Talk:Pectus excavatum

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Peer review Pectus excavatum has had a peer review by Wikipedia editors which is now archived. It may contain ideas you can use to improve this article.
This article was previously a Medicine Collaboration of the Week.
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[edit] Agenda for MCOTW

Clearly, this one is a small article that has eminent potential with MCOTW. Could I make the following recommendations?

  • Apply WP:MEDMOS. Even if the diagnosis is instantaneous on inspection, we need to mention the typical appearance in detail, as well as differentiating features from pectus carinatum, kyphoscoliosis and other related chest deformities.
  • Apply WP:MEDRS. Emedicine is nice, but the perfect source is a recent review article from a peer-reviewed journal. There are 907 articles on PubMed, but restricting to "major subject headings" and "review articles" gets us 43 papers, none of which are free. PMID 15619190 sounds like a recent review of relevance. Perhaps the author could be persuaded to send us a few reprints.
  • Depopulate the intro. Much of what is now mentioned in the intro could be moved to the relevant sections.
  • Does anyone know a plastic or cardiothoracic surgeon who could assist here?

I'll see if I can have a stab at this some time later. JFW | T@lk 09:35, 13 April 2008 (UTC)

Actually, PMID 1621629 (Crump 1992) is free on FindArticles, and already referenced. Sounds like a useful starting source. I have updated the reference. JFW | T@lk 09:40, 13 April 2008 (UTC)
Nice selection for MCOTW. I'll get to work on your suggestions throughout today and perhaps have a quick search around to expand things a little. Regards, CycloneNimrod (talk) 13:29, 15 April 2008 (UTC)
Right. I've 'depopulated' the introduction paragraphs by moving some information into their own catagories (diagnosis and epidemiology). I'll try and get round to expanding the article tomorrow. Regards, CycloneNimrod (talk) 21:21, 15 April 2008 (UTC)
Triple posting, sorry. JFD, i've had a look through PubMed and as far as I can tell there are 101 free articles for use? Heres one I found that might be at least slightly useful: Breda JR, Breda AS, Gastaldi SA, Freitas AC, Costa Júnior Ada S, Pires AC (2007). "Simultaneous repair of congenital heart defect and pectus excavatum". Rev Bras Cir Cardiovasc 22 (3): 355-8. PMID 18157424.  (free version: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382007000300015&lng=en&nrm=iso&tlng=en) CycloneNimrod (talk) 21:34, 15 April 2008 (UTC)

What I've tried to do is find review articles, which tend to be better sources than case reports etc from a WP:MEDRS perspective. I'm not sure if there's been a reply from the author of PMID 15619190 with regards to us using that review. JFW | T@lk 22:23, 16 April 2008 (UTC)

This is why I love MCOTW, just look at the difference we've made half way through the week: http://en.wikipedia.org/w/index.php?title=Pectus_excavatum&diff=206504469&oldid=204098829 CycloneNimrodtalk? 18:05, 18 April 2008 (UTC)

[edit] Trying to figure out a cause.

While the article says unknown, I've found some statements on what some believe: "it is caused by shortening of the central portion of the diaphragm, which pulls the sternum inwards when the person inhales" (Dorland's Medical Dictionary), "It is caused by excessive growth of the the connective tissue joining the ribs to the breastbone, which causes an inward malformation of the sternum." (Dorland's Medical Enyclopedia (think that's correct name)), and "A hollow at the lower part of the chest caused by a backward displacement of the xiphoid cartilage." (Answers.com Medical dictionary). Should any be used, or are these just speculation. I have PE, but I'm not that great in the legit info field. :) §hep • ¡Talk to me! 00:19, 16 April 2008 (UTC)

The problem is that pectus excavatum has no clear cause, being that it can come from more than one other subjunctive condition (Marfan syndrome and other congenital conditions can lead to PE). This is further demonstrated by the lack of clarity from the two quotes you've submitted, from the same publisher. If an individual publisher cannot adequately explain the cause, the cause clearly isn't certain. The first quote states that the sternum moves inwards when the person breathes, that isn't very typical of the PE mentioned in this article as it is more of a permanent deformity of the chest. Regards, CycloneNimrod (talk) 18:31, 16 April 2008 (UTC)
So could a list of probable causes be lsited, or would that not be necessary. Thanks for your help. §hep • ¡Talk to me! 00:15, 17 April 2008 (UTC)
That'd be fine as long as we don't go expanding too much into each plausible cause as this can be left to their respective Wikipedia articles (e.g. Marfan syndrome) Regards, CycloneNimrod (talk) 06:36, 17 April 2008 (UTC)

[edit] Lead picture

I think a less severe case ought to be found as the lead image, but keep the severe case for elsewhere, LeeVJ (talk) 03:05, 16 April 2008 (UTC)

I hadn't previously spotted that the photo was described as "severe" and as I've only experience of my own pectus excavatum, it may well be. However mine is comparable to that in the photo and it has never been indicated to me by doctors that it is of particular severity. I'd be interested to know. Mutt Lunker (talk) 08:42, 16 April 2008 (UTC)

Even if it were severe (which I don't particularly think it is, but I don't know much about the condition), it illustrates the case sufficiently/adequately and surely that is all that is required? CycloneNimrod (talk) 18:26, 16 April 2008 (UTC)

I have gone to a few specialists and mine looks the same as in the photo. They always say it's severe and on the pectusinfo.com message boards I've seen mild cases, this isn't one of them. Maybe we could get a few of the members there to donate thier pics and we could make a chart comparing the serverities? I'll send some emails out to my friends there. §hep • ¡Talk to me! 23:51, 16 April 2008 (UTC)

I also emailed someone asking if they would release some CT scans and X-rays. §hep • ¡Talk to me! 00:32, 17 April 2008 (UTC)

[edit] Technical Magnetic Mini-Move Procedure (3MP)

Was reading a translated Portugese wiki and found this: In an effort to make the operation pectus excavatum better for the patients and their families, a new method to correct the Pectus Excavatum, deformity of chest wall. With the Magnetic Mini - Move Procedure (3MP), the deformation coastal cartilage is gradually reformed by a controlled and progressive traction, "pull" on the sternal depression. This is achieved with only a minimal surgery and without the need for painful implanted chest wall pillars.

Two magnets, one in the chest and the other outside the chest, are used to create a magnetic field force which applies a force controlled and sustained. The goal is to promote the rib cartilage to move to a more normal position. This results in a more gradual correction of the chest over a period of months using nominal force - is the same principle used in moving teeth with orthodontics keys.

This technique was developed by UCSF - University of California, San Francisco

In that procedure the patient go home the same day, after the healing of the micro-surgery he begins the treatment of lifting the sternum (the breast bone).

Found a related site: http://pedsurg.ucsf.edu/conditions--treatments/magnetic-mini-mover-procedure.aspx §hep • ¡Talk to me! 22:18, 17 April 2008 (UTC)

Nice find. Would you like to add it to the article or for someone else to? Regards, CycloneNimrodtalk? 22:37, 17 April 2008 (UTC)
Actually, my writing skills are a bit limited. If someone would add it, that'd be great. §hep • ¡Talk to me! 00:19, 18 April 2008 (UTC)
I'll get round to it this afternoon for you. Regards, CycloneNimrodtalk? 09:26, 18 April 2008 (UTC)
I've added a section for 3MP, if someone could expand it with the risks of the procedure, that'd be grand. Regards, CycloneNimrodtalk? 14:28, 18 April 2008 (UTC)
You guys are doing a superb job improving this BTW. I will chip in more this weekend. JC Petit 02:02, 19 April 2008 (UTC)