1981) replaced the term psychomotor seizures with complex partial seizures. The ILAE classification of the epilepsies uses the term temporal lobe epilepsy and divides the etiologies into cryptogenic (presumed unidentified etiology), idiopathic (genetic), and symptomatic (cause known, eg, tumor).

Would it be correct to redirect psychomotor epilepsy to complex partial seizure? If so, would the same also be true of psychomotor seizure, for example as used in the John Hughlings Jackson article? -- The Anome (talk) 16:23, 16 March 2008 (UTC)

Better to redirect psychomotor epilepsy to temporal lobe epilepsy and psychomotor seizure to complex partial seizure. I assume you are creating redirects in case someone searches for the term, rather than to use those terms in an article? The John Hughlings Jackson article has no reason to use the outdated term psychomotor seizure since, as your source points out, it was first used 30 years after his death. What a shame Jackson's article isn't in better shape. It reflects badly on Wikipedia when these medial heroes are neglected. Colin°^Talk 21:53, 16 March 2008 (UTC)

I think the Jackson article is not half bad. It just needs some sources. JFW | T@lk 23:01, 16 March 2008 (UTC)

Yes, perhaps I sounded too negative. The lack of sources is what I picked up on. I'm thinking of all the charlatans who end up at AfD where folk spend hours fighting over whether a handful of published papers makes someone notable or not. If they'd spend those hours writing about the folk who shaped medicine.... *sigh* Colin°^Talk 23:45, 16 March 2008 (UTC)

New page

I think this page didn't exist until today, Challenge-dechallenge-rechallenge, which I believe is a medical protocol for small subject designs and idiosyncratic responses to medications. Confirm/delete? There seems to be support for it in medical literature, [6], but my familiarity stops at Talking back to prozac. WLU (talk) 23:14, 12 March 2008 (UTC)

It has very little to do with Breggin and his antipsychiatry lot. It has to do with, like you said, drug allergy. In tuberculosis treatment, rechallenge after drug-induced hepatitis is used commonly. The stub should be rewritten with a useful source (i.e. not Breggin). JFW | T@lk 00:15, 13 March 2008 (UTC)

Yeah, Breggin was where I read about it about eight to ten years ago and I remember a vivid example from the book. I'm ashamed. WLU (talk) 00:30, 13 March 2008 (UTC)

The page has been re-written to a certain extent to expand beyond the Breggin reference. However, it's still very much focussed on SSRIs, so if there's any extra info regards other uses of the protocol, feel free to expand or drop them on the talk page and I'll have a go at it. WLU (talk) 19:56, 17 March 2008 (UTC)

Overdiagnosis

Could someone with medical knowledge take a look at overdiagnosis? Today it was completely rewritten by, I believe, someone working in the field (but new to Wikipedia). I did some wikification but I don't have any domain knowledge so an extra pair of eyes would be very welcome. Haukur (talk) 19:40, 17 March 2008 (UTC)

PXE and COI problems

Could I have a few more pairs of eyes on a series of articles related to pseudoxanthoma elasticum? Sfterry (talk · contribs) (who has the same name as a well-known advocate and researcher on the PXE scene) has created articles about PXE International, a charity run by S.F. Terry, and Patrick F. Terry (also created by SFT). Now along comes a user called Kinuvian (talk · contribs) who creates an article Sharon F. Terry within an hour of Sfterry editing. I am assuming good faith here, but I have previously counselled this user on COI. JFW | T@lk 10:00, 6 March 2008 (UTC) ?

I started de-promotionalizing PXE International from the bottom up. I'd be happy to have someone else take on a section -- nothing like having half a dozen WP editors involved to keep people from thinking it's all just a personal vendetta by JFW instead of a normal application of the usual rules. I haven't looked at the biographies yet.

I don't want to run off these authors (I wish every such person in the world checked our articles on "their" topic every single day) but I don't think that they have yet fully grasped the idea that Wikipedia is not an extension of their own website. The organization is "the only hope for many individuals who desperately fear blindness"? Definitely a line out of the marketing playbook. WhatamIdoing (talk) 18:38, 6 March 2008 (UTC)

I completely agree that the Terry's prominent role in the PXE community is perfectly verifiable, and when I expanded the PXE article itself I was pleased that Sharon found no major problems in my writing. Hopefully my messages will set things straight, but I didn't want to be too heavy-handed without a second opinion from the project. JFW | T@lk 20:16, 6 March 2008 (UTC)

Well perhaps there is sock-puppetry going on, but at this point does anyone here care to find out? For newbies they are behaving extraordinarily well and should be encouraged and gently guided. --Una Smith (talk) 03:46, 19 March 2008 (UTC)

I am sorry I didn't see this sooner. Those two users got jumped on fast and quit without a fight. That's selection in action, folks; chase away cooperative spirits and all we're left is ... uhoh ... us. --Una Smith (talk) 04:00, 19 March 2008 (UTC)

I tried to cooperate for quite a while with Sfterry (talk · contribs) and she even agreed to upload some images of typical PXE disease manifestations under the GFDL. After I beefed up the PXE article with MEDMOS, citations and stuff Sharon gave her seal of approval. Most of the deletion discussions on the Terry's articles and the PXEI page happened while I wasn't looking and I'm sure, like you said, this could have been handled more gently. JFW | T@lk 07:09, 19 March 2008 (UTC)

Yup. A lot happens while others are not looking. The trouble is, people who watch a lot of pages tend to become rather irritated and irritable. Not conducive to warmth and gentleness. --Una Smith (talk) 07:31, 19 March 2008 (UTC)

That is exactly why I have stopped using a watchlist. But I'm not sure which user you are referring to with "irritated and irritable"... Nobody was particularly heavy-handed in this particular case. JFW | T@lk 10:39, 19 March 2008 (UTC)

That's a very general observation. Specific to this case, I think the editors who executed the speedy deletes were cranky. I did not say heavy-handed. --Una Smith (talk) 13:52, 19 March 2008 (UTC)

HIV is at FAC

HIV is at FAC here. --Una Smith (talk) 02:43, 19 March 2008 (UTC)

Not any more. SandyGeorgia (Talk) 18:22, 19 March 2008 (UTC)

AIDS FAR

AIDS has been nominated for a featured article review. Articles are typically reviewed for two weeks. Please leave your comments and help us to return the article to featured quality. If concerns are not addressed during the review period, articles are moved onto the Featured Article Removal Candidates list for a further period, where editors may declare "Keep" or "Remove" the article from featured status. The instructions for the review process are here. Reviewers' concerns are here. SandyGeorgia (Talk) 01:09, 20 March 2008 (UTC)

Appendices

Apparently the order of appendices ("See also" and "External links" and so forth) was standardized last year. Most of our longer articles were written before the order was settled. User:Betacommand has written a bot that can automatically conform the order (of just the appendices, not the rest of the articles) to what's listed in WP:LAY:

• See also
• Notes (or Footnotes)
• References (or combined with Notes into Notes and references)
• Bibliography (or Books or Further reading)
• External links

Would we like to do this for the WPMED articles? Personally, I'd much prefer that his bot did this for our 12,000+ articles, instead of doing it by hand. If we can demonstrate a consensus for this, then it sounds like it will be easy enough to get this one-time bot use approved. WhatamIdoing (talk) 19:19, 11 March 2008 (UTC)

No. I don't want Betacommand anywhere near articles I work on. It's not worth risking the errors and disruption just to get the layout right. SandyGeorgia (Talk) 19:20, 11 March 2008 (UTC)

So you don't mind it being done, or being done by a bot, but you think his programming may not be sufficiently robust? WhatamIdoing (talk) 19:38, 11 March 2008 (UTC)

Lots of concerns about Betacommand. Of course we should do it, and as far as I know all of our recent FAs comply. I'm just not interested in turning Betacommad loose on articles, and I don't think the upside (compliance with WP:GTL) is worth the potential downside of issues I've seen in the past with Betacommand. SandyGeorgia (Talk) 19:40, 11 March 2008 (UTC)

I support the use of the bot for this purpose. --Arcadian (talk) 19:48, 11 March 2008 (UTC)

I agree the work should be done by a bot, no opinion on whether it should be Betacommand's or someone else's. delldot talk 22:04, 11 March 2008 (UTC)

I'll feel a lot better about it if Betacommand allows Gimmetrow to examine the code, but if this goes forward and if past experience is a guide, we should be prepared for mistakes and civility issues. Don't say I didn't warn 'ya :-)) SandyGeorgia (Talk) 22:09, 11 March 2008 (UTC)

I don't know anything about bot programming. Is it difficult to restrict edits to a certain category, or to do a hundred pages and stop for the rest of the day, and then pick up where you left off the next day? Something like that would give us time to discover problems. WhatamIdoing (talk) 23:22, 11 March 2008 (UTC)

It almost certainly could be set up to work like that. We could also have the bot only update articles currently marked with a "stub" tag, until it had proven itself. --Arcadian (talk) 03:41, 12 March 2008 (UTC)

That's a workable idea (but how many stubs have all those sections?) SandyGeorgia (Talk) 03:43, 12 March 2008 (UTC)

Does anyone else want to express an opinion? The current idea is to have a bot scan and correct article layout, probably in manageable chunks rather than all at once. It'd be nice to hear from another half-dozen people, if you're out there. WhatamIdoing (talk) 04:21, 14 March 2008 (UTC)

I support (whether by using a bot or such) to organize all the articles so that there is consistency throughout in accordance with the above... I am sure a test of 100 articles can be done to see what bugs occur with the bot doing this and if so, the bot can be modified or maybe someone can go about making the fixes at whatever pages have errors... I am sure there won't be a problem on a majority of the articles. Calaka (talk) 04:45, 21 March 2008 (UTC)

Source of article : Wikipedia