Talk:Shaken baby syndrome

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[edit] Possible Status as a Legal and Medical Fad

Because SBS isn't the sole cause of subdural hematomas or retinal hemorrhages, some people have no doubt been falsely accused of SBS. Since this is a highly emotionally charged accusation that currently plays well with jurys, groups have been formed to bring what they see as a more balanced view of these injuries to the legal system.

Because false allegations such as Satanic ritual abuse and the Salem witch trials can sometimes enjoy a brief status as a legal fad, and diagnosis can gain the status of a medical fad, caution must be taken in a legal context to insure the rights of both the accused and the victims of SBS.

This is definatly POV. I'm deleting it until someone can attribute/cite this or otherwize NPOV it.

I have added a Not verified tag to this article. As it stands now this article seriously misrepresents how controversial the diagnosis of SBS is. There are a lot of "Oral" references - 8 in total - these are useless as they can not be verified - you can in fact put anything down and put Oral after it ie the moon is made of green cheese (Oral). Plus what does the reference to BMJ articles in 2005 mean. I am a subscriber to that august journal and can not find any since 2004. If this is not made more specific I suggest deleting it as it gives an impression of factual basis that may not be in fact true. Chris 9/02/2006

[edit] Whale.to

Ombudsman (talk • contribs) is pushing a link to a bizarre site linking SBS to vaccinations. See his talkpage for more information on this. JFW | T@lk 21:30, 2 November 2005 (UTC)

Whale.to is hardly a 'bizarre' site: it is perhaps among the most comprehensive and well chosen archival resources on the net. "Shaken baby syndrome" + autism nets over 41,000 google hits, while + vaccine gets over 39,000, with the whale.to link at the very top - not at all the position generally found for a 'bizarre' site on an important issue. To dismiss the issue out of hand is, unfortunately, a symptom of the politically induced intolerance toward such matters. If the detractors to the inclusion of this material have done their homework, they would know there are many pediatricians and parents engaged in this aspect of the dispute over vaccine injuries. About the author of the study cited: "Viera Scheibner, PhD, is a retired principal research scientist with a doctorate in natural sciences. During her distinguished career she published three books and some 90 scientific papers in refereed scientific journals. Since the mid-1980s when she helped develop the Cotwatch breathing monitor for babies at risk of cot death (sudden infant death syndrome, or SIDS), she has done extensive research into vaccines and vaccinations and in 1993 published her book, Vaccination: The Medical Assault on the Immune System."[1] Ombudsman 22:28, 2 November 2005 (UTC)

Even reputable scientists are entitled to a lapse of judgment. JFW | T@lk 08:30, 4 November 2005 (UTC)

80 papers? Web of knowlage thinks that only three papers have Scheibner V as an author. Of those one has never been cited. "CAFFEINE EXPOSURE IN-UTERO INCREASES THE INCIDENCE OF APNEA IN ADULT-RATS" racks a 8 citations and the remaining letter racks up one citation. I'm not impressed.Geni 11:25, 4 November 2005 (UTC)

'We' all know it has nothing to do with credentials so lets kill that old deception shall we--called 'word game' or ad hominem in propaganda research [2]('bizarre site'--Jdwolff. Bizarre being her euphamism for thinking exposing medical faults). Never mind how many medical doctors or scientists like Scheibner link vaccines or vit C deficiency to SBS, Some here BayatiButtram MD Kalokerinos MD Donhoe MDYazbak MD [or how many parents have been falsly accused [3]with vaccines, vit c defiency and brittle bones being ignored. It is just the vaccinators (drug using medical doctors--allopaths) usual way of dealing with vaccine criticism or vitamin C issues--suppress it. Parents and other laypeople are deemed to stupid to do their own thinking--stupidity being the state they want us in so they can carry on regardless. Medical editors like Jdfwolff ought to be exposed as suppressors of truth, and how many children have been killed by actions such as that over the years? They should be thoroughly ashamed of themselves. 86.128.165.240 12:39, 9 December 2005 (UTC)

I agree with 86.128.165.240 that information about vaccines and their side effects should not be suppressed. However, the whale.to link is not an appropriate source for this information because of the competing extremist information and conspiracy theories as outlined on the RFC on Talk:MMR vaccine. As already reviewed by InvictaHOG, the commentary on Illuminati mind control, Jewish conspiracy, genocide via vaccination, Roman Catholics, psychic assassins, Mormons, Walter Cronkite, demons sacrificing girls for growth hormone, or links to alien implant removers distracts from the criticisms of vaccines and decreases the value of whale.to link. Andrew73 13:12, 9 December 2005 (UTC)
That is an ad hominem reason, basically, using those 'hard to believe' items to distract from the medical information. That is what a medical person would do, and I see you are one Andrew--interests in hematology and oncology. You even have a Protocols page on Wikipedia [4], and the whale page doesn't mention Jewish conspiracy, only a quote saying the Jesuits wrote it [5], they are Catholic as I recall. You try and prove those things don't exist--you can't--you have to collect them to do the research, and that is basically what whale.to is, a database of material to find the truth. 86.128.205.40 15:02, 9 December 2005 (UTC)
86.128.205.40 (all your IP iterations!), I would like to invite you to continue this discussion at the designated RfC (Talk:MMR vaccine) so that your valuable comments may be incorporated into the general discussion and not missed by the general Wikipedia community. I personally believe that the tone and content of non-vaccine sections at [whale.to whale.to] in general reflects poorly on the position of those seeking change in the current vaccination schema. The information should be free, not wrapped in a shell of off-putting conspiracy theory about unrelated subjects. I look forward to hearing your thoughts about the discussions underway at the RfC! As for the Protocols at whale.to, you will see that Protocols has a charge against the Jewish people for using vaccination. Whale.to highlights this. InvictaHOG 15:58, 9 December 2005 (UTC)
Whale doesn't seek change in vaccination, it is anti-vaccine. Use of the term 'conspiracy theory' is just ad hominem. The Protocols don't mention Jewish that I can see, but that is basic ad hominem. The information on whale about vaccination is irrefutable and well documented, which is why medical Wiki editors want to suppress links to it. They can't deal with the facts on whale.to about vaccination, as those facts take apart vaccination completely, so they have to use ad hominem 'conspiracy theory', buzzwords (eg protocols, child sacrifice, satanism, psychic assassinations)etc which you hope the average uninformed person will think weird and unbelievable, more likely trigger a FEAR response causing rejection with a RATIONALISATION--- instead of reasoned argument--as they know they don't have an argument--see my reply to their mumps vaccine man [6]. Smallpox vaccination, for example, is completely shredded. And you obviously have no idea about conspiracies, or are covering up the medical one/medical monopoly, which has been well documented by researchers such as Mullins, Lanctot MD, Bealle, Hans Ruesh, Coulter etc [7]. Which is the only reason vaccination continues. When you have a monopoly it is by definition Fascism, as Fascism is when Corporations run the country, and anyone with half a brain can see Corporations run the country. It is getting more obvious every day. 86.128.169.252 18:34, 10 December 2005 (UTC)

This discussion should be taking place on Talk:MMR vaccine, where the suitability of whale.to is discussed in more detail. JFW | T@lk 21:39, 10 December 2005 (UTC)

Yes, you'll find even more examples of Name Calling by vaccinators like Jd and Hog trying to suppress links to an anti-vaccine website! john 14:55, 18 December 2005 (UTC)

The anti-vaccinator doing his own share of name-calling. Blah blah blah. JFW | T@lk 22:07, 18 December 2005 (UTC)
I don't expect you to understand the meaning of 'name calling' but calling you a vaccinator isn't 'name calling', it is 'labelling'. The beginning of wisdom is to call things by the right names. That way I can never waste time expecting you to see the sense of my argument, as it is mostly impossible for vaccinators to become anti-vaccinators, given the nature of medical beliefs and politics, as well documented over the centuries. And I like to point that out to the not so enlightened, hence the labelling. Also, many medical doctors like to live with the delusion that they are unbiased. I have to live with the truth, so you can too. john 20:55, 27 December 2005 (UTC)

I consider myself biased against your incessant agitation. Howzat. JFW | T@lk 22:32, 27 December 2005 (UTC)

[edit] Not the result of shaking?

The comment in the article, "Despite its name it rarely occurs as a result of actually shaking a baby" was not cited, and was contradicted in every source I have found (although some sources talk about impact in addition to or instead of shaking). So I added a different sentence and made that one invisible, because it would be weird to have the article say two completely opposite things. Can anyone cite the source for the statement? If you make it reappear, you'll have to take out my sentences or somehow reconcile them. --Delldot 06:18, 5 November 2005 (UTC)

I think that this page is targeted because some people insist that any childhood illness without randomized controlled trials documenting pathophysiology are instead the result of things like vaccination. Most likely there will be a subpar, POV link soon. Thanks for improving the article, it's been on my list! InvictaHOG 14:53, 5 November 2005 (UTC)

___ if you google Dr. Plunkett, he has said that it is extremely rare (as in since 1978 ) he has not seen any baby that has actually died from just shaking. there HAS to be a pretty hefty "slam" invovled. I'm reading a case people v. leslie martin, where a Bronx man was accused of shaking his 5-month-old daughter. his lawyer was among the first ever in the Bronx to try to disprove sbs. Martin was aquitted of murder in the 2nd and served 2 years. __

You know, that makes sense in that it's in line with what I've heard about Diffuse axonal injury, a really common result of shaking. DAI is also rarely a cause of death, but a frequent cause of vegetative state because the parts of the brain affected are often the ones that regulate concsiousness but not as much the centers that regulate functions necessary for survival. So it's not surprising that you say that impact is more deadly than shaking. On the other hand, in an EMT recertification class I recently took, the instructor stressed that if caretakers claim the baby fell from a bed or something and that's the cause of the symptoms that you should be suspicious, because in a study they found that only a very small percentage of actual falls can produce the symptoms found in SBS, unless the fall is from somewhere really high like a second story window. In that same class, they stressed how hard babies are shaken in this type of abuse: One confessed abuser was quoted as saying something like 'you'd be surprised his head didn't fall off,' he shook him so hard. So the sheer force involved might explain why shaking would produce those types of symptoms, which may otherwise be perplexing. delldot | talk 03:44, 30 November 2005 (UTC)

[edit] Removal of link to relevant information (eg. whale.to)

Geni, maybe you could clarify your reason for removing links on vaccine topic pages (at least this, Chickenpox and Vaccine) and engaging in edit wars on that? Jkpjkp 17:20, 6 November 2005 (UTC)

The link was inserted again[8]. The (un)acceptability of whale.to as an external link has been discussed on Talk:MMR vaccine, and I think nothing more needs to be said over here. JFW | T@lk 22:37, 17 November 2005 (UTC)

Jfdwolff (and many others) is just continuing the 200 year history of medical industry suppression of vaccine damage, and vaccine criticism. 86.128.165.240 12:10, 9 December 2005 (UTC)

This discussion should be taking place on Talk:MMR vaccine, where the suitability of whale.to is discussed in more detail. JFW | T@lk 21:39, 10 December 2005 (UTC)
All links to whale.to articles are being suppressed by JFW and InvictaHog, two allopath editors, as they don't want any anti-vaccine or vaccine critic point of view. Which just points out the bias of Wiki on medical matters. To see what they are afraid of read this whale article.86.128.205.102 08:44, 12 December 2005 (UTC)

Baloney. It's not the criticsm we're suppressing, it's whale.to. JFW | T@lk 11:24, 12 December 2005 (UTC)

[edit] Creating page to Dr Archie Kalokerinos MD

I am interested to hear there is a yardstick we can put on people to see if they should be linked on Wiki. I would like to know what is acceptable so I can see if he fits it, and I also would like to run the rule over some of the other linked articles and people. Is it peer reviewed articles published, years in clinical practice, personal recommendation from well established scientists? You see, I would rather you put it in writing as I think it is unfair if you are the only one with the rulebook, as people who own the rulebooks can be tempted to move the goalposts, especially if no one else can see what is in the book. Secondly, I don't accept that you are qualified to be the judge for the reason you are an allopathic physician and Dr Kalokerinos is an orthomolecular physician, so you are biased from the position of medical politics, quite apart from your ignorance of the subject, which you are demonstrating now by trying to keep him off Wiki. Thirdly since you have orthomolecular scientists eg Irwin Stone [9] and Linus Pauling [10] on Wikipedia I find it extraordinary that you don't want the physicians on also, as what use is the science if no one puts it into clinical practice? Fourthly, and most significant, you already have two on, Dr Klenner [11], and Abram Hoffer [12], so not only should a link to put to his articles or my page devoted to him, but a page should be put up to him on Wiki. He duplicated most of Fred Klenner's clinical work, and did much more besides, so he is deserves a page more than them. Not forgetting his research into shaken baby syndrome (he has acted as an expert witness), so a link to his page on whale.to would be also sensible. john 13:50, 28 December 2005 (UTC)

I dealt with this character on Talk:Sudden infant death syndrome. JFW | T@lk 14:27, 28 December 2005 (UTC)
Here is a foreword to his book by Linus Pauling [13]. So that is a recommendation by a Nobel prizewinner (the only person in history to individually receive two Nobel Prizes), I think I'll take that over your opinion. john 20:03, 28 December 2005 (UTC)

[edit] Legal and Technical Concerns

Tulane Med School, J Am Physicians & Surgeons, criminal trial court admonitions are not fringe sources. Please try to respond on a technical level. Nor is this just an "orthomolecular" or "vitamin C" issue, it is about a basic, airtight, science based approach to "mainstream" SBS protocols (clarified) founded on the cumulative body of 20th century science and medicine. I think you should recognize that I have tried hard to neutrally downplay certain sensitivities. --69.178.31.177 06:19, 12 February 2006 (UTC)

The citations you've given are from only one person (who is now emeritus at Tulane) and the journal you cite is far from a mainstream medical journal. In fact, the Journal of American Physicians and Surgeons is not even indexed on PubMed! Given these factors, the vitamin C deficiency hypothesis has to be viewed with considerable skepticism. Andrew73 13:06, 12 February 2006 (UTC)

Emeritus is CABC's advantage here, he has seen stuff you won't see. I think mom, pop and society would like as complete, measured answers as possible on $1+ million multiple life altering decisions, not just the word of 'ex-spurts'. --69.178.31.177 15:17, 12 February 2006 (UTC)

Again, references to only one person's opinion have been provided. If this was an "airtight" observation, I would have expected other people to have published similar opinions. Andrew73 14:30, 12 February 2006 (UTC)
(Later clarification: airtight in * "mainstream" SBS procedures* --69.178.31.177 03:10, 13 February 2006 (UTC))

As I said, 'sensitivities' here. On 1/2 doz refs, Tulane is "mainstream" and CABC is reasonably concise and focused for an average reader. --69.178.31.177 15:17, 12 February 2006 (UTC)

This isn't a "sensitivity" issue. We're talking about only one person's opinion. Just because he works at an academic institution does not automatically mean his views are mainstream. Mainstream means more than one person's view. Andrew73 15:33, 12 February 2006 (UTC)
It's amazing what people with academic credentials get away with these days. JFW | T@lk 21:28, 12 February 2006 (UTC)

We most definitely are not talking about just one person's opinion, just an appropriate ref. Tulane is mainstream, the author highly credentialed, and tends to imply some previous anchor point. I am simply steering a wide berth around authors that mention vaccine injury/involvement beyond a secondary or peripheral degree, in part because of the ongoing outbursts exchanged, as above and MMR - I am not interested to participate. It is important to note that some of the questioned SBS diagnosis problems are instances of "single point observations" i.e. allowing just retinal hemorrhages rather than the "triad". This nutriture position is also partly delineated in the external link at the bottom of the SBS article. Further, here is one 'satisfied' family[14]: almost destroyed on the single issue of retinal hemorrhages; her suggested lengthy test schedule greatly exceeds this nutriture position. After Sardi: "adults who are vitamin C deficient may exhibit retinal hemorrhages" Postgraduate Medical Journal 66: 687, 1990; "vitamin C and bioflavonoids resolve cases of retinal hemorrhage" J Medicine Lyon 53: 1681-86, 1972.

A highly credentialed professor he may be, but what he argues about shaken baby syndrome is not mainstream (who knows, maybe time will prove me wrong). Take for example, Peter Duesberg, who is obviously quite accomplished...do you also believe his controversial views on HIV just because he is a tenured professor? Finally, I can see the link between scurvy and retinal hemorrhages (at least the isolated case report in the journal you cite is more "mainstream"), but again this association and shaken baby syndrome is tenuous at best. Andrew73 22:31, 12 February 2006 (UTC)

I thought the whole section is pretty obviously outside "mainstream", even if it primarily questions a perceived gap in high stakes procedures and mentions their constructive responses - technically conservative in the sense of covering the bases. Take jfdw's roll of the eyes, I am simply trying to make sure that CABC and his refs are not casually dismissed as is so popular here. Tenuous? For doctors under 70, it almost seems as though the bulk of vitamer/nutrient research never even took place, as if lost in a proprietary wilderness for over 40 yrs. I am truly curious what US med school really thinks that it still covers this research. It seems like we "merely" forgot the Apollo (moon) program, and are now all "denialists" because we can't go there now. --69.178.31.177 03:10, 13 February 2006 (UTC)

[edit] Quotation from Archie Kalokerinos

I trimmed out the quotation from Kalokerinos. A couple lines about the vitamin C hypothesis should be sufficient, not a whole monograph (should every point in the article be supplemented with lines and lines of quotations?). Andrew73 21:07, 19 February 2006 (UTC)

[edit] Organization of article is goofy

This article is quite disorganized. Obviously some contributors have a strong POV to discredit the concept of SBS. Skepticism regarding parts of SBS is not unreasonable, inasmuch it is difficult to duplicate the condition in lower animals, and institutional boards have understandably not been forthcoming on intentional shaking of nonsedated higher primates. Nonetheless, skepticism should properly be voiced in its own section within the article, not distributed throughout the portions attempting to the describe the syndrome itself.

The idea that SBS is a "theory" does not in any way invalidate the condition. Evolution by natural selection is "only" a theory, E=mc2 is only a theory, elevated LDL/low HDL contribution to coronary artery disease is only a theory, even cigarette smoking contribution to lung carcinoma is only a theory. Some theories have more or better data to support them. It takes time to gather supporting and contradicting data. That's how science works.

The majority of medical professionals accept the reality of SBS as the "best" explanation for the clinical situation presented by infants with the appropriate signs and symptoms. This does not invalidate the naysayers among the lay, legal, and medical populations. Still, before presenting contrary views / links, the Wiki article should at least present the medical description first! SBS is first a medical diagnosis, and only secondarily a social phenomenon and legal issue. Mixing contrary opinions with the primary description makes the article unreadable at best. —The preceding unsigned comment was added by Bticho (talk • contribs) .

[edit] Appropriate references

I added a few references to demonstrate that there are plenty of actual scientific studies supporting the SBS concept. I could obviously go on, adding many, many more, but the point is: including articles on "scurvy" in a Wiki article about shaken baby syndrome is silly. If you've got any decent science (even half-decent science) documenting scurvy in SBS-type patients, please post that. And material from the scurvy literature of 100 years ago before SBS was even recognized would not make good references.

The reference section should be purged to the normal Wiki length of a few, truly representative articles. —The preceding unsigned comment was added by Bticho (talk • contribs) .

[edit] Anatomy and pathophysiology

I have re-added information that was lost in User:70.171.229.32's zeal. The section had lost all information relating to the actual anatomy and physiology of the condition. Also remember to use edit summaries. ... discospinster talk 03:22, 8 October 2006 (UTC)

[edit] 9/10 Oct'06 revision of refs

The article had a bizzar system of inline url links and a manually organised list of references that duplicated the url external links - yet neither linked to the other (and there is one extra inline link not included in the references, so the numbers were out of sync). Generally eithe rHarvard styling (Author, Year) is used with a reference section in alphabetical order, or a footbnote system such as the older {{ref|}} {{note|}}, or the newer system of cite.php (see WP:FOOTNOTES.

I've moved the refs in accordance with cite.php ref system. This also then allows duplicate citing of the same source via duplicate links.

I tend to highlight the references when viewed in edit mode by use of html hidden tags (oterh editors structure over several lines, indentiting in teh process) - but thats just my preference.

Finally the citation markup is non-standard (yes I know there is no absolute guideline on this), but the citation templates lend themselves to linking on an article's title. This is assumed as a default to be to an html webpage unless otherwise specified in a format parameter. Finally accessdate used to check the validity of an external url address can be shown.

Finally try to use PubMed to search for papers, and the PubMed abstract number can be inserted into Diberri's tool] to autogenerate cite journal template markup. David Ruben Talk 23:14, 9 October 2006 (UTC)

[edit] Someone please fix this article!

Due to vandalism by User:70.171.229.32, several responsible attempts to make this a standard Wiki article have been undermined. As written by the above user, there is hardly any accurate, non-biased or useful information about shaken baby syndrome as understood by the general medical community (as opposed to SBS deniers).--—The preceding unsigned comment was added by Bticho (talk • contribs). 04:35, 10 October 2006

Partisan deprecation of an editor's efforts should be avoided. These edits look legit, if obviously reflecting a current controversy and a new editor. Seems other parties with legal and scientific clue-sticks have not yet achieved serious medical industry attention to the concept of researching, evaluating, documenting, and excluding alternate hypotheses with a biological basis. Please show us some data (references) that strongly address these specific points to support such an assertion. Constructive contributions are welcome.--TheNautilus 09:45, 11 October 2006 (UTC)
Btw, I don't deny that there is such a thing as SBS. It concerns me greatly that simple, even cheap data are not collected that would provide retrospective information. Also I would classify each mistakenly prosecuted case as a multimillion dollar error that may leave a wife and siblings without support, missing a parent, and an innocent person in prison. An unjustly convicted innocent is something the founders strove strenuously to avoid. Further, if such data were collected, it might help resolve some other medical related controversies. So who's afraid of science and a few facts?--TheNautilus 09:54, 11 October 2006 (UTC)
I apologize to User:70.171.229.32, but do not agree that her edits are legitimate. A standard article about a disease should describe the standard understanding of the disease, as understood by the medical community first. User:70.171.229.32 thwarted attempts to organize the article with objections / controversies placed separately within the article. This is partisanship.
I am not sure which cheap data you're hoping to see on SBS. I agree that a nationwide study of SBS is needed, but this would not be cheap. A retrospective study is not likely to be enough, as you probably would not have adequate control of SBS inclusion criteria to satisfy critics. The idea that scurvy or osteogenesis imperfecta are legitimate alternative explanations is pretty lame. I agree that it will be pretty easy to demonstrate this, though to spend NIH money to show that scruvy is not prevalent in modern society is a little sad.
Although I sympathize with innocent persons falsely accused of child abuse, they are still alive, and they have means of legal defense. 1 and 2 year old abuse and murder victims need advocates too. The Wikipedia article should not attempt to solve this problem, but present the current understanding in a logical fashion: first the medical description, than the objections and controversies. Just don't mix them together. Bticho 11:54, 11 October 2006 (UTC)
This is *not* just a medical article, especially if they *are* all abuse cases. "Medicine" glommed on to a social issue in the 70s *and* has been successfully challenged on its thin science cover in the legal arena (I can remember roommates from college first remarking on this new reporting expectation with concern during residency, it sounded like an alien invasion then and it sounds like the chickens are coming home to roost now). Cheap data would be checking "clear" body fluids at presentation and autopsy for vitamin C presence. The apparent presence of vitamin C wouldn't really conclusively confirm the abuse hypothesis but its absence would be definitely notable, deserving of followup. The vitamin C problem described is not considered classical, persistent scurvy and so does not appear on the medical radar. If one wants to help effectively address legitimate abuse cases (e.g. convince a knowledgable jury), the lack of data *is* a scientific gap problem. Medicine doing its homework, especially at autopsy, to exclude several defenses would scientifically tighten real abuse cases considerably. User:70.171.229.32's edits are notable both for the actual legal results with a rising internet concern, *and* that they have multiple scientific support from long standing medical observations that appear unchallenged by relevant scientific data in the conventional medical wisedom. They are encyclopedic with several major populations in play (medicine v science v social welfare v population v legal).
The measurement issue is most credible in the Clemetson references. In case some don't recognize who C Alan Clemetson is, he was one of conventional medicine's big guns on vitamin C (e.g. 3 huge volumes at CRC Press) in the 70s and 80s (he seems to be actively retired as prof emeritus). Current medical protocols *have* been seriously questioned as legally and scientifically deficient protocols and represent only one, albeit major, facet of this touchy article. May I suggest that you explore how to work cooperatively with User:70.171.229.32 to find a balanced, rational presentation of a multifaceted issue? IMHO, the Intro should make passing reference(s) to the potentially confounded/overlapped diagnosis problem, revisited in the article, and the block quote, 3rd paragraph - Caffey originally hypothesized... is not Intro material. Again you are dealing with a new editor, AGF. That may require patience and education.--TheNautilus 19:45, 11 October 2006 (UTC)

I agree, this article is ludicrous and currently next to useless. The syndrome with its current medical and legal usage needs to be clearly described as any other medical condition. There should be a "criticism" section describing the minority of people who for various reasons attack the concept. A reader should be able to discern the difference between the usages and viewpoints, and the major flaw here is that widely accepted and fringe or unsupported concepts which are inextricably mixed. Much of the article now has a "how to defend yourself when you "accidentally" beat up your baby" flavor. alteripse 15:17, 10 October 2006 (UTC)


The contention that there is unanimity among the medical community is wrong, and presenting the topic as if there were would be incorrect. There is not a medical consensus, and the "momentum" of the topic is actually to discredit the previously accepted concepts about SBS -- to the point that more recent textbooks in forensic pathology discuss it in terms of "The Shaken Baby Controversy" (for instance, see Forensic Pathology: Principles and Practice, David Dolinak et al. Elsevier Press, 2005) rather than in terms of an accepted pathophysiologic process. That different specialties view it with differing scepticism is not surprising; the same thing happened with respect to near-SIDS/suffocation a few years ago. The bottom line is that this topic is up in the air. Any article that portrays it as an established diagnosis is wrong. Any article that portrays it as completely debunked is wrong. User:Billollib 22:04, 19 October 2006

And yet the current mixture doesn't represent that idea at all. Why don't you give us a synopsis of the perspective and controversy as described in recent forensic medicine texts. It would be far better than this. alteripse 01:11, 20 October 2006 (UTC)

I clarified the "Focus" reference which is not an "independent review" as previously described, but rather a single doctor's editorial. This editorial clearly states that it does not represent the views of the Royal Society. IMHO, such an article does not deserve the amount of space devoted to it in the Wiki article, as there are more pluralistic consensus reviews by pediatric ophthalmology groups. Contrary to Dr. Newman's editorial, the vast majority of pediatric ophthalmologists are comfortable with the generally accepted pathophysiology of SBS. The fact that there is no good animal model is largely due to researcher reluctance to purposefully shake higher primates, for ethical reasons.

[edit] Occular manifestations

I reverted back the deleted sections on occular manifestations (blanked as ref tag error threw the whole article into disorder), correcting the opening & closing ref tags so that it displayed correctly.

Shaken baby syndrome though needs some reorganisation - it is getting quite long and the additional information is both perhaps a little too detailed too quickly (articles should slowly increase in complexity of knowledge) and sits awkwardly in the current article structure.

  • It is disporportionately long compared to other features of SBS mentioned - perhaps this is appropriate to some extent if occular signs are the most impirtant (I don't know as not my area of expertese). Reducing down the occular discussion is one option (but would be a shame), increasing discussion of other features (but I'm not sure length discussion on brain stem or cerebral hispopathology features are appropriate for a general encyclopaedia) or separating this out as a separate article with just a short paragraph summarising main points here (with a {{main|XXX}} tag used to point the reader to a more detailed article on the specific sub-topic, eg Shaken baby syndrome occular manefestations).
  • Finally articles on disease should generally follow the standard article layout (see Wikipedia:WikiProject Clinical medicine/Template for medical conditions and Wikipedia:Manual of Style (Medicine-related articles)): Symptoms and signs, Cause/Etiology, Diagnosis, Pathophysiology, Treatment/Management, Prognosis, Prevention/Screening, Epidemiology, History, Social Impact, Notable cases. The occular additions forms a very neat coherent whole, so I'm not sure how one would split it to have Symptoms & signs (for occular and other features), pathophysioology (for occular and other features), diagnosis (for occular and other features), treatment (for occular and other features) etc.
    • In its current form, we have Signs and symptoms (intro and only discussion of non-occular features), a subsection of Occular manefestations (which is listing the signs & symptoms) with sub-subsection on Mechaism (the pathophysiology) and likewise its treament, then jump back up for other features non-occular features to 'Anatomy & pathophysiology', 'Prognois' etc:
1 Signs and symptoms intro and only discussion of signs of non-occular features
...1.1 Ocular manifestations which is listing the signs & symptoms
......1.1.1 Mechanism of ocular injuries the pathophysiology
......1.1.2 Treatment of ocular injuries
2 Anatomy and pathophysiology which is only about neck & brain injuries (no memntion of occular)
3 Prognosis which is only about prognosis from the direct brain injuries.
4 Prevention

The two options here are to use a separate page, eg Shaken baby syndrome occular manefestations, or to divide up the occular manifestations and its sub sections across the top-level sections: Signs & Symptoms, Anatomy & Pathophysiology, Prognosis. David Ruben Talk 14:42, 15 October 2006 (UTC)

I've added a sentence[15] to address what I think are Stroll's immediate concerns about "ocular balance".--TheNautilus 02:46, 16 October 2006 (UTC)

I changed the inserted section on “Ocular” to be shorter, more informative (easily comprehended), accurate, and objective by providing information from and a link to the American Academy of Ophthalmology’s web site [16] for “Shaken Baby Syndrome Resources.” This web page has sections on - Child Abuse - Shaking Injury - Ocular Involvement – Prognosis - Shaken Baby Syndrome (SBS) – Reporting - Additional Resources and Figures; in addition to references. Also added information from an independent review of prominent Ophthalmology studies and their findings concerning "Inflicted Childhood Neurotrauma" (SBS) that was published in the Spring 2005 issue of The Royal College of Ophthalmologists' "Focus."[17] Added four references documenting other causes of retinal hemorrhages.

The Stroll 01:07, 17 October 2006 (UTC)

[edit] Yurko, the hero of anti-vaxers and the ICA

Heads up! A new subject is being introduced without mention in the article, and it's happening in the "See also" section.

The section is now being used to add information regarding career criminal Alan Yurko, who injured his son so badly (bruises, broken bones, etc.) that the child died and he was convicted. He then became the poster boy of the anti-vax movement and was declared a "hero" by the International Chiropractors Association, who even established a "Chiropractor's Hero Fund to raise money for the mother to pay for the father's defense." (Also originally copied to Yurko's website: [18]) They are so much against vaccination that they will even defend a baby killer! [19][20] Ironically, one of the best sites that debunks anti-vaxers is made by a chiropractor. (There are some very sensible ones out there.)

Yurko himself did the expected thing in such a case -- he denied it all and began to research possible defenses for his actions, and he found anti-vaxers and chiropractors to be willing supporters. He then studied their material and became an expert in using their twisted logic as a defense. You can get an idea of who the fringe doctors (some have articles here) and others who defend him are by reading one of his mails posted here. While reading it, keep in mind that these are the manipulative rantings of a man desperate to avoid paying the consequences of his actions, and who had a long history of crimes from his youth. This wasn't a lone incident in the life of an otherwise normal and non-criminal person. One of his comrades in crime (they stole cars as youths) even emailed me that he wasn't surprised at all, and that this was a logical progression in his life. It just had to happen sometime that he'd end up killing someone.

A long time ago I collected some information here and here. Unfortunately some of the links aren't good anymore (and I can't access those pages). The Internet Archives are great in this situation!

If this article is going to get used to defend the claims of the anti-vax fanatics and to defend baby killers, then it needs to be discussed in a short secton of the article reserved for critics before such links are added here.

Be warned... delving into the subject about Yurko and the anti-vaxers should make any normal person physically sick, so get your barf bags ready. It's sickening business, but a substantial portion of the alternative medicine community believes this junk, so it is a significant minority viewpoint. -- Fyslee 07:21, 22 October 2006 (UTC)

[edit] Can we get rid of the vit c stuff?

The vitamin C topic takes up a bizarrely large proportion of this article and is barely worth a 1 sentence mention in this context.

  • As mentioned, there has never been a reported case of vitamin c deficiency prosecuted as SBS.
  • Scurvy rarely occurs in the age range susceptible to SBS. When it does occur in late infancy it produces a range of bone and skin and neuromuscular effects quite different from SBS. In other words it is quite unlikely to be mistaken for SBS.
  • A vitamin C level can be obtained as easily as any other send-out test (e.g., from Quest diagnostics); even the biggest hospitals rely on commercial labs for many tests; all the crap about how hard it is to get is irrelevant and misleading to the general reader (as it is meant to be) and adds zero to the understanding of SBS.
  • All Kalokrinos had to do to convince people he discovered a useful preventive measure against crib death was to publish the details of his research in a way that it could be verified and reproduced. I don't think he has done so, but instead has allowed himself to be made a cause celebre by the anti-vaccine quacks. Anyway, crib death and SBS are two different things and the conflation of the two is scientifically weak and again is used primarily to obfuscate the primary issues about SBS.

Any objections to simply reducing the entire vitamin C discussion to the following? Prolonged vitamin C deficiency (scurvy or Barlow's disease) can increase bone fragility and skin fragility, but rarely produces these effects in early infancy and is readily distinguished from SBS by many other differences between the two conditions. alteripse 20:29, 22 October 2006 (UTC)

Full agreement. -- Fyslee 20:37, 22 October 2006 (UTC)
I object. Although I would agree the section could be cleaner & shorter, IMHO, this drastic of an edit looks ill advised, ".... rarely produces these effects..." seems precisely one of the major legal questions asked w/o real, hard evidence based medical answers. Also, if all this vitamin C data is so easy to get, why the major resistance to check vit C residuals if there is no such documentation? Where are all the little binders full of this type data and the resultant studies? Again, as far as recent medical opinions on "scurvy" and related conditions, Clemetson seems much more the expert as far as deficiency conditions that are better known to Clemetson's generation in things that are alien concepts (e.g. early, rapid onset variations of different etiology) to younger doctors. Clemetson, as a long known vitamin C expert for conventional medicine as well as a Tulane (conventional medicine) professor (emeritus) of ob/gyn, seems credible. Conventional medicine is being criticized across the board for failure to address a number vitamin C questions diligently, competently, scientifically, and truely authoritatively.--TheNautilus 10:21, 23 October 2006 (UTC)
Has Clemetson ever described a single actual case of scurvy mistaken for SBS? His paper is hypothetical "might be" from someone who apparently has never seen a single case of either condition, published in a very obscure journal (which I suspect mainly serves as a political advocacy organ for the AAPS) and promulgated by extremely untrustworthy sources. SBS and infantile scurvy are not similar, and the link exists only in the theoretical discussions of those who look for ways to attack the diagnosis. See my note below. For the best description of infantile scurvy, see Kumaravel Rajakumar. Infantile scurvy: a historical perspective. Pediatrics 201:108. Please do not replace. alteripse 10:55, 23 October 2006 (UTC) I tried to replace the Clemetson link from the 2004 paper, but it kept replacing the entire rest of the article. This is the removed cite, if one of you would like to reinsert it. "Clemetson2004">Clemetson CA (2004). "Was it "shaken baby" or a variant of Barlow's disease?" (PDF). J Am Phys Surg" 9: 78-80.  I don't understand why inserting it as copied deletes the remainder of the page. alteripse 10:55, 23 October 2006 (UTC)
I just reviewed the Clemetson reference and the journal itself. The paper is sheer speculation, medical hypothesis, with zero actual data about vitamin C in infants, let alone infants with SBS. The journal is the organ of the AAPS, an organization that officially denies that SBS even exists [21]. This is conceivably the weakest of all evidence, and deserves nothing more than a brief reference as described. alteripse 13:27, 23 October 2006 (UTC)
Clemetson is pointing out inferential gaps in the conventional medical case, potential errors of omission. Bad science to not address them directly. I would be careful about "zero data" on Clemetson, he may have 20 lbs of publications on you there. He has pointed out weaknesses in the diagnosis; medical authority & conventional wisedom aside, this is the proponent's burden in a criminal trial (supposedly, or have we already gone to the "efficient system"?). Your brethern show up to Salem w/o the residual data, especially if there is a demonstration of rapid onset or early problems (animal models even?), and failing a Perry Mason moment ("I did it, I did it..."), the defendent might take a walk. In adversarial technical forums it is often amazing what *does* come out of the woodwork. You're asking for a disproof of *your profession's* inferential hypothesis (from what I have read), based on "expert opinion" that has been contested with mixed results. I think you might be surprised on the rapid onset part & vascular fragility. Think what happens with hemorhaggic disease. It is not that Clemetson presents huge data but rather that the medical profession may have so little in this particular area. You are being dismissive of Clemetson and that's not so easy. You, too, have very pronounced views.--TheNautilus 00:13, 24 October 2006 (UTC)
Clemetson's argument is basically, "I can imagine this is the cause of SBS, so it is up to everyone else to disprove it". How can you respect that? It is then seized upon by the unholy alliance of child abuse defendants' lawyers and those who see the opportunity to blame anything bad that might happen to a child on immunizations. No relevant data, no intellectual integrity, no evidence to back claims, just lots of claims, lots of attacks against "authority", lots of irresponsible obfuscation and intellectual dishonesty. There are legitimate arguments against some of the conceptual framework of SBS, but if the mechanism is disproven, it will be by scientists, not the zealots and quacks who push their claims way past anything for which they have evidence. It doesnt matter how much Clemetson knows about vitamin C, he has not provided any evidence that any actual cases of SBS have ever been caused by it. Until someone does, it does not deserve anything more than a sentence in a brief encyclopedia article like this. The medical literature is littered with bright plausible hypotheses that never got confirmed, thousands of them. They never make it to honest and high-quality review articles, textbooks, and encyclopedia articles until someone takes the trouble to investigate and provide some support, but there are always a few of those ideas that get taken up by quacks, cranks, and fools for their own purposes, or by those who just enjoy the fun of being contrary and "against authority" regardless of the value of the assertion or the harm it may do. Which party do you represent? alteripse 01:22, 24 October 2006 (UTC)
Medicine's argument is apparently, "I can't imagine this is a cause of SBS, so it is up to everyone else to absolutely disprove the sacred, monolithic signs of SBS - we were here first and King's X". How can you respect that? - I don't. "It is then seized upon by the unholy alliance of child abuse defendants' lawyers" perhaps you prefer the efficiency of the people's court under Adolf? Clemetson's argument is basically "I have seen stuff like this and listening to them, I am concerned that my younger, less experienced collegues may be dangerously & prejudicially hasty." He also states he takes opportunities *to avoid* anything bad that might happen to a child on immunizations with screening & carefully considered vitamin supplements. "irresponsible obfuscation and intellectual dishonesty" yes, I've seen a lot of it in all my decades. "There are legitimate arguments against some of the conceptual framework of SBS, but if the mechanism is disproven, it will be by scientists, not the zealots and quacks who push their claims way past anything for which they have evidence." But those scientists better plan on all their future funding outside the hallowed halls of conventional medicine and the industrial complex.
"It doesnt matter how much Clemetson knows about vitamin C" It appears some zealous doctors' minds may already be made up, hang 'em all, let God sort them out. "he has not provided any evidence that any actual cases of SBS have ever been caused by it." he did provide the pregnant graph of histamine concentration vs neutralizing ascorbate in one of the references that you deleted as well as references to sequelae. "Until someone does, it does not deserve anything more than a sentence in a brief encyclopedia article like this." as a FACT that may be true, and perhaps (I am not a real contender here) that applies to SBS itself from what I have seen and read. The section was identified as a notable hypothesis. The original Nutriture Hypothesis section obliquely referred to the other vitamins/minerals but studiously avoided the vax part. Perhaps those need to be added too. The medical literature and history are littered with bright, self-serving medical practices and pronoucements that later turned out to be totally wrongheaded. DNA science showed that perhaps as many as 20% of selected, contested criminal convictions were at direct variance with new facts - ugh. Many self evident or simple scientific propositions never make publications until generations later. "investigate and provide some support" sounds like a self challenge "just enjoy the fun of being contrary and "against authority" regardless of the value of the assertion or the harm it may do." I believe in the scientific outlook no matter how unpopular and perhaps have more insight (experience) into proven miscarriages of justice and science. I do have doubts about institutional purveyors of rigid formalism gate keeping. "Which party do you represent?" Bystander trying to be a good samaritan at the start of a street fight or mugging.--TheNautilus 03:21, 25 October 2006 (UTC)

To User:The Stroll. I am not sure "where you are coming from", as this seems to be the only article you are interested in. I am guessing you do not have a medical background, but perhaps I am wrong. The basic explanation for my simplification of the grotesquely overgrown, inaccurate, and misleading vitamin C section is concisely outlined above. I can assure you my brief summary is both more clear and more accurate than what I removed: I am a pediatrician who has seen cases of SBS as well as a case of early childhood scurvy, and I can give you references for both topics. Finally, the vitamin C stuff is off-topic in two ways: (1) it's the wrong vitamin-- vitamin K deficiency can cause intracranial bleeding in the first months of life and has been mistaken for inflicted head injury in real cases, and (2) the real scientific controversies over the SBS diagnosis and wrongful abuse accusations have been covered in detail recently in the British medical literature (BMJ and Arch Dis Ch) and are not even mentioned or referenced. Again, a simple literature search will reveal them, but I am planning to supply them. I am not trying to cover up real controversy, just to beginning to clear out the misinformation and irrelevant information. If you tell me what your interest here is, I can even post some appropriate references for you. Finally, some of the stuff on vitamin C testing might be appropriate for the scurvy article if you hate to see it wasted. alteripse 10:55, 23 October 2006 (UTC)

[edit] next topic, prevention

Any objection to pruning the prevention section? Prevention is basically "don't abuse your child" and belongs in the child abuse article, rather than in an article on a specific type of abuse. It contributes nothing to the reader's understanding of SBS. Again, my goal is to prune the junk so we can begin to deal with the real topic. We don't need expansive discussion of other causes of crying in this article. Sepsis?-- I could give you 90 more diseases that cause babies to cry. alteripse 13:34, 23 October 2006 (UTC)

Good points. In an article on murder, we don't list among the preventive measures: don't insult people, don't jump in front of their guns or knives, don't hang around with known criminals, don't default on loan payments from Mafia loan sharks, etc.. Removing the responsibility for the commission of a crime is abominable. To excuse crime is to justify it, in which case it is no longer a crime. It can often be explained, but that is not the same as excusing it. We can also forgive wrong actions, but forgiveness doesn't make them right or remove the responsibility for their commission. On the contrary, it makes it clear that the action was wrong, and an ethically mature person will accept the responsibility for their actions and will also pay the price without attempts to evade it. -- Fyslee 10:33, 5 November 2006 (UTC)
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