Wikipedia talk:WikiProject Clinical medicine

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Announcement: Please have a look at the nascent Medical classification scheme here, add to it, correct it, modify it, whatever seems fit. It would be good to have a sound logical scheme worked out before trying to implement it.

You may also want to add and argue at the Very Important Pages and Where They're At. (this link redirects to Wikipedia:WikiProject Medicine)


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This is the doctors' mess (or lounge, if you're from the USA). In order to streamline the project, this page contains sections where participants can raise ideas for general discussion and debriefing. To communicate recent work and seek collaboration or peer-review of pages, please see WikiProject Clinical medicine/Collaboration.

Contents

[edit] AFD

Wikipedia:Articles for deletion/List of people who have died of Lyme disease - PROD was contested. Please give your views. JFW | T@lk 23:00, 18 December 2006 (UTC)

[edit] Cancer.gov copyright

Is the information found on http://www.cancer.gov/ public domain? I couldn't find any copyright notice on the website. Could be very useful for some of the cancer related articles. --WS 21:59, 21 December 2006 (UTC)

Yes, it is public domain. The copyright notice for that website is here and it states, "Most of the information on the National Cancer Institute's (NCI's) Web site has been written by federal government employees. This material is in the public domain and is not subject to copyright restrictions. Therefore, no special permission is required to use it or reproduce it. However, any reproduced material should contain proper acknowledgement of NCI as the originator and the NCI Web site, www.cancer.gov, as the source." Also, accoring to Wikipedia:Public_domain#U.S._government_works, "we can assume works produced by the U.S. government or its employees in the course of their duties to be copyright-free and in the public domain world-wide." Sarah 18:08, 6 January 2007 (UTC)

[edit] Move Myocardial infarction -> Acute coronary syndrome!

The suggestion has come up that Myocardial infarction is not only the incorrect term but a sprawling article. I am bringing up the suggestion to move the article to Acute coronary syndrome. Please keep the discussion on the myocardial infarction talk page. I don't recall if there needs to be any official vote to move an article (which is funny, since I was definitely involved in the move from Heart attack to Myocardial infarction), but given that it was recently a collaboration of the week I figure we should take this slow to make sure we are doing this the right way. For what it's worth, as a cardiologist, the term ACS really does make a lot more sense, since sometimes a detectable infarction (formation of new q waves or ST abnormalities) doesn't always occur in a "myocardial infarction". Ksheka 01:30, 24 December 2006 (UTC)

[edit] Ehrlichiosis Induced TTP Mimic

Please vote Wikipedia:Articles for deletion/Ehrlichiosis Induced TTP Mimic. Background is on Talk:Thrombotic thrombocytopenic purpura and User_talk:CaliforniaLyme. JFW | T@lk 13:53, 24 December 2006 (UTC)

Some vanity at Wikipedia:Articles for deletion/Sharon Moalem. JFW | T@lk 17:07, 24 December 2006 (UTC)

My frustration with edits by CaliforniaLyme (talk • contribs) is mounting. Riding roughshod through infectious disease articles suggesting that the whole world is suffering from rare infections. JFW | T@lk 22:08, 24 December 2006 (UTC)

Agree 100% Don't even get me started on dealing with agenda pushers in medicine in Wiki-ville.Droliver 21:51, 25 December 2006 (UTC)
Perhaps if Droliver would spend as much time discussing as he does making accusations, there would be a more cooperative environment. Those who disagree are "POV pushing". I suggest WP:AGF and be respectful of those who disagree, rather than continuing to engage in a relentless campaign to discredit other editors Jance 08:22, 27 December 2006 (UTC)
Dr Oliver's work in preserving the goals of encyclopedia writers and addressing the vandalism of our project has been tireless and valuable (it tired me out long ago) Will TALK 23:50, 5 January 2007 (UTC)

[edit] Tick-borne meningoencephalitis

JDW is I think in part referring to Tick-borne meningoencephalitis which has had a huge amount of (mostly russian) links inserted, with claims that a single TBEV flavivirus is the sole cause and that in turn this is the cause of Amyotrophic Lateral Sclerosis. The additions assert that it is activated by many antibiotics but treatable by Phosphrenyl (?any ideas what this is), interferon, and phytotherapy. The cited studies are real enough, in as much as PubMed abstracts them, but it is unclear whether this is a group of different viruses causing a clinical picture (as ICD10 codings suggest) or a single virus (which article now seems to claim, but which I suspect is merely the Russian sources in fact discussing their one specific local type of Tick-borne meningoencephalitis). Some additional comments and opinions would be helpful (see article's history and talk page). David Ruben Talk 02:41, 25 December 2006 (UTC)

[edit] Wikipedia Day Awards

Hello, all. It was initially my hope to try to have this done as part of Esperanza's proposal for an appreciation week to end on Wikipedia Day, January 15. However, several people have once again proposed the entirety of Esperanza for deletion, so that might not work. It was the intention of the Appreciation Week proposal to set aside a given time when the various individuals who have made significant, valuable contributions to the encyclopedia would be recognized and honored. I believe that, with some effort, this could still be done. My proposal is to, with luck, try to organize the various WikiProjects and other entities of wikipedia to take part in a larger celebrartion of its contributors to take place in January, probably beginning January 15, 2007. I have created yet another new subpage for myself (a weakness of mine, I'm afraid) at User talk:Badbilltucker/Appreciation Week where I would greatly appreciate any indications from the members of this project as to whether and how they might be willing and/or able to assist in recognizing the contributions of our editors. Thank you for your attention. Badbilltucker 18:10, 30 December 2006 (UTC)

[edit] AFD

Wikipedia:Articles for deletion/Ergadenylic acid - it's a disguised claim that adenosine monophosphate is a vitamin. --Uthbrian (talk) 08:21, 5 January 2007 (UTC)

[edit] Idiopathic pulmonary fibrosis

I marked this article for speedy deletion because most of it was taken directly from here (see the logs for the page). Because a few articles link to it, I've recreated it as a redirect to Diffuse parenchymal lung disease, with the reasoning that idiopathic just refers to a case of a disease where the cause is unknown. I have also made pulmonary fibrosis a redirect again because a lot of articles linked there. I've taken this here in case I made a mistake (I'm not a medical expert), or in case an article needs to be written in the place of the redirect. Graham87 11:47, 5 January 2007 (UTC)

I personally don't like the term diffuse parenchymal lung disease. IPF needs its own article and we should have a large article on interstitial lung disease. I'd identified the need awhile ago but haven't had the time to start such a project. InvictaHOG 22:59, 5 January 2007 (UTC)
I've taken the liberty of redirecting it as interstitial lung disease. Andrew73 02:26, 8 January 2007 (UTC)

Is this the same thing as Cryptogenic Fibrosing Alveolitis (CFA)? Jellytussle 09:08, 10 January 2007 (UTC)

[edit] Breast implants

Whilst this article has previously had a long-running edit war which I appreciate can be off-putting to many editors, it is currently protected and civil discussion is currently considering which of 2 versions to use as a basis for further development. The article has suffered for lack of a resonable number of editors participating (vs just a few individuals arguing which tends to increase the heat). I would encourage those with an interest in medical topics to offer further opinions at Talk:Breast implant#Moving forward David Ruben Talk 03:00, 6 January 2007 (UTC)

[edit] Graves disease v. Graves-Basedow disease

This entity is listed as Graves-Basedow disease, but I bet more people are familiar with this disease as "Graves disease." Thoughts? Andrew73 02:31, 8 January 2007 (UTC)

Of the standard disease sources given in the Template:Infobox Disease: ICD10's E05.0, OMIM and MedlinePlus links refer only to "Graves Disease". eMedicine titles its article as "Graves Disease" and under 'Synonyms and related keywords:' lists "diffuse toxic goiter, thyrotoxicosis, hyperthyroidism" before mentioning Basedow's disease. Finally Diseases Database link is headed "Graves' disease aka/or Basedow's disease".
eMedicine's Goiter, Diffuse Toxic article explains that "This condition was first described by the English physician Caleb H. Parry (1755-1822). The disorder is known as Graves disease (after Robert J. Graves) in the English-speaking world and as Basedow disease (after Karl A. von Basedow) in the rest of Europe.". So given this is English-language wikipedia, I suspect the article should follow the term used in "the English-speaking world", although mention of non-English speaking world's term in the article's introduction would be appropriate. David Ruben Talk 03:16, 8 January 2007 (UTC)
Here in non-English speaking the Netherlands located somewhere in the rest of Europe, I have never heard of Basedow disease :-) --WS 20:18, 11 January 2007 (UTC)

I've copied above points over to Talk:Graves-Basedow disease#Move/Rename from Graves-Basedow disease to Graves disease and formally tagged the article's talk page for renaming and suitably notified at Wikipedia:Requested moves. David Ruben Talk 04:12, 14 January 2007 (UTC)

<Outcome> Moved to Graves disease David Ruben Talk 01:03, 23 January 2007 (UTC)

[edit] HDCN Dialysis conference links

Jtdaugir added a number of links to http://www.hdcn.com/ site as external links on some dialysis topics, which I removed. I collect together our various postings and invite other editors' opinions to the sensible issues Jtdaugir raises:David Ruben Talk 20:36, 8 January 2007 (UTC)

Hi thanks for some good additional material on peritoneal dialysis. I have though removed the external links to the Nephrology conference. Wikipedia is not a directories listings, nor a collection of external links, if it were then every conference on every subject would seek to insert its link into all possible articles on wikipedia. The conference website was I think a poor external link for wikipedia as:

  • Access to the actual material is not open and seems to require some form of registration. (hence articles citing papers from a journal often include a link to the freely accessible PubMed abstract, but direct url links to the journals' article is not done if this requires subscription to the journal).
  • Much of the conference talks are off-topic for encyclopaedia readers (e.g. for the day on peritoneal dialysis, I see some of the talks were on how to set up such a PD service - of importance to a Nephrologist but not to general readership or indeed really for dialysis patients)
  • Similarly we don't have for dialysis topics links to Journal of Urology homepages. Instead if there is a particular presentation that might be useful (e.g. a revised simpler & safer description of home peritoneal dialysis for patients to follow, then a direct link would be more appropriate.)
  • Finally adding the link to multiple pages might seem like spamming – see WP:SPAM#How not to be a spammer point 5) Don't gratuitously set off our spam radar. re "Adding the same link to many articles", for which I seem to be acting as that "itchy trigger finger on the revert button" – sorry :-) David Ruben Talk 01:50, 8 January 2007 (UTC)
Dear David,
HDCN is a major repository of information pertaining to all stages of dialysis. About half of the material is free of charge. You can convince yourself of this by going to the following link:
http://www.hdcn.com/inslidef.htm
It's basically an encyclopedia unto itself. There are approximately 800 lectures in slide audio format posted on the site, and more than 3000 audio lectures.
I suppose the argument can be made that it's like linking to a journal, although all of the content of HDCN is online only and is more multimedia in format.
It is a problem, since most of the content-rich sites on the web are either password protected and require some form of registration, or require a paid subscription.
My main concern about posting links to HDCN, actually, is that the material is not intended for patients, but for doctors and nurses. So I have no problems with not posting it on wikipedia.
I did post different links to different topics, since there are various "channels" on HDCN; there is so much content there, that it is broken up into various pieces.
I personally don't believe that excluding paid content sites on the web from wikipedia is necessarily a good idea, but if that is the policy, that's fine with me. The costs are quite reasonable - for example, one week access to thousands of lectures for $18.00. But if this is the policy, then that's the policy. Just please be sure that this is not something that you have a personal bone to pick about but is actually generally enforced.
John Daugirdas, MD Jtdaugir 06:57, 8 January 2007
Thanks for thoughtful reply - again sorry if I seemed a bit harsh removing the links. You make some interesting points about the HDCN site and raise some wider issues on professional vs patient orientated resources (wikipedia is indeed not a medical textbook). As for links to subscription or partial subscription sites, we do of course wikilink to freely available material on the NEJM or BMJ journal websites, even if most other articles have restricted access - perhaps then specific freely available articles on the HDCN site could be directly linked to. I'm not sure there is a firm policy re links to paid websites, after all any citation to a book will be to a resource that must be bought (discounting book & journal access via a library) - but clearly if there is the choice between appropriate equally good resources of free-access and by-subscription, then the former is to be preferred.David Ruben Talk 20:36, 8 January 2007 (UTC)

[edit] Epinephrine v. adrenaline

I may be opening up a Pandora's box, but input welcome at Talk:Epinephrine. I prefer "epinephrine." Andrew73

There is a divide between UK and N. America. Epinephrine in NA has until recently been officially called Adrenaline in the UK. Although I think the official nomenclature in the UK has recently changed, the medical profession and the public in the UK still talk about Adrenaline and Noradrenaline. Jellytussle 09:04, 10 January 2007 (UTC)

[edit] Diobesity

Diobesity article recently created and seems imply a separate condition of type 2 diabetes with obesity. The term has zero hits on PubMed and seems a gimicky term, I've Wikipedia:Proposed deletion tagged the article, thoughts of other editors sought at Talk:Diobesity David Ruben Talk 05:56, 10 January 2007 (UTC)

Delete. Diobetes is a daytime TV made-up type term on a par with Bullheimers. Obesity is a common part of the Type 2 diabetes phenotype.Jellytussle 09:01, 10 January 2007 (UTC)

"Proposed deletion" tag was removed x2 (which I suppose counts as disputed) and therefore more formal WP:AfD set up - see therefore Wikipedia:Articles_for_deletion/Diobesity. David Ruben Talk 01:05, 11 January 2007 (UTC)

<Outcome> - Deleted. David Ruben Talk 01:02, 23 January 2007 (UTC)

[edit] Metformin

Hello there CLINMED members. I have recently made some changes to the metformin article and intend to nominate it for Good Article status. I believe some members of this project, most notably Davidruben (talk • contribs) and Jfdwolff (talk • contribs), have contributed quite extensively to the article and, as such, may be interested in checking for any factual inaccuracies I may have introduced or alterations I may have done to their own edits. Thank you, Fvasconcellos 13:58, 11 January 2007 (UTC)

[edit] PMID 8474513

Hi there. Since I know nothing about medicine, I am bringing this here. PMID 8474513 is apparently a cancer-related topic. However, besides currently reading like an essay, it gets 42 hits at Google (28 if using quotes). Do any of you think this is a notable topic for Wikipedia, or just some original research? I would appreciate if you could prod/send to deletion if not, or at least contact me so that I can do it myself. Thanks! -- ReyBrujo 19:32, 11 January 2007 (UTC)

Hmm... seems PMID automatically creates an external link... interesting... -- ReyBrujo 19:34, 11 January 2007 (UTC)
I think this should be put up for deletion. --WS 20:22, 11 January 2007 (UTC)
Someone has nominated already - Wikipedia:Articles for deletion/PMID 8474513 Dlodge 00:39, 12 January 2007 (UTC)
Proposed for AfD - see Wikipedia:Articles for deletion/PMID 8474513
The name of the paper is not PubMed's later decission as to what abstract number to use, also as pointed out using "PMID" followed by a number gets autolinked by wikimedia software. Aside from failing to explain why teh study is important or the question it resolves, or how clinical practice changes as a result (discussing teh statistics is all well and good, but virtually irrelevant if these otehr points not well addressed), surely the place for a significant study would be under fecal occult blood testing article or colorectal cancer as footnotes to some suitable sentance or paragragh on screening & prevention. Th eissue as to who decides what studies are notable enough for WP is hugely problematic if article names are just to be PMID abstract numbers - who is to say what study was important or confirm how it changed clinical practice - this is fine in a medical textbook, but that is not what WP is.
There are some merits in what is discussed at Talk:PMID 8474513 and perhaps a new project for the Wikimedia Foundation to consider, but not I think suitable for wikipedia itself. I expect some interesting discussion will ensue :-) David Ruben Talk 00:53, 12 January 2007 (UTC)

<Outcome> Deleted David Ruben Talk 01:02, 23 January 2007 (UTC)

[edit] Recent edits to genetic disorders

Users 151.205.100.212 and Dom_Kaos have added a substantial amount of text to several medical articles such as Phenylketonuria, Duchenne muscular dystrophy, Cystic fibrosis and Down syndrome. These good-faith edits are not always encyclopaedic in style and are unsourced. Can project members please review them. Thanks. Colin°Talk 16:31, 20 January 2007 (UTC)

[edit] Open access sources

I've posted a proposal about open sources/open access content at Wikipedia_talk:Citing_sources#Proposal_for_policy_on_freely_available_sources_--_encouraging_open_content_.26_open_access. I think it is very much relevant to this project and important to consider-- with the recent discussion about open content in Nature.[1] I'd like input from people here at that discussion. Thanks. Nephron  T|C 10:56, 26 January 2007 (UTC)

[edit] Redirecting and merging articles into Sepsis

I'd propose (however I don't know how to properly tag them) that the article SIRS redirect to Sepsis. SIRS is not up to date with current literature and is essentially fully encompassed by the article on Sepsis. Secondarily, I tend to think that Septic Shock and Multiple organ dysfunction syndrome should be merged into Sepsis. Both Septic Shock and MODS are spectrums of Sepsis. All three articles cover much of the same material and it would stengthen the Sepsis article to include a bit more on the full spectrum of the disease process without making it significantly longer and would eliminate redundacy. Especially as Sepsis is a very hot topic in critical care right now, it will certainly be easier and more complete to keep 1 article current than to keep 3 (or 4) articles up to date. Bdolcourt 18:02, 26 January 2007 (UTC)

The above text was copy-pasted to Talk:Systemic inflammatory response syndrome#Redirecting and merging articles into Sepsis. Please post replies there. Dlodge 18:39, 27 January 2007 (UTC)

[edit] Pushing of Phage therapy

User:Glenalpine (prior to signing up as User:67.123.250.229 ) has been adding information to several articles on phage therapy being alternative approaches to the treatment of infectious diseases (see Contributions/Glenalpine). A discussion was started at Wikipedia talk:WikiProject Medicine#67.123.250.229 promoting Phage therapy, but phage therapy was added back to several articles with considerable additions of research papers, in my view out of proportion to the fact that these therapies are not generally available nor accepted in Western Medicine (even in Eastern Europe their role has diminished) (see these changes to Antibiotic_resistance). Could other editors have a look at the articles being so edited and comment at the Wikipedia talk:WikiProject Medicine#67.123.250.229 promoting Phage therapy discussion please. David Ruben Talk 01:49, 30 January 2007 (UTC)

WP:NOR applies here. When did you last prescribe antistaphylococcal phage therapy for a furuncle? JFW | T@lk 00:51, 31 January 2007 (UTC)

[edit] Updates to Template:WhoNamedIt

Just to let people know, the Template:WhoNamedIt to link to Who Named It Database of syndromes and associated doctors previously generated a hyperlink on the database's entry number. Use of this template in External Links sections then required separate mark-up as to what/who was being linked. I've provided an optional additional parameter for the relevant doctor/syndrome name and a shortened template form (Template:WhoNamedIt2) for when several entries are to be listed. David Ruben Talk 02:02, 30 January 2007 (UTC)

[edit] Medicine Collaboration of the Week -> Month

Because of the lack of interest, I would like to change Medicine Collaboration of the week to month. It has already been collaboration of the fortnight, but the promoted articles still have just a few edits. Maybe more time could lead to better results. Any comment? NCurse work 19:02, 30 January 2007 (UTC)

I'm a bit shocked about the state of meningitis (the present MCOTW). I've brainstormed a bit on the talk page but we need to do this together. Where's Knowledge Seeker when you need him? And who told Encephalon he was free to leave? JFW | T@lk 00:51, 31 January 2007 (UTC)

[edit] Alt-med article collaboration

I've been looking through a number of articles on alt-med topics and people recently, and wondering how they can be improved. Currently, many are written from a promotional viewpoint or one that uncritically accepts the effectiveness of said therapies. Criticism of the pharmaceutical industry (much of it totally legitimate) is leveraged to suggest that any "skepticism" comes from people who want to suppress cheap, natural alternatives - while the profits and largely unregulated nature of much of the alt-med world are not examined or even mentioned. There are quite a few excellent pro-alt-med editors active, but my experience has been that alt-med articles often become the closely guarded province of a POV-pushing minority, which are edited at one's own risk. Wikipedia ought to be a good, neutral reference which makes a distinction between scientifically tested/proven claims and promotional or speculatory theories. Many of the alt-med treatments do have a base in the scientific literature, but it's often hard to differentiate this from dubious, unreliable, or promotional info. My question is whether there is, or ought to be, some kind of collaborative effort from Wikiproject:Medicine and the more alt-med-focused editing community to improve these articles, because right now Wikipedia's articles on alt-med topics are kind of a poor reference source, and taking it on single-handedly is like wading into a tar pit. MastCell 22:11, 3 February 2007 (UTC)

I have quarrelled with exponents of alt med in the past. I have found there are always problems with WP:RS. With regard to many remedies there are no reliable statistics as to their popularity etc. I'm always open to the mention of popular "alternative remedies" for common conditions (e.g. echinacea for the common cold), but only if there are reliable sources to support this claim of popularity.
The promotional stuff needs to go. The good alternative health article states clearly: (1) which branch of alt med it belongs to, (2) its historical background, (3) its composition, modes of administration, etc, (4) evidence of (in)effectiveness, (5) side-effects, contraindications and warnings, (6) very very very well known popular culture references.
Wouldn't it be good if we could have alt med articles of the same quality as our WP:CLINMED flagships? JFW | T@lk 21:03, 4 February 2007 (UTC)
Yes, definitely. I'm wondering what the best way to accomplish that would be, or if it's even reasonable given the amount of effort necessary to deal with entrenched interests. MastCell 22:54, 4 February 2007 (UTC)

Case in point was the ephedra article. It was written as if ephedra was totally safe and the FDA had overreacted by banning it, and its reliable sources were Yahoo! Health Forum and ephedra.com. Sigh. Anyhoo I took a crack at it and am now sitting back waiting for the deluge. MastCell 20:48, 8 February 2007 (UTC)

I have become burned out on Wikipedia several times by paying attention to the alt-med articles. There are a number of ways one can use one's time here productively. Arguing on alt. med. articles can sink time and energy. Kd4ttc 23:15, 2 March 2007 (UTC)
You're right, it's just that every few weeks I need to be painfully reminded of that. It would be nice to form some kind of collaborative effort with the more reasonable alt-med-centric editors in an effort to truly improve some of the bigtime alt-med articles - right now things that actually have an evidence base get lumped in with complete BS, which is unfortunate. MastCell 23:31, 2 March 2007 (UTC)

[edit] DCA

RoyBoy (talk • contribs) seems to be convinced that Cancer should make a mention of dichloroacetate (DCA). This has been hyped senseless by New Scientist and ABC News articles, and people are calling for clinical trials before it has even been tested in animal models! I have asked RoyBoy to leave it out of the article until consensus is achieved. Could you guys offer your opinion? JFW | T@lk 07:21, 14 February 2007 (UTC)

Gladly... I had a patient come in a few days ago requesting to be treated with DCA, and he handed me the Wikipedia page on DCA as a reference! That darn disclaimer is too small. Anyhoo, I'm happy to give my 2¢ at the article, which is that I hope it works, but lots of drugs kill cancer reliably in Petri dishes and in mice but turn out to be useless or disappointing in humans. It's impossible to know until clinical trials are done, which they will be, pharmanoia notwithstanding. MastCell 17:24, 14 February 2007 (UTC)

Good. Glad my bullshit detector still works. JFW | T@lk 22:11, 18 February 2007 (UTC)

[edit] Squat toilets

Jonathan108 (talk • contribs) has decided to edit several pages to reflect the views of Denis Burkitt, namely that squat toilets reduce the risk of many colorectal diseases. This is - in my view - not an established theory at all and I dispute the need to deal with it so extensively in appendicitis (where I haven't removed it yet). Please offer your views. I note that this editor has tried to push his case several times in the last few years. JFW | T@lk 22:11, 18 February 2007 (UTC)

Is there any medical theory so crackpot, so unproven, so utterly unsound that no one bothers to try to cram it into as many Wikipedia articles as possible? I have yet to encounter one. MastCell 04:28, 19 February 2007 (UTC)
I took the liberty of removing that "toilet theory". It is so fringe as to not merit inclusion. Unless someone shows me some contemporary surgical textbook promoting that it serves as a distractor. For that matter a great deal of that appendicitis entry is not really mainstream.Droliver 04:09, 22 February 2007 (UTC)

... and yet it's such a bread-and-butter surgical topic. Maybe we can get a general surgeon involved? The last only appy I did was as a med student. MastCell 06:16, 22 February 2007 (UTC)

So that means you're a doctor, eh?--Dr.michael.benjamin 08:03, 22 February 2007 (UTC)

Yes. And I have noticed we're pretty internal-medicine-heavy. Appendicitis is the prototypical surgical disease... do we have any enterprising surgeons out there with free time (hah!) to work on the article? For instance, it would be nice to a) remove the fringe stuff from the first paragraph (the squat toilet theory is back), and to have something about the history of appendicitis and appendectomy, first time one was performed, etc. Surgeons are usually into that sort of thing, no? :) MastCell 17:36, 22 February 2007 (UTC)

It is indeed curious we still don't have any surgeons contributing big-time (apart from Rob, who is mainly into the reconstructive/esthetic business). We also desperately need a neurologist (e.g. for the beleaguered Parkinson's disease), a pulmonologist (Axl comes and goes), a nephrologist (although Nephron is doing a splendid job) etc etc. We've got a couple of people working on gastroenterology and haematology topics, and Arcadian seems to be continuously expanding large amounts of preclinical stuff. JFW | T@lk 20:34, 22 February 2007 (UTC)
Yes, hopefully Samir will come back - he's a huge loss. I'm happy to tackle some of the pulmonary/renal topics, although it will involve some reading, but neurology is probably a little far afield for me. Of course, a surgeon would maintain that they're too busy operating and saving lives to sit around and B.S. on Wikipedia like an internist. (Or maybe just the surgeons I've known). MastCell 20:51, 22 February 2007 (UTC)

OMG where has Samir gone? JFW | T@lk 22:13, 22 February 2007 (UTC)

See your email (just sent you one), and here. MastCell 22:54, 22 February 2007 (UTC)
JFW, I'm actually board-certified in surgery (which I trained in prior to Plastic Surgery) and feel pretty fluent in most areas of general surgery (and it's subspecialties) to some degree.Droliver 02:07, 23 February 2007 (UTC)
To be sure, I'm not questioning your qualifications, Rob. Rather, the breast implant has given you rather a lot of work. If you think you could assume responsibility over some important surgical articles, that would be rather welcome. JFW | T@lk 22:28, 24 February 2007 (UTC)
Absolutely. By the way, my comments above were meant in fun - I hope you didn't find them offensive. MastCell 22:45, 24 February 2007 (UTC)

Just should mention that defecation is more difficult for patients when one is seated with the knees extended over 90 deg. Occasionally elderly patients constipation improves when adjusting posture by raising the feet. Kd4ttc 23:07, 2 March 2007 (UTC) However, the note in the article about full sealing of the IC valve is amusing. It is even referenced. Kd4ttc 23:11, 2 March 2007 (UTC)

[edit] WPCM Userbox

I copied the WPCM userbox from {{WPCM member}} to {{User WPCM}} to comply with WP standards for user boxes, and because the Babel template can't handle any userbox which doesn't start with "User". Should we ask all WPCM members to migrate to the new (correct) userbox? --DrGaellon | Talk 03:55, 23 February 2007 (UTC)

[edit] Amniocentesis

The following comment was added by an anon to the Down syndrome article:

Although amniocentesis is very accurate, there are a significant number of pregnancies where the test is impossible to perform because of the position of the placenta. Please would someone add some statistics here!!!

Would anyone be willing to help out with sources? I'm having trouble finding references to support this, meanwhile I've made the statement inline. Fvasconcellos 13:51, 23 February 2007 (UTC)

Actually, there's conflicting evidence as to whether going through the placenta increases the risk of fetal loss. Considering the malpractice rates most OB's face, in the US at least, they're understandably reluctant regardless of the evidence. However, if you wait a week or two, often the technical approach will be easier as the uterus/placenta change positions. I'll dig up refs for you. MastCell 02:28, 24 February 2007 (UTC)
Thanks—much appreciated. Down syndrome is an FA; I couldn't well leave the statement "floating around" like that, but if someone thinks the article could be more comprehensive, then we should do something about it :) Fvasconcellos 10:43, 24 February 2007 (UTC)

[edit] AFD time again

Wikipedia:Articles for deletion/Lipid hypothesis JFW | T@lk 19:29, 26 February 2007 (UTC)

Unfortunately, we seem to be heading toward a precedent where minoritarian, fringe, or fraudulent medical topics are deemed worthy of an article partially in order to counteract the disinformation on the Web (see the above, or here for recent examples). I think this is OK in theory, but as the number of such articles grows, I'm afraid it will exceed the capacity and energy of those of us who watch such things to keep them from turning back into POV vehicles. Such articles attract single-purpose editors who can quickly suck up a lot of time from more valuable projects.MastCell 21:27, 27 February 2007 (UTC)

The good thing is, that if the article is kept it is still perfectly valid to merge the entire content (which doesn't amount to much) into a larger article. My concern is more with the principle of lending credence to "independent researchers" and their terminology by employing that terminology as the title of the article. I've been trying to find a responsible article that actually examines these people's views. That would be a good WP:RS to use here. JFW | T@lk 21:40, 27 February 2007 (UTC)

  • agree with above sentiments. It's like death by popcorn with fringe medical/science entries and ideas popping up all over. I wouldn't object to some form of the sentiment be added to other entries, but it would be worthy of minimal/passing reference. There is not some raging debate in cardiology/medicine/vascular surgery going on over this, and those less fluent in medicine would get the wrong impression from it.Droliver 02:39, 2 March 2007 (UTC)

[edit] Frequency of autism (aka Autism epidemic)

Wikipedia:Articles for deletion/Frequency of autism -- Colin°Talk 12:11, 9 March 2007 (UTC)

[edit] Juvenile idiopathic arthritis

I did some major revisions on juvenile idiopathic arthritis. Interesting is how things can deteriorate... and how a few well-intentioned edits can distort an article that was reasonably accurate but not so well written. Any case, an article on childhood arthritis ought to be written at some point (that explains the transient stuff) to disambig things and clarify how JIA fits into the grande scheme of things. Any rheumatologists out there? Nephron  T|C 19:19, 3 March 2007 (UTC)

[edit] Featured articles

Coeliac disease is now a candidate for WP:FA. Please vote at Wikipedia:Featured article candidates/Coeliac disease. JFW | T@lk 23:36, 6 March 2007 (UTC)

See also Myocardial infarction at Wikipedia:Featured article candidates/Myocardial infarction and Antioxidant at Wikipedia:Featured article candidates/Antioxidant. Cheers, Colin°Talk 07:57, 7 March 2007 (UTC)

Oh, what a good run! :) Let's work on them! NCurse work 15:37, 7 March 2007 (UTC)

I need some more help on the coeliac article, before the request gets archived. In particular, I'm looking for a good supportive source that many physicians gluten restrict patients based on serology alone. Most guidelines regard this as bad practice. I'm tempted to remove the whole sentence if no support is available for the assertion.

I'm waiting for some further resources to tighten up the serological diagnosis section. If it comes to it, we can always use the NIH consensus conference documents (which has good sensitivity/specificity data).

Would anyone be happy to look at the "genetics" section. This is rather densely worded, and my English is just too poor to turn it into easily digestible (no pun intended) text. JFW | T@lk 19:05, 13 March 2007 (UTC)

I can't promise anything, but I'm going to try to find time for it tomorrow. NCurse work 22:01, 13 March 2007 (UTC)

Please vote!!!! JFW | T@lk 22:03, 21 March 2007 (UTC)

[edit] AFD's added

I went thru some of the Plastic Surgery personalities and made AFD's for some some marginal people listed. Keep in mind that I'm fairly proactive in added some of the more signifigant plastic surgeons, but there are a few that don't pass the sniff test to me. Toby Meltzer is a renomination. He has a fairly vocal trans-gender fanclub, but in all fairness this is not a figure of any notability in contemporary plastic surgery.[2] Steve Sohn & Pierre Foldès are two others which are very out of place in meriting inclusion IMO. Sorry I can't figure out how to link to the specific RFD segment! Droliver 07:47, 14 March 2007 (UTC)

[edit] Cholangiocarcinoma

Hello - I've just finished a major update and expansion of the cholangiocarcinoma article from its prior stubby state. I'm going to ask for peer review with the goal of getting it into featured-article shape, and wanted to ask you folks to take a look at it and comment here or on the article talk page. I'd particularly like some decent images, either pathology or ERCP/biliary; Samir had some, I think, but he's not been around recently. MastCell 21:33, 14 March 2007 (UTC)

[edit] Haemochromatosis

On haemochromatosis there is a discussion whether secondary sources are adequate, or indeed preferable, where academic sources exist. Please comment. JFW | T@lk 23:05, 18 March 2007 (UTC)

I created Wikipedia:WikiProject Medicine/Reliable sources when extracting some non-style issues from Wikipedia:Manual of Style (medicine-related articles) (which now links to it, albeit in a subtle way). I had hoped that page might be a focus for discussion on the use of sources in medical articles but there have been no further contributions to date.
The Policy WP:RS is in favour of secondary sources and limits the use of primary sources (e.g. to "only make descriptive claims that can be checked by anyone without specialist knowledge"). A peer-reviewed journal article may be a secondary source if it is a review. A textbook may often be effectively a review-per-chapter that is edited by an authority in his/her field. What is wrong with them? I don't see big problems with editor's citing the primary article as long as they are honest about the extent to which they have read it and are careful what they draw from it. But if the importance and long-term reliability of that article is confirmed by a good secondary source, then surely that is worth mentioning? Colin°Talk 23:39, 18 March 2007 (UTC)
I commented on the article talk page, but briefly, my understanding is that primary (peer-reviewed journal article) sources are fine (even preferred) as bedrock sources. The issue is that if we can only quote what the study says (for instance in its discussion section); if we want to parse what a study "means", or how it should be interpreted, then we need secondary sources rather than providing our own gloss. MastCell Talk 23:43, 18 March 2007 (UTC)
I prefer to use reviews as the main source of my medical contributions. Secondary sources may be fine, but webpages and material provided purely to inform laity are generally far short of being truly useful in medical content. I certainly do not agree with Malangthon's approach on the HHC page.
Primary sources have an important place. Usually, a primary source should only be inserted if a secondary source identifies that primary source as relevant. For historical and encyclopedic interest, we should be providing references to primary sources too. JFW | T@lk 00:03, 19 March 2007 (UTC)

[edit] Featured article nomination: cholangiocarcinoma

Hello - after a lengthy expansion of cholangiocarcinoma, I felt good enough about it to nominate it for featured-article status. Please leave your feedback on the nomination page. Thanks - MastCell Talk 19:13, 20 March 2007 (UTC)

[edit] Statin

On Talk:Statin, Jtclemens (talk • contribs) insists that Wikipedia should mention a non-standard diagnostic entity that according to his data occurs on exposure to common statins. I was wondering what people's thoughts are here. JFW | T@lk 14:40, 22 March 2007 (UTC)

Why are all of the contrarians, cranks, etc attracted to the areas where Western medicine has actually been most successful (vaccination, the identification of HIV and development of effective treatment, lipid lowering agents, etc)? There are plenty of areas where Western medicine could do a much better job, but people always seem to focus on what are really the success stories. Just a philosophical question - please ignore it. MastCell Talk 21:37, 22 March 2007 (UTC)
You're right. There are not many diabetes cranks. Can you help out on Talk:Statin and explain to Mr Clemens that he is pushing WP:NOR? JFW | T@lk 22:22, 22 March 2007 (UTC)
Actually, given the length and formatting, I couldn't really make heads or tails of what he was proposing. I just asked him to briefly formulate what he would like to change about the article and provide references. MastCell Talk 22:47, 22 March 2007 (UTC)

[edit] Reliability of external links / cardiac surgery linkspam

In recent years the Internet has become a huge marketing tool directed toward Internet savvy health consumers who research their diagnoses online. Most medical information websites (even highly-regarded international clinics) are created by to increase patient referrals - patients view the website and self-refer or request referrals from their own physicians. These websites contain a wealth of information, but most are biased to varying extents and often hype unproven therapies. It is very difficult (especially for non-medical people) to evaluate medical information on the Internet, and similarly difficult to create a Wikipedia policy regarding appropriateness of medical external links. It would be practically impossible for Wikipedians to critically appraise every medically orientated external link.
A link to heart-valve-surgery.com has been repeatedly added to (by various IP addresses) and removed from (by multiple authors) most pages in the cardiac surgery realm. heart-valve-surgery.com contains a wealth of information on various cardiac surgery procedures, but it is linkspam - the website exists only to market a book explaining cardiac surgery. Most externally linked medical sites are not as blatant in their sales pitch, and in consideration should be given to proposing banning addition of the links to heart-valve-surgery.com on any Wikipedia page.
Comments? Dlodge 22:27, 23 March 2007 (UTC)

I'm a minimalist about external links to begin with - often they don't add much to what would be in the Wikipedia article, assuming the article reaches featured quality - and the presence of a commerical bent makes me even more prone to remove them. It may be worth adding to the spam blacklist if the IP's are intolerably persistent and are acting against consensus. Regarding medical article external links, I like to link a few large, non-profit orgs (e.g. the American Cancer Society, Leukemia & Lymphoma Society, NIH, CDC, etc - note the U.S.-centricity though), and stay away from just about anything with a .com suffix, for the reasons you spelled out above. MastCell Talk 22:42, 23 March 2007 (UTC)
The site is probably already blacklistable by existing policies, per Wikipedia:External_links#Links_normally_to_be_avoided. You may want to consider requesting a blacklist at http://meta.wikimedia.org/wiki/Talk:Spam_blacklist#Proposed_additions . Also, if you haven't seen this tool before, you can use http://en.wikipedia.org/w/index.php?title=Special%3ALinksearch&target=www.heart-valve-surgery.com to see where it currently is linked. --Arcadian 23:39, 23 March 2007 (UTC)
  • That link is clearly inappropriate and link-spamDroliver 02:04, 29 March 2007 (UTC)

[edit] what be the opinion of this forum

Federation Proceedings are in fact attributable to a reliable published source. I suggest that this be allowed inclusion into the Seizure article. In part? Then which part, or in whole.

Public announcement:

From clandestine research Edgewood Arsenal, Maryland, Dr. Sim reported to Medical World News: "Marijuana… is probably the most potent anti-epileptic known to medicine today". Marijuana Medical Handbook, Todd Mikuriya, M.D.

Proceedings:

Jean P. Davis M.D., and H.H. Ramsey, M.D. The demonstration of anticonvulsant activity of the tetrahydrocannabinol (THC) cogeners by laboratory tests (Loewe and Goodman, Federation Proc. 6:352, 1947) prompted clinical trial in five institutionalized epileptic children. All of them had symptomatic grand mal epilepsy with retardation; three has cerebral palsy in addition. EEG tracings were grossly abnormal in the entire group; three has focal seizure activity. Their attacks had been inadequately controlled on 0.13 gm. of Phenobarbital daily, combined with 0.3 gm. of Dilantin per day in two of the patients, and in a third, with 0.2 gm. of Mesantoin daily.

Two isomeric 3(1,2-dimethyl heptyl) homologs of THC were tested, numbers 122 and 125A, with ataxia potencies 50 and 8 times, respectively, that of natural Marijuana principles. Number 122 was given to 2 patients for 3 weeks and to 3 patients for 7 weeks. 3 responded at least as well to previous therapy; the 4th became almost completely and the 5th entirely seizure free. One patient transferred to 125A after 3 weeks, had prompt exacerbation of seizures during the ensuing 4 weeks, despite dosages up to 4 mg. daily. The 2nd patient transferred to 125A was adequately controlled on this dosage, except for a brief period of paranoid behavior three and a half weeks later; similar episodes had occurred prior to cannabinol therapy. Other psychic disturbances or toxic reactions were not manifested during the periods of treatment. Blood counts were normal. The cannabinoids herein reported deserve further trial in non-institutionalized epileptics. Federation Proceedings, Federation of American Society for Experimental Biology, vol 8, 1949, p.284.

By admitting his true opinion, "I am fully capable of deciding for myself what I think of that nefarious poison called cannabis…", JFW has provided evidence of motive to remove and omit this qualified and vital information due to the bias of his opinion contrary to written guidelines.

Preconceived notions are not scientific and evaluation should be limited to the text itself and its attribution only, thank you.

In relation to the Beware of Tigers article, I believe there should be a Beware of Lemmings article. Please have the skill and courage to present your own opinion. "Our lives begin to end the day we become silent about things that matter"

Alphaquad 15:59, 24 March 2007 (UTC)

Provide an actual PubMed reference (just the PubMed ID number is sufficient), so we can actually look at this study. It was published in the peer-reviewed literature, right? MastCell Talk 17:52, 24 March 2007 (UTC)
This is a user with a pro-cannabis agenda. JFW | T@lk 09:24, 25 March 2007 (UTC)
Yes of course that be the case JFW. I wish you had such propensity to state the obvious with regard to real medicine and the pesticide, phenothiazine-based poisons in use today. The state laws currently being generated today and the results of this medicine speak loud and clear.
As if that weren't enough, 9 of 11 states, fortunate enough to have medical-cannabis laws in effect, have approved the use of cannabis for seizure disorder, as this state-by-state legal report can verify.
Assuming that a publishing in the peer-reviewed literature automatically coincides with Federation Proceedings I will see if such information can be found. Need I remind that federal agencies have continually conspired to hide information since 1937. Thank you, Mastcell.
Without a majority objection in this forum I believe cannabis should be added (on the merit of this information alone) to the Seizure article as state-approved treatment and to the Anticonvulsant article, regardless of the ill-willed DEA and countless uninformed AMA practitioners. Alphaquad 19:52, 25 March 2007 (UTC)

Alphaquad, your desire to tout the benefits of marijuana blinds you to how absolutely ridiculous your request is. A proceedings is not peer reviewed nor verified; it just means that in 1949 someone got up at a meeting and claimed it worked in 3 children. If you were interested in seizures instead of marijuana it would never in a million years occur to you that an anecdote about a drug that was described to help 3 people in 1949 and was never heard from again belonged in an encyclopedia article about seizures. I will even support the inclusion in the seizure disorder if the article becomes so comprehensive that we mention every agent tried and thought to benefit someone in the last century; this mention is no more significant than a hundred other such anecdotes of treatments that never proved reproducible or usable. alteripse 20:14, 25 March 2007 (UTC)

Firstly, Alphaquad, please stick to the point and don't cloud this discussion with your other bugbear (phenothiazines). If you don't like the state laws, don't use Wikipedia to have them changed but phone your Congressperson.
Unfortunately, the link to the 2006 SBS report is broken. I wouldn't regard the Marijuana Policy Project as an impartial source, though.
The Federation Proceedings are a source over 50 years old that does not use any of the endpoints used in modern-day epileptology research.
You already have a majority objection from myself and from MastCell. Please provide a better link for the claim that 9 states "approve cannabis in the treatment for seizures". At the moment this evidence is not available. JFW | T@lk 20:23, 25 March 2007 (UTC)

Alteripse, the link works fine, watch the download, as it is over 4 megabytes. Ok that is all well and good and I can understand what you (Alteripse) is saying. But if we had any concern for the suffering of those whose seizures were uncontrollable yet controllable with cannabis as I have seen so many times, which is my concern and not that of simply "a pro-cannabis agenda", we would have the heart to concede that mainstream thought is getting in the way of this important issue, which is vital to those suffering unnecessarily. And their seizures are being caused by, you guessed it, neuroleptic drugs. Not a suprise at all.

So you see, this statement "...your desire to tout the benefits of marijuana blinds you to how absolutely ridiculous your request" is just another pre-conceived notion on the part of JFW that IS NOW influencing you (Alteripse).

JFW, I thought you said you werent going to respond to me anymore, step aside, you're the one with the agenda, as demonstrated by your need to jump in and "cloud the issue". MastCell has not objected. Alphaquad 20:48, 25 March 2007 (UTC)

I'm not the aside-stepping kind. I'll respond to legitimate postings and will ignore personal attacks, such as the ones you felt the need to make on your talkpage. I'd rather not miss out on this interesting discussion here, eh?
How can you claim that I'm influencing Alteripse? Will you deny that you've got a pro-cannabis agenda?
If you have evidence that cannabis can control intractable seizures, has that report been published? Or perhaps it's time to read "no original research", one of our content guidelines. JFW | T@lk 21:20, 25 March 2007 (UTC)
very weak source - if there are any follow-up studies that cite this, then I'd suggest putting them in - but a 60 year old study on five children with no follow-up? nope, I could not support inclusion. --Fredrick day 21:36, 25 March 2007 (UTC)

JFW, Of course it pro-cannabis due to the obtained results only. If something works for you and it were legally unobtainable, no doubt you'd be pro-something as well. But you are trying to skew that meaning into another for your admitted opinion of cannabis - "nefarious poison" which is that of propagandized America. It was once illegal to NOT grow cannabis in Virginia. It is clear how your prior statement influenced Alteripse. And your asking of a published report of illegal research is ludicrous and an attempt to thwart this very real issue, now THAT is a careless agenda. Win or lose is no reflection on me, but a reflection of mainstream carelessness and the loss to those looking for an answer at wikipedia. You only care about being right and seeing this die, for a despicable agenda. Alphaquad 21:44, 25 March 2007 (UTC)

A very quick browse of your contributions would have achieved exactly the same effect. Alteripse is a serious contributor who would not make these comments without verifying my terse comment that you had a particular interest in promoting the beneficial effects of cannabis.
As there is no report of this "illegal research", it is not verifiable to include cannabis into a list of anticonvulsants. This is an encyclopedia, not a messaging board. It has nothing to do with carelessness. It has to do with thoroughness and objectivity and being neutral as well as verifiable and reliable.
I don't see the point in your personal attack at the conclusion of your post. JFW | T@lk 21:49, 25 March 2007 (UTC)
re "what be the opinion of this forum" title for this thread - wikipedia is not a forum. Alphaquad your comments above breach the official policy of Wikipedia:Civility. An apology is in order to JFW, not as you stated on the administrators noticeboard that "I will of course retract anything as directed by the administrators for the sake of the public" but, because your above language is both uncivil and fails to assume good faith (a Wikipedia guideline). It is essential for any view in an encyclopaedia to be able to WP:Cite from WP:Reliable sources in order to WP:Verify, if one can't (as you seem to claim is impossible with the drug being illegal) then this would remain unverifiable opinion (and would count as inadmissible original research). This applies whether or not the "fact" in question is true or not - Wikipedia does not follow Scientific point of view nor is it a soapbox to argue a case, instead encyclopaedias reflect on accepted knowledge (even if possibly wrong), and Wikipedia follows Neutral Point of view.
You clearly have some detailed knowledge, so apologise and move forward by working with other editors :-) We are here to collaborate on this project, but further disruptive accusations and soapbox arguing is disruptive to the process and may result in WP:RFC or administrative action. David Ruben Talk 01:59, 26 March 2007 (UTC)
Agreed - I don't have anything to add to that. MastCell Talk 23:32, 26 March 2007 (UTC)
  • Mention of canabis in re. to seizure treatment is clearly an innacurate connection that should not be maintained in that entry. Droliver 02:07, 29 March 2007 (UTC)

[edit] DermAtlas

I'm currently involved in a polite disagreement over at Wikipedia_talk:WikiProject_Spam#DermAtlas, and I'd welcome feedback from this community. --Arcadian 01:59, 29 March 2007 (UTC)

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